Sleep apnea is defined as a cessation of airflow during sleep for 10 seconds or longer. Central sleep apnea is caused by a failing of the central nervous system. Obