Obstructive Sleep Apnea: Is This Why I Have Difficulty Breathing?

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Obstructive sleep apnea is caused by the persistent collapse of an individual’s upper airway while sleeping. This occurs when the muscles in the throat which support the soft tissues,   like the tongue and soft palate relax. When this happens, it causes the passage of air one breathes to momentarily stop. It is important  to constantly maintain a smooth flow of air from the mouth to the nose and then into the lungs, when breathing while asleep. Obstructive sleep apnea (OSA) causes breathing problems and is a serious condition which needs intervention by an experienced ENT specialist. If your partner is constantly waking up while sleeping or experiences heavy snoring, then it is important to exclude obstructive sleep apnea by visiting a sleep apnea and snoring specialist.

Dr. Annabelle Leong from the ENT Clinic in Singapore, treats both young and old who have obstructive sleep apnea. Dr. Annabelle counts over 18 years of ENT experience and has had her training in countries like the UK and Canada receiving a distinction from Guy’s, King’s and St. Thomas’s Hospitals in London. She can undertake a thorough and careful assessment for your sleep apnea and airway with personalized care and  necessary treatment to suit your needs. Every patient is different and treatment for sleep apnea should be tailored appropriately.

What are the symptoms related to obstructive sleep apnea?

Most people who have this condition complain of daytime tiredness and sleepiness. This is because an adequate amount of oxygen does not reach important organs such as the brain and the heart when sleeping. This leads to a poor quality of sleep. Some of the common signs to look out for include loud snoring, snorting, sleep interruptions, gasping and choking.  Many people often dismiss more worrying signs of sleep apnea like loud snoring as trivial or “normal”  when really,  it should be given significant importance.

Obstructive sleep disorder can decrease a person’s quality of life and impact on work productivity. The condition can cause forgetfulness, grumpiness, morning headaches, drowsiness as well as hyperactivity in kids and drop in school grades. Drowsiness in daytime increases the risk of road accidents and therefore obstructive sleep apnea should be treated as soon as it is known.

What are the complications caused by sleep apnea?

There are many complications which sleep apnea can bring if left untreated.

Daytime Lethargy: This condition can lead to difficulty in concentrating and cause irritability and altered mood. It may elevate stress and anxiety levels too.

Hypertension and Cardiac arrest: Obstructive sleep apnea can cause a sudden drop in blood oxygen levels, this can cause the  affected individuals suddenly stop breathing in their sleep. This can elevate your blood pressure and put a strain on the cardiac system. It increases the incidence of cardiac arrhythmias (irregular heart rhythms) and stroke and may even lead to even sudden death due to these abnormal cardiac events.

Type 2 diabetes: Sleep apnea can increase the insulin resistance in the body leading to poor glucose control and diabetes.

Metabolic syndrome: Reduced quality of sleep can lead to abnormal cholesterol levels and lead to obesity and stress, which in turn is associated with cardiac disease.

What are the risk factors which can cause obstructive sleep apnea?

The presence of certain factors can increase the risk of obstructive sleep apnea. These factors include:

Obesity: Excess fat deposits around the upper airway can cause an obstruction for breathing. Also people with thicker necks can have narrow airways.

Gender: Males have a higher tendency to suffer sleep apnea than females. However, obese females have an increased risk after menopause.

Genetics: It can run in families and older adults are more at risk

A narrow airway: Individuals who have a narrow throat and those with enlarged tonsils and adenoids are particularly at higher risk.

Alcohol and drug use: The use of sedatives, drugs and alcohol can worsen the sleep apnea condition. Smoking can increase throat irritation and cause the muscles to relax and increase fluid retention in the upper airway.

Medical conditions: Chronic conditions such as hypertension, diabetes, cardiac conditions can all increase the risk. In addition, hormonal disorders and chronic lung conditions as well as certain allergies and nasal conditions can help one to develop obstructive sleep apnea.

How is sleep apnea diagnosed?

The physician will take a complete medical history and perform a physical examination. Your partner can provide valuable information about your condition such as frequency of snoring, breathing difficulties while sleeping and other sleep habits. To confirm the condition, one may need to do a sleep study, often performed in the comfort of your home. A sleep test or polysomnography monitors the physiologic variables recording abnormal sleep patterns which may indicate sleep disorders. The doctor may also use a pulse oximeter to detect the oxygen saturation in the body.

What are the treatment options available?

Lifestyle modifications would be advised initially. These include losing weight and cutting down on alcohol and drug consumption. If these modifications are not helping, then other treatment options would be made such as continuous positive airway pressure (CPAP). This device helps to keep the airway open at night and is effective for sleep apnea. Other oral appliances include the bilevel positive airway pressure machines. This has a setting to deliver inhaled and exhaled pressure. Another simple way would be to sleep on your side. Positional therapy can help to reduce sleep apnea.

If none of the above interventions are working, then surgery is considered. This is the best option for severe sleep apnea when structural problems can be identified, such as having large tonsils, enlarged turbinates, and a crooked or deviated nasal septum. The ENT specialist may advise surgery based on your overall health and her evaluation.