Obstructive Sleep Apnea Specialist

What Is Obstructive Sleep Apnea in Adults?

Obstructive sleep apnea (OSA) is a common problem that affects a person’s breathing during sleep. A person with OSA has times during sleep in which air cannot flow normally into the lungs. The block in airflow (obstruction) is usually caused by the collapse of the soft tissues in the back of the throat (upper airway) and tongue during sleep.

Apnea means not breathing.  In OSA, you may stop breathing for short periods of time. Even when you are trying to breathe, there may be little or no airflow into the lungs. These pauses in airflow (obstructive apneas) can occur off and on during sleep, and cause you to wake up from a sound sleep. Frequent apneas can cause many problems. With time, if not treated, serious health problems may develop.

OSA is more common in men, women after menopause, and people who are over the age of 65. OSA can also occur in children. Treatment for OSA should always be under the guidance of a sleep specialist doctor or Obstructive sleep apnea specialist doctor. People who are at higher risk of developing sleep apnea include those with:

• Enlarged tonsils and/or adenoids
• Family history of OSA
• Excessive weight – obesity
• Jaw problems such as micrognathia (small jaw) or retrognathia (a pulled back jaw)
• Chronic Alcoholics

What are the symptoms of obstructive sleep apnea?

You may not be aware that you have OSA, but these symptoms may be more obvious to a spouse, another family member, or close friend.

Common symptoms you may have during sleep:

• Snoring is usually loud and bothers other people trying to sleep near you. Snoring can come and go through the night.
• Gasping or choking sounds.
• Breathing pauses observed by someone watching you sleep.
• Sudden or jerky body movements.
• Restless tossing and turning.
• Frequent awakenings from sleep.

Common symptoms you may have while awake:

• Wake up feeling like you have not had enough sleep, even after sleeping many hours.
• Morning headache.
• Dry or sore throat in the morning from breathing through your mouth during sleep.
• Sleepiness during the day.
• Fatigue or tiredness throughout the day.
• Personality changes, such as mood swings and difficulty getting along with others.
• Problems with poor memory or inability to concentrate.

Can OSA be dangerous?

Of all people with hypertension, about 30% have obstructive sleep apnea. If you have obstructive sleep apnea, there is a 50% chance you also have hypertension.

Problems with the rhythm of your heart may occur with OSA such as trial fibrillation (a type of irregular heartbeat) and bradycardia (slow heart rate). People with severe obstructive sleep apnea are four times more likely to have atrial fibrillation compared to those without OSA. Dr. Parthiv Shah – obstructive sleep apnea specialist doctor in Mumbai advocates extreme caution against patients with loud snoring and heart diseases.

What kinds of cardiovascular problems can I get with obstructive sleep apnea?

Of all people with hypertension, about 30% have obstructive sleep apnea. If you have obstructive sleep apnea, there is a 50% chance you also have hypertension.

Problems with the rhythm of your heart may occur with OSA such as atrial fibrillation (a type of irregular heartbeat) and bradycardia (slow heart rate). People with severe obstructive sleep apnea are four times more likely to have atrial fibrillation compared to those without OSA.

People with obstructive sleep apnea are also more likely to have coronary artery disease. Coronary artery disease (also known as the hardening of the arteries) happens when the small blood vessels that supply blood and oxygen to your heart become narrow. Narrowed coronary arteries can lead to heart attacks and heart damage. If you have severe OSA that is untreated, you are twice as likely to develop a heart attack in the future as those without OSA. In addition, research shows that up to 70% of people admitted to the hospital because of coronary artery disease were found to have obstructive sleep apnea.

If you have heart failure, obstructive sleep apnea can also make it worse.

How do I know I have OSA?

If you have symptoms of OSA, you need to talk with your healthcare provider. Your healthcare provider can help you decide if you need a sleep study and whether you should be evaluated further at a sleep center.

Dr. Parthiv shah – Obstructive sleep apnea specialist doctor would do a sleep study (polysomnogram) for its detection. The asleep study is often done at a sleep center where you will be scheduled to test sleep overnight. Alternatively, a home sleep apnea test may also be used to diagnose OSA. During a sleep study, your breathing, heart rate, and oxygen levels will be monitored.

