Snoring/OSA Obstructive Sleep Apnea

OSA - Obstructive Sleep Apnea is a common disorder that can be very serious. It is the cessation of breathing that occurs during sleep. Usually due to obstruction of the airway, it can also be due to inability of the brain to initiate respiration. Often, OSA is accompanied by snoring. Snoring is produced by the oscillation of the uvula, the free edge of the soft palate and the faucial pillars. When the person stops breathing, the oxygen carried in the blood is reduced. This is made worse in people who are overweight, as obesity itself prevents the lungs from delivering the normal levels of oxygen to the blood; when an overweight person stops breathing the drop in the oxygen level in the blood becomes more severe. As the oxygen falls in the blood, the person will awaken. Since this awakening is often only very brief, the individual is not aware of this cycle.

These sleep disruptions lead to a tendency for excessive sleepiness and an increased drive for sleep. This drive for sleep contributes to the loss of muscle activity in the upper airway and therefore the upper airway is more prone to collapse and become obstructed. This leads to a cycle of recurring apneic events.

Evaluation of the nasal airway, soft palate, base of tongue, lateral pharyngeal wall, hyoid position and mandibular projection is essential. This includes studies such as nasal endoscopy and cephalometric exams. If the history and physical exam suggests evidence of sleep apnea, then an overnight split Sleep Study, or Polysomnogram (PSG) with CPAP titration (calibration) is essential. Following a diagnosis, the sleep specialist will work with you and your doctor to plan appropriate treatment.