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Obstructive Sleep Apnea: Common Sleep Disorder Often Goes Unrecognized

March 1, 2007

People with sleep apnea don’t have trouble breathing—they have a ‘getting breath’ problem. That’s because during sleep their upper airway becomes obstructed. An obstructed airway during sleep results in a reduction of airflow. In response to a sensation of suffocating, the brain signals the body to arouse briefly. Once aroused, the airway opens and adequate air is restored. When the person returns to sleep the obstruction—whether it’s from the tongue, tonsils or the soft tissue in the back of the throat—recurs and the pattern is repeated. The apnea can interrupt sleep hundreds of times a night.

Obstructive Sleep Apnea (OSA) affects more than 12 million Americans. Snoring is a sign of the disorder. Most people aren’t aware that they snore—they’re asleep after all. The repeated sleep interruptions are brief, people with OSA often don’t remember them. That’s why it’s usually a bed partner, or in the case of a child, a parent, who recognizes the sleep disorder.

Repetitive interruption of sleep can cause morning headaches, daytime sleepiness and reduced ability to concentrate. OSA is associated with inattentive driving and increased risk of car accidents. Untreated sleep apnea also can lead to mood disorders, hypertension and coronary artery disease. Children whose sleep is disrupted often have behavior issues. Like adults, children who are overweight or have enlarged tonsils are more prone to sleep apnea. Alcohol and sleeping pills can increase the risk of sleep apnea.

An overnight sleep study is used to diagnose OSA. Sleep specialists measure oxygen saturation, heart rhythm, breathing effort and airflow, duration of sleep stages, body position and limb movements. Treatment can prevent or reverse the risks of sleep apnea. Weight loss can increase the size of the airway. Some people only have sleep apnea when sleeping on their back.

Enlarged tonsils can block the entrance to the airway during sleep. According to Virginia Pascual, MD, sleep specialist and medical director of the Bozeman Deaconess Sleep Disorders Center, 95% of OSA cases in children are corrected with tonsillectomy.

In adults, continuous positive airway pressure (CPAP) is a treatment that gently forces air into the space between the tongue and the back of the throat, reproducing the size of the opening of the throat when awake. A pneumatic splint worn during sleep, CPAP keeps the airway open for adequate airflow.

Pascual says when appropriate, some people with the disorder are fitted with oral appliances that reposition the mandible so the tongue doesn’t obstruct the airway during sleep.

The Bozeman Deaconess Sleep Disorders Center, now located on the second floor of Highland Park 4, specializes in evaluation of all sleep disorders. For more information contact Merle Phipps, supervisor,Sleep Disorders Center, 585-5058.

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