How is obstructive sleep apnea treated?

Sleep apnea can be effectively treated, and there are a number of ways to do so. The choice of treatment will depend on the reason for and severity of the sleep apnea. If your OSA is from being overweight, weight loss may cause the apnea to go away completely.

As alcohol can suppress breathing and make OSA worse, avoid alcohol for at least 4 hours before going to bed. Sleep apnea is often worse when a person sleeps on his or her back. If you sleep on your back, you can use a pillow or some other strategy to force yourself to sleep on your side. Some people sew a tennis ball into their pajama bottoms to remind them not to turn on their back. apnea and who is not overweight. These devices are usually custom-made and fitted under the supervision of a specialized dentist or oral surgeon who works with these problems.

When the tonsils or adenoids are causing the throat to be blocked, surgery can be done to take out the tonsils (tonsillectomy) and/or adenoids (adenoidectomy). Surgery may also be helpful for people with jaw problems. Other surgeries for OSA either clear out a tissue from the back of the throat, reposition the tongue forward. These surgeries are not, however, as effective as CPAP to control OSA and are usually reserved for people who fail CPAP.

Hypoglossal nerve stimulation (HGNS) uses a pacemaker-like stimulator device that a surgeon places in the neck and use electricity to activate the muscles in the tongue to hold the airway open. HGNS recently received approval by the Food and Drug Administration (FDA) and is being used increasingly in the past year

Will my OSA ever go away?

In general, OSA is considered a lifelong condition, although there are few exceptions in which OSA can improve or go away. Obesity is a major risk factor for OSA and weight loss has been shown to lead to an improvement in OSA. Stomach stapling (bariatric surgery) can be highly effective for losing weight, although as with any surgery, complications can occasionally occur. The other situation in which apnea can resolve is in people with large tonsils that are blocking airflow in the throat. Removal of tonsils, particularly in children, has been shown to improve OSA. However, the removal of tonsils is typically not sufficient to treat OSA in adults.

Why should I wear CPAP at night?

Dr parthiv shah – Obstructive sleep apnea specialist notes three major benefits of using CPAP with sleep:

■ Snoring is often annoying to the bed partner, such that many people with sleep apnea use CPAP to keep their partner happy. Some people think snoring is funny or a nuisance, but it can have a big impact on the quality of life if it interferes with intimacy or disrupts the sleep of the bed partner.

■ CPAP can improve symptoms. Many people feel better after wearing nightly CPAP. Research trials have shown improved daytime sleepiness, quality of life, and reduced risk of car accidents.

■ CPAP can improve cardiac and diabetes risk. CPAP has been shown in research trials to improve high blood pressure and likely reduces the risk of heart attack and other serious medical conditions.

Why should I wear CPAP at night?

Dr parthiv shah – Obstructive sleep apnea specialist notes three major benefits of using CPAP with sleep:

■ Snoring is often annoying to the bed partner, such that many people with sleep apnea use CPAP to keep their partner happy. Some people think snoring is funny or a nuisance, but it can have a big impact on the quality of life if it interferes with intimacy or disrupts the sleep of the bed partner.

■ CPAP can improve symptoms. Many people feel better after wearing nightly CPAP. Research trials have shown improved daytime sleepiness, quality of life, and reduced risk of car accidents.

■ CPAP can improve cardiac and diabetes risk. CPAP has been shown in research trials to improve high blood pressure and likely reduces the risk of heart attack and other serious medical conditions.

What happens if I can’t tolerate CPAP therapy?

CPAP therapy can provide major benefits for some patients but it is not for everyone. OSA specialist doctors Most sleep experts will recommend further attempts of a different type of positive airway pressure therapy for patients who don’t like CPAP. A variety of masks and pressure delivery approaches are available so patients are encouraged to try various devices before giving up. Education and support can also be helpful in getting people used to using the CPAP machine. Sometimes psychologists or respiratory therapists can be helpful in getting you to get used to the equipment and being able to sleep with the equipment on. CPAP can be uncomfortable when you are not used to it but is not invasive, so many patients do well if they stick with it over time.