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  • Paul Sandvick

An Introduction to Obstructive Sleep Apnea (OSA): Symptoms, Risk Factors, and Treatment Options

Do you snore so loudly that you wake up your partner? Do you frequently wake up with a headache? Do you get 8 hours of sleep, but wake up in the morning with grogginess that turns to afternoon exhaustion, frequently requiring naps to get through the day? According to the American Medical Association, about 30 million people in the United States suffer from Obstructive Sleep Apnea (OSA), while only an astounding 1.8 million of these people are diagnosed and treated for the disorder. Let's define and break down the symptoms, risks, and common treatments for Obstructive Sleep Apnea, so you can get the quality of sleep that you deserve.

What is Obstructive Sleep Apnea (OSA)?

OSA is a condition characterized by repeated episodes of partial or complete obstruction of the upper airway during sleep. This obstruction leads to interruptions in breathing, often accompanied by snoring, gasping, or choking sounds. These interruptions in breathing can occur multiple times throughout the night, disrupting the normal sleep cycle and preventing the affected individual from achieving restorative deep sleep. 

At Sleep Clear Now, we have found that many of our patients first become aware of symptoms of obstructive sleep apnea through their partners or family members. During the night, a bed partner may notice you gasping for air, which is called witnessed apneas and can be quite alarming. If you or your partner have observed these symptoms, we strongly recommend that you reach out to a sleep doctor or your primary physician to schedule a sleep study.

A diagram showing a normal airway of someone sleeping, the airway is open and the person can breathe easily. Next to it on the right hand side, there a similar graphic of a person sleeping but their airway is obstructed, causing Obstructive Sleep Apnea. The graphic also contains the SleepClearNow logo at the top left corner of the image.

Think you may Have Obstructive Sleep Apnea?

One of the hallmark features of OSA is fragmented sleep. The interruptions in breathing, called apneas, force the brain to rouse from deep sleep to reopen the airway, albeit briefly. These frequent disruptions prevent individuals from progressing through the various stages of sleep effectively, including the deep sleep stages where the body repairs and rejuvenates itself. 

In people with Obstructive Sleep Apnea, we often see periods of slow or shallow breathing on top of periods of apneas, or complete obstructions of the airways. These instances of shallowing breathing, called hypopneas, decrease the amount of oxygen in your blood and trigger the body’s stress response, resulting in repeated awakening. These awakenings are often too brief to remember consciously and can add to the feelings of non-restful sleep upon waking up to start the day. 

OSA doesn’t just affect the quantity of sleep; it also impacts sleep quality. Studies have shown that individuals with OSA often experience impaired cognitive function, including difficulties with memory, concentration, and decision-making. This cognitive fog can persist into the waking hours, contributing to feelings of fatigue and sluggishness throughout the day.

The disrupted sleep structure associated with OSA can lead to excessive daytime sleepiness, even after what appears to be a full night’s sleep. This persistent drowsiness can impair daily functioning, affecting productivity at work or school and increasing the risks of accidents, especially while driving or operating machinery. 

More common symptoms of Obstructive Sleep Apnea include morning headaches, dry mouth or sore throat, irritability, and mood disturbances. If left untreated, OSA has been linked to high blood pressure (hypertension), heart problems, type 2 diabetes, metabolic syndrome, and liver problems.

Get an at-home Sleep Test!

If you are suffering from any of the above symptoms, it may be time to consult with a trained professional. No matter who you see, a sleep test will have to take place to provide an initial diagnosis and calculate the severity of the disorder. Some clinics offer in-office sleep tests; However, most patients and clinics prefer to conduct at-home sleep tests, which enable patients to test in the comfort of their own bedroom. These tests use sensors to track core vitals and breathing, along with other metrics like sleep position.

One key metric assessed during these tests is the Apnea-Hypopnea Index (AHI), which measures the number of pauses in breathing (apneas) and shallow breaths (hypopneas) that occur per hour of sleep. A higher AHI indicates more frequent disruptions in breathing patterns during sleep, suggesting a more severe form of OSA. Sleep testing allows healthcare professionals to accurately diagnose OSA and tailor appropriate treatment plans, including lifestyle changes, continuous positive airway pressure (CPAP) therapy, or oral appliances, ultimately improving sleep quality and overall health.

