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Obstructive Sleep Apnea (OSA) is a common yet serious sleep disorder characterized by the repeated cessation and resumption of breathing during sleep due to the upper airway becoming wholly or partially obstructed. This obstruction reduces or completely stops airflow, even though the body continues to try to breathe.

🔍 What Causes Obstructive Sleep Apnea?

  • Relaxation of throat muscles during sleep causes soft tissues in the back of the throat (including the tongue and soft palate) to collapse and block the airway.
  • Common contributing factors:
    • Obesity (especially fat deposits around the neck)
    • Enlarged tonsils or adenoids
    • A naturally narrow airway
    • Age (more common in older adults)
    • Gender (more common in men)
    • Use of alcohol or sedatives
    • Nasal congestion

🛑 Symptoms of OSA

  • Loud snoring
  • Gasping or choking during sleep
  • Excessive daytime sleepiness
  • Morning headaches
  • Poor concentration or memory
  • Irritability or mood changes
  • Dry mouth or sore throat upon waking
  • Insomnia or restless sleep

🧪 Diagnosis of OSA

OSA is typically diagnosed through sleep studies (polysomnography), which can be done:

  1. In a sleep lab (in-lab polysomnography) – Monitors brain waves, oxygen levels, heart rate, breathing, and leg movements during sleep.
  2. At home (home sleep apnea test, HSAT) – Simplified version used for patients with high likelihood of moderate to severe OSA.

Diagnosis involves measuring the Apnea-Hypopnea Index (AHI):

  • Mild OSA: 5–14 events/hour
  • Moderate OSA: 15–29 events/hour
  • Severe OSA: 30+ events/hour

⚠️ Health Risks Associated with OSA

If left untreated, OSA increases the risk of serious health issues, including:

  • Cardiovascular problems: high blood pressure, heart disease, heart failure, arrhythmias (like AFib), and stroke
  • Type 2 diabetes and insulin resistance
  • Obesity and difficulty losing weight
  • Depression and anxiety
  • Cognitive impairment and dementia risk
  • Fatigue-related accidents: especially dangerous for driving or operating machinery

💊 Treatment Options for OSA

1. Lifestyle Changes

  • Weight loss (can significantly reduce or eliminate OSA in some)
  • Avoid alcohol and sedatives before bedtime
  • Stop smoking
  • Sleep on your side instead of your back
  • Regular exercise

2. CPAP (Continuous Positive Airway Pressure)

  • Most common and effective treatment
  • Delivers steady air pressure through a mask to keep the airway open
  • Must be used consistently to be effective

3. Other Airway Devices

  • BiPAP: for those who can’t tolerate CPAP
  • AutoPAP: automatically adjusts pressure
  • Oral appliances: fitted by a dentist, they hold the jaw or tongue forward to keep the airway open (more effective for mild to moderate OSA)

4. Surgery

  • Uvulopalatopharyngoplasty (UPPP): removes tissue from the throat
  • Inspire therapy (hypoglossal nerve stimulation): an implantable device stimulates tongue muscles to keep the airway open
  • Nasal surgery or jaw repositioning (for anatomical issues)

📝 Follow-Up and Monitoring

  • Long-term follow-up is essential to ensure treatment is effective and well-tolerated.
  • CPAP compliance is usually monitored remotely.
  • Untreated or undertreated OSA should not be ignored—it can worsen over time and harm quality of life.

 

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