Obstructive Sleep Apnea is a condition where a person's throat closes down involuntarily during sleep. During that time,
the patient is not able to breathe and will awaken repetitively to take in air.
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Dr. Micheal Frye: Obstructive Sleep Apnea is a condition where a person's throat closes down involuntarily at night during sleep. It's worse than snoring is that step beyond snoring, where the throat completely closes and despite the patient trying to breathe, the throat is closed and the patient is not able to breathe. Ultimately definitely, after often as long as 30 or 40 seconds, they will awake and just enough start to breathing again and began snoring again. But they do this repeatedly throughout the night and it leads to a great disruption of their overall sleep. The next day they complain of awakening and feeling unrefreshed. They are tired throughout the day.
Patients are often prompted to nap. It affects their moods that make them cranky and often irritable. Obstructive sleep apnea patients do get to sleep very readily, they will walk along all day long very sleepy and is no problem for them to get to sleep. The problem is that they can sleep eight or ten hours, but their sleep is so destructive by the repetitive closures of their throat and that they don't get restful sleep during the night.
Just as you are able to hold your breath for thirty or sixty seconds, the patients are in effect holding their breath for that period of time. So their oxygen level often goes down during those long obstructive apneas. But even if the oxygen levels doesn't go down, just the fact of having the airway closed and having to awaken or have what we in medicine call EEG arousal. That disrupts the sleep significantly and patients have their day time symptoms of sleepiness and unrefreshed sleep even if it doesn't affect their oxygen level at night.
Initially their clinician suspects that they saw the patients reported snoring and may be even witnessed apneas by their bed partner. It comes to the attention of the physician, who can order an overnight sleep study. And in the sleep lap, the patient is monitored closely all night by one of our trained sleep technicians. And the study reveals that the patients, tries to breathe and can't breathe throughout the night and has these closures of their airway, which leads to the repetitive awakenings throughout the night and the sleep disruption.
We'll rarely and see patients that have obstructive sleep apnea that don't really snore, but that's the exception. A vast majority of our patients do snore. But snoring isn't a very specific marker of obstructive sleep apnea, because if you look at the adult population of men in the United States, about 50% snore. Yet the incidents of obstructive sleep apnea in men is about 4%. About half that number of women snore, 25% of adult women and about 2% of adult middle aged women have obstructive sleep apnea. So, it is a very both of those conditions are very common in the United States.
In addition to the daytime sleepiness and neurocognitive problems that result from obstructive sleep apnea, patients are also at risk of hypertension, coronary heart disease including heart attacks and strokes. If their obstructive sleep apnea is untreated, there is a numerous investigations suggesting that the untreated obstructive sleep apnea leads to higher incidence of these conditions and that treatment can lessen their risk of developing those complications.
The condition can be treated in a variety of ways to try to assist patients keep the throat open during the night. Well, the most common treatment for obstructive sleep apnea is continuos positive airway pressure. Most people refer to that as CPAP, which is the first letter of each of those words. CPAP is a method of delivering pressure to a patient's nose and that pressure is transmitted to the back of the throat and inflates the throat to hold the throat open all throughout the sleep so that the patient can breathe comfortably throughout the night.
Here is a model demonstrating a typical CPAP mask fitted on the nose. The hose goes to a machine which supplies the positive pressure and the patient will wear this all through the night all asleep. Patient's suprisingly get used to it very quickly and I have many patients that just will tell me, you can change anything about my treatment, but don't take away my CPAP mask, because they find that it improves the comfort of breathing, so dramatically it offsets any discomfort of having a mask on the face.
There is a surgical, there are numerous surgical treatments. One is an uvulopalatopharyngoplasty. That's typically a procedure that's done by the otolaryngologist or ENT surgeons. It's a condition to surgically trim off part of a the soft palate in the back of the throat and there by open up the airway usually reduces the severity of snoring and is a treatment option for obstructive sleep apnea that's may be effective up to 50% of patients that's it is used on.
There are dental appliances, which can be used and are typically effective and mild obstructive sleep apnea. These are a type of bicarb that fits on your upper and lower teeth and it poles the jaw forward as you sleep at night that makes more rim in the back of the throats that the patients continues to breathe easily throughout the night.
Another form of therapy is just conservative measures. We know that obstructive sleep apnea is worse in patients that have more or a higher weights. And if they can lose weight, the severity of their obstructive sleep apnea is usually less and also if they happen to be on CPAP therapy, the pressure requirement is usually lower if they are able to lose some weight.
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