Sleep Apnea/Snoring
Sleep Apnea is a serious medical condition that affects over 4 percent of the adult population. It is characterized by a cessation of breathing during sleep. Sleep apnea results in the patient waking up several times during the night time, often without realization of the arousals. Many patients will awaken hundreds of times during the night, awakening un-refreshed, sleepy and completely unaware of the arousing events.
Some of the symptoms of sleep apnea are: daytime sleepiness, snoring, fatigue, irritability, dry mouth and sore throat. Often the partner is the first one to report the problem. Not surprisingly, there has been a reported correlation between patients with sleep apnea and partners with hearing loss. However, not all snorers have sleep apnea, and not all sleep apnics snore.
The risk factors for sleep apnea include: increasing age, male sex, obesity, large neck size, small mandible (micrognathia), alcohol consumption and large tonsils. However, affected people, often will not have these characteristics.
There are several consequences of untreated sleep apnea. Because the patient stops breathing, he/she does not receive enough oxygen and the patient suffers several episodes of hypoxia each night. There is a well documented correlation between sleep apnea and hypertension, pulmonary hypertension, strokes and congestive heart failure. Also, excessive daytime sleepiness leads to thousands of accident related deaths each year.
There are several treatment options for obstructive sleep apnea. For the patient with mild sleep apnea, lifestyle changes may be sufficient to improve sleep and resolve daytime sleepiness. These changes include weight loss, alcohol cessation and sleeping on one's side as opposed to one's back. More often, the patient will require additional therapy. The gold standard for treating obstructive sleep apnea is CPAP ( Continuous Positive Air Pressure). CPAP involves blowing room air through a thin tube that is attached to a mask that the patient wears over his/her nose. The air that blows through the patient's airway is sufficient to keep the air way patent, and prevent it from obstructing.
It is important for patients to be aware of the symptoms of sleep apnea and also important for primary care providers to ask all patients about their sleep history.
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