Sleep Apnea

What is Sleep Apnea?

Sleep ApneaSleep apnea is disturbed or interrupted breathing during sleep. For those affected by sleep apnea, there can be many temporary interruptions in breathing, each usually lasting about 10 seconds, throughout the sleep period. These interruptions in breathing can occur as often as 20 to 30 times per hour.

Many people consider snoring a minor annoyance, but it can signal a potentially serious condition called sleep apnea (temporary interruptions in breathing during sleep). An article in the June 13, 2001, issue of JAMA reports an association between sleep-disordered breathing and a generic marker called apolipoprotein E 4. The authors speculate that this marker may be one of the many genetic factors that make someone susceptible to developing sleep-disordered breathing.

Symptoms of Sleep Apnea

Sleep apnea is disturbed or interrupted breathing during sleep. For those affected by sleep apnea, there can be many temporary interruptions in breathing, each usually lasting about 10 seconds, throughout the sleep period. These interruptions in breathing can occur as often as 20 to 30 times per hour. These interruptions in breathing can occur as often as 20 to 30 times per hour.

Heavy snoring, although not everyone who snores has sleep apnea
Struggling to breathe during sleep
Interruption in breathing during sleep followed by a snort when breathing begins again
Being excessively sleepy during the day
Falling asleep during activities that require attention and concentration, such as driving, working, or talking
Children have restless sleep, frequent wakening, gasping while sleeping, enuresis(bedwetting), daytime hyperactivity or poor school performance
If you or your child are experiencing these symptoms, see a doctor, you may have sleep apnea or some other condition that needs medical attention.

Causes of Sleep Apnea

Obstructive
Partial or complete obstruction of the airway, which can be caused by relaxation of the muscles of the throat, soft palate, and tongue during sleep.

Central
Problems with signals from the brain that control breathing.

Risk factors for sleep apnea include:

Being overweight
Having enlarged tonsils and adenoids (in children and adults)
Having another physical abnormality in the nose, throat, or other parts of the upper respiratory tract
Having high blood pressure

Treatment

For mild cases of sleep-disordered breathing one can:

Sleep on one’s side instead of back
Avoid drinking alcohol before sleeping
Avoid using sleeping pills
Avoid smoking or using other tobacco products
Lose weight, if overweight
The most common medical treatment for sleep apnea is continuous positive airway pressure (CPAP) , which is a therapy that uses pressure from an air blower to circulate air through the nasal passages and upper airway. The patient wears a mask over the nose that is connected to the air pressure hose, and the air pressure is adjusted to keep the airway open during sleep. Other therapies include dental appliances that change the position of the jaw and tongue.

Snoring or obstructive sleep apnea may respond to various surgical treatments now offered by many Otolaryngologist- Head and Neck surgeons:

Tonsilectomy and Adenoidectomy

The 2011 Clinical Practice Guidelines from the American Academy of Otolaryngology-Head and Neck Surgery recommends tonsillectomy and adenoidectomy for children with enlarged tonsils and sleep apnea, also known as sleep disordered breathing. Growth retardation, enuresis (bedwetting), poor school performance and behavior problems may also resolve after tonsil surgery as the quality of sleep improves. Children with an abnormal sleep study should be considered for tonsillectomy, although a sleep study is not required prior to surgery if sleep apnea is suspected. Sleep disordered breathing may persist after tonsillectomy, and the child may require further management by a sleep specialist.

Uvulopalatopharyngoplasty

Uvulopalatopharyngoplasty (UPPP) is surgery for treating obstructive sleep apnea. This procedure removes soft tissue on the back of the throat and palate, thereby increasing the width of the airway at the throat opening.

Laser

Assisted Uvula Palatoplasty (LAUP) treats snoring and mild obstructive sleep apnea by removing the obstruction in the airway. A laser is used to vaporize the uvula and a specified portion of the palate in a series of small procedures in a doctor’s office under local anesthesia.

Somnoplasty

Somnoplasty is a minimally invasive procedure that occurs in an outpatient environment. It utilizes a needle electrode to emit radio frequency energy to shrink excess tissue to the upper airway including the palate and uvula (for snoring), base of the tongue (for obstructive sleep apnea), and nasal turbinates (for chronic nasal obstruction).

Genioglossus

Genioglossus and hyoid advancement is a surgical procedure for the treatment of sleep apnea. It prevents collapse of the lower throat and pulls the tongue muscles forward, thereby opening the obstructed airway.

Nasal Surgery

Nasal obstructions such as a deviated septum may play a role in sleep apnea, and can be corrected through appropriate surgical procedures.