Sleep apnea: What you need to know

Each year the lives of millions of Americans are affected by sleep-related disorders, including obstructive sleep apnea (OSA). Sleep apnea is characterized by periods of partial or complete cessation of air flow during sleep. OSA has significant effect on health, safety and quality of life.

Sleep apnea is increasing among men and women. Recent data showed that among adults 30 to 70 years of age, 13 percent of men and 6 percent of women have moderate to severe sleep apnea. Unfortunately, as many as 85 percent of people who have sleep apnea remain undiagnosed and untreated.

Sleep apnea ranges from mild to severe, and in severe cases, breathing may be interrupted hundreds of times per night. During these episodes a drop in blood oxygen level develops until the apnea is terminated by a brief awakening or brain arousal, and breathing is restored. Repeated apneas cause multiple brain arousals during the night, which lead to disrupted sleep and sleep loss.

Symptoms of obstructive sleep apnea include gasping or choking, witnessed episodes of apnea, snoring, excessive daytime sleepiness, daytime fatigue and morning headaches. Multiple factors increase the risk of OSA: elevated body mass index, a large neck circumference, a crowded oropharynx and high blood pressure. Sleep apnea diagnosis is confirmed by an overnight sleep study or polysomnogram, a test that helps to differentiate sleep apnea from other sleep disorders.

Patients with severe OSA frequently fall asleep while driving and are involved in motor vehicle accidents two or three times more often than the general population. Sleep apnea contributes to increased risk of traffic and occupational accidents because fatigued patients suffer from decreased ability to concentrate, decreased cognitive skills and decreased reaction time.

Several studies have shown that OSA increases the risk of stroke, sudden cardiac death and high blood pressure. Sleep apnea is also linked to a slower recovery after a heart attack and to higher rates of cancer in patients under the age of 65. Obstructive sleep apnea is known to contribute to the development of pulmonary hypertension. In addition, OSA can aggravate left ventricular heart failure.

Fortunately, sleep apnea is treatable. Therapies include weight loss, the use of continuous positive airway pressure (CPAP) devices, intra-oral mandibular advancement devices and surgery. A recent review concluded that CPAP therapy reduces blood pressure in sleep apnea patients. CPAP therapy involves wearing a mask connected to a small portable air flow generator that delivers air at positive pressure, creating an air splint to keep the airway open throughout the entire breathing cycle.

Visit with your doctor to learn more about OSA or to be referred to a sleep specialist for further evaluation.

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