A graphic containing a table that illustrates the Apnea Hypopnea Index, or AHI Index. The graphic also features the Sleep Clear Now at the top left corner of the image

Who is at Risk for Obstructive Sleep Apnea?

  • Family History- Having family members with OSA may increase your risk for your disorder.

  • Use of Alcohol, Sedatives, or Tranquilizers- While some people may correlate drinking alcohol or using sedatives and tranquilizers with falling asleep faster, they actually can affect your quality of sleep. These substances relax the muscles in your upper airway, which can worsen obstructive sleep apnea.

  • Smoking- Smokers are 3 times more likely to have OSA than people who've never smoked. Smoking can increase the amount of inflammation and fluid retention in the upper airway.

  • Weight- According to the National Library of Medicine, obesity is the most common *reversible risk factor for OSA. Anybody overweight, including bodybuilders and athletes, is at a greater risk for sleep apnea. Volume around the neck, whether muscle or fat, can put pressure on the anatomy of the throat, constricting the airway when sleeping.

  • Nasal Congestion- If you have trouble breathing through your nose - whether from an anatomical problem or allergies - you're more likely to develop obstructive sleep apnea.

  • Medical Conditions- Congestive heart failure, high blood pressure, and type 2 diabetes are some of the conditions that may increase the risk of Obstructive Sleep Apnea. Polycystic ovary syndrome, hormonal disorders, prior stroke, and chronic lung diseases, such as asthma, also can increase the risk of developing the disorder.

  • Sleep Position- Many people may only experience OSA symptoms while in a certain sleep position. Usually, the most common position that gives people problems is the supine position, or sleeping on your back. Gravity can cause the tongue to fall to the back of the throat, naturally narrowing the airway in the supine position. It is less common for a person to have positional sleep apnea when sleeping on their side or stomach, but it's not impossible!

In infographic displaying 10 stick figure men and 10 stick figure women, 3 of the men and 2 of the woman are highlighted showing that 3 in 10 men who snore and 2 in 10 women who snore also suffer from some degree of OSA. The Sleep Clear Now logo is at the top left corner and there is text that read "Snoring May not be the Only Concern"

Common Sleep Apnea Treatments

Continuous Positive Airway Pressure (CPAP)- CPAP machines are the most common treatment, especially for those with moderate to severe OSA. A CPAP machine uses a motor to provide a continuous stream of air through tubing that is connected to a mask, allowing the air to streamline directly into your airway. The pressure created causes the air to expand your airway and allows you to breathe peacefully throughout the night. Some patients love their CPAP machines, while others find them incredibly uncomfortable and are intolerant of the devices.

Mandibular Advancement Devices (MADs)- MADs are an alternative treatment mainly for those diagnosed with mild to moderate OSA or for those who can't tolerate their CPAP machines. These devices focus on moving the jaw forward, in hopes of manually elongating the airway. They are typically custom-made for patients by dentists who are trained and certified in dental sleep medicine. A 2020 study found that oral sleep appliances are 65-80% as effective as CPAP machines in managing sleep apnea symptoms. If you can't tolerate your CPAP machine, ask your provider about MADs!

Lifestyle Changes- Certain aspects of a patient's lifestyle can cause OSA. For example, drinking alcohol before bed may be the only cause of a patient's symptoms; Therefore, the provider would encourage their patient to limit the use of alcohol before bed to treat the disorder. Your provider will execute a treatment plan tailored to your lifestyle. Smoking, drinking alcohol, and obesity are the most common lifestyle factors that increase the risk of developing Obstructive Sleep Apnea.

In conclusion, Obstructive Sleep Apnea is wildly undiagnosed. A large portion of those living with OSA aren't aware that they have it. Undiagnosed OSA can call for a lifetime of unrestful sleep and strain on your body, specifically the heart. If you or a loved one is struggling with the symptoms above, we strongly recommend getting a sleep test! Most sleep clinics, like Sleep Clear Now, will even give you access to a free at-home sleep test! Everybody has a right to quality, restful sleep and we are here to provide you with just that.

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