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Obstructive Sleep Apnea

by Marcus Peterson

Obstructive sleep apnea is a condition characterized by recurrent hypoxemia and arousal, due to partial or complete obstruction of the upper airways during sleep with consequent daytime somnolence.

Symptoms are loud snoring, hypersomnolence (excessive daytime sleepiness), and restless sleep. Other symptoms of obstructive sleep apnea include choking or gasping during sleep, unrefreshing sleep, morning headaches, daytime fatigue, personality changes, memory impairment, impaired concentration, poor judgment, mood disturbances, recent weight gain, polyurea, and impotence.

The goal of treatment for sleep apnea patients is to keep the airway open and prevent pauses in breathing during sleep.

Methods to alleviate sleep apnea include behavioral measures such as avoiding alcohol and CNS depressants close to bedtime, weight reduction and sleep posture modification.

Continuous Positive Airway Pressure (CPAP) works by gently blowing pressurized air through the nasal passage of the patient at a pressure high enough to prevent the throat from collapsing during sleep.

Oral or dental appliances reposition the lower jaw and the tongue, opening up the space at the back of the throat, and helping treat sleep apnea.

Uvulopalatopharyngoplasty (UPPP)

Which is the most common type of surgery to treat sleep apnea, enlarges the airway by removing redundant tissue (tonsils, adenoids, uvula) from the pharynx.

Laser-assisted Uvulopalatoplasty (LAUP), which can be performed in a specialist's office involves the use of a laser to remove part of the soft palate, shorten the uvula (the tissue that hangs from the middle of the back of the roof of the mouth) and remove other excess tissue from the pharynx.

Tracheostomy is a procedure in which a small hole is made in the trachea or windpipe below the site of obstruction and a tube is inserted into the opening. This tube is opened only during sleeping hours, so that air flows directly into the lungs, bypassing any blocked air passage in the throat.

Another relatively new procedure is radiofrequency ablation (RFA), which makes use of radiofrequency energy to remove tissue from uvula, soft palate and tongue and thereby help treat sleep apnea. In children and adolescents removal of enlarged tonsils or adenoids stands as a viable option in the treatment of sleep apnea.

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