Discover the facts behind obstructive sleep apnea - from diagnosis to potential treatments - and take the first step towards a better night's rest.
Sleep apnea is a common sleep disorder that impacts millions of people around the world every night.
Sleep apnea causes you to stop breathing during your sleep. It not only disturbs your sleep but also affects your quality of life and leads to serious health issues.
There are 3 types of sleep apnea:
Obstructive sleep apnea is the most common type of sleep apnea.
It is a condition characterized by recurring episodes of partial or complete obstruction of the upper airway during sleep.
Airway obstructions may be described as hypopneas or apneas:
Hypopnea is when airflow is reduced by 30% or more for at least 10 seconds.
Apnea is when airflow is reduced by 90% or more for at least 10 seconds.
The number of episodes of partial (hypopnea) and complete (apnea) airway obstructions can help doctors determine the severity of OSA.
The severity of sleep apnea is usually measured using the apnea-hypopnea index (AHI), i.e. the average number of apneas and hypopneas per hour of sleep.
There are different levels of sleep apnea severity:
In all cases, sleep apnea can affect a person’s quality of life. Untreated Obstructive Sleep Apnea is also associated with an increased risk of mortality and cardiovascular diseases.
Obstructive sleep apnea usually occurs when the muscles that control the upper airway relax too much while you are sleeping, thereby causing the throat to narrow.
This is what happens:
This cycle can repeat hundreds of times each night, and cause abnormal levels of both oxygen and carbon dioxide in the blood, as well as fragmented sleep. All of this leads to severe health consequences if left untreated.
Obstructive sleep apnea is a common sleep disorder.
A recent analysis suggests that more than 930 million adults aged between 30 and 69 years may suffer from obstructive sleep apnea worldwide 1.
However, even though obstructive sleep apnea is common, many people may not even be aware of their interrupted sleep because they have obstructive sleep apnea.
Obstructive sleep apnea is a significant, yet under-diagnosed and under-treated chronic disease
Some signs of obstructive sleep apnea are:
Think you may have sleep apnea? It’s important to have it checked.
Anyone can develop obstructive sleep apnea, though certain factors put you at increased risk:
Certain physical features also make a person more likely to develop OSA. These include:
Other risk factors may include:
To diagnose obstructive sleep apnea, doctors look at a patient’s medical history and symptoms, conduct a physical exam, and refer them for a sleep study.
While reviewing a person’s medical history, a doctor may inquire about risk factors as well as both nighttime and daytime symptoms. In some cases, a doctor may have a person fill out a questionnaire to look for additional symptoms and help differentiate between OSA and other conditions.
As sleepers may not recognize their night-time symptoms, roommates, bed partners and relatives may be asked to report a person's symptoms.
Doctors typically perform a physical examination to check for physical features that increase the risk of obstructive sleep apnea, including a person’s neck and waist size, and signs of health complications associated with OSA.
A sleep study is necessary to confirm (or repudiate) a diagnosis of obstructive sleep apnea, and also measure the severity of breathing disruptions. Also called polysomnography, a sleep study involves an overnight stay at a specialized sleep laboratory, often located within a sleep center or hospital.
Sometimes a sleep study can be completed at home with a portable sleep monitor.
When considered together with a person’s symptoms, the number of breathing events per hour found during a sleep study can help doctors determine the severity of OSA.
People suffering from OSA should discuss their symptoms with a sleep apnea doctor to find the most effective treatment for them, as patients are quite different and require tailored approaches.
The primary treatment for OSA is positive airway pressure (PAP) therapy.
PAP therapy involves the use of pressurized air that is pumped through a bedside machine and blown into into the patient's nose and/or mouth to keep the airway open during sleep.
PAP therapy may be provided using one of the following methods:
Although CPAP has proven to be a very effective treatment for obstructive sleep apnea, patients are often uncomfortable with the mask and adherence to this type of treatment remains problematic. For this reason, alternative sleep apnea treatments have been developed in recent years 2.
In recent years, new and innovative treatments have emerged for patients who do not tolerate PAP therapy. One of the most promising angles is hypoglossal nerve stimulation.
Hypoglossal nerve stimulation (HGNS) relies on controlled stimulation of the tongue nerve – the hypoglossal nerve that enables tongue movement – to maintain the airway open during sleep. The effectiveness of HGNS has been scientifically proven.
This kind of therapy is a serious option for people looking for an alternative to CPAP.
Thousands of patients worldwide rely on hypoglossal nerve stimulation to treat their obstructive sleep apnea
Hypoglossal nerve stimulation helps to prevent the potential side effects of CPAP therapy such as dry mouth, nasal congestion or skin irritation caused by the mask.
As it does not involve a CPAP machine and mask, HGNS may be recommended to patients who have failed, are intolerant to, or refuse CPAP therapy.
Surgery is for people who have anatomical issues causing or worsening their sleep apnea. For example, if you have a deviated nasal septum, swollen tonsils, and adenoids, or a small lower jaw that causes your throat to be too narrow, surgery might help you.
Surgery remains a last resort option. Sleep apnea doctors usually try other treatments first.
Dental appliances or oral "mandibular advancement" devices keep your tongue from blocking your throat or bring your lower jaw forward. This may help keep your airway open while you sleep.
MAD therapy is usually more suitable for mild to moderate obstructive sleep apnea.
Behavior and lifestyle changes can also be a starting point in the treatment of OSA as it allows most people to better manage their condition:
Untreated obstructive sleep apnea is associated with numerous negative health consequences:
Untreated OSA can be deadly:
It’s important for people who are diagnosed with obstructive sleep apnea to be well informed about their diagnosis and understand the importance of appropriate treatment.
While OSA typically cannot be cured, treatment does help most people reduce breathing disruptions, improve sleep quality, and minimize health consequences.
The following tips can help people learn to live with sleep apnea:
People living with sleep apnea should also ensure that they get enough sleep each night.
In addition to comply with their therapy, people can improve their sleep by following basic sleep hygiene practices: