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Obstructive Sleep Apnea

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Obstructive sleep apnea is breathing that starts and stops during sleep due to repeated airway closures. But what causes it and what treatments are available?

Does your partner’s breathing abruptly stop, then restart in the middle of the night? It may be that obstructive sleep apnea (OSA) is to blame.

OSA is breathing that starts and stops during sleep because of repeated airway closures. During sleep, throat muscles may relax too much. If throat muscles lose tone, parts of the airway, including the uvula and tongue, may flop backwards, blocking air to the lungs.

Is snoring OSA?

Snoring occurs when parts of the airway vibrate as a person breathes in. Although most people with OSA snore, not all people who snore have blocked airways or apnea (periods without breathing, lasting 10 seconds to 2 minutes).

With OSA, sleep is commonly interrupted by snoring, apnea, and gasping or startled awakenings (the body’s wake-up call to breathe). The person often wakes only enough to regain airway muscle tone but doesn’t realize they had stopped breathing.

Is OSA potentially life-threatening?

People with OSA lack quality sleep, affecting their ability to concentrate, work, socialize, exercise, or safely drive vehicles.

The heart may attempt to compensate for low oxygen levels during periods of apnea by beating quickly. This stresses the heart and may lead to cardiac damage. OSA has been linked to heart attack, stroke, hypertension, and emotional problems.

What causes OSA?

The main cause is weight gain; fatty deposits may narrow the airway or cause loss of tone to throat muscles. Aging may also factor into loss of tone. Inflammation and narrowing of the airway can be caused by smoking, and use of alcohol or sedatives may cause airway muscles to relax. Genetic inheritance may also be a factor, but this remains unproven.

Large tonsils or adenoids may cause OSA in children; left untreated this can lead to problems, including hyperactivity and behaviour disorders.

Weight loss or sleeping on the side may be all that is needed for some OSA sufferers (see below for more treatment options), but evaluation at a sleep lab may be required if this is not effective.

Recognizing obstructive sleep apnea

Common features in OSA

  • Breathing that starts and stops during sleep
  • Snoring or gasping
  • Interrupted sleep
  • Daytime sleepiness
  • Poor concentration
  • Irritability or feeling depressed

Treatment options

  • Lose weight
  • Quit smoking
  • Sleep on side
  • Avoid alcohol and sedatives at night
  • See a health practitioner to treat causes of narrowed airways, including nasal congestion, large tonsils, or adenoids
  • Ask your health practitioner about using a continuous positive airway pressure (CPAP) device that provides air pressure from a mask to gently push the soft, floppy parts of the throat open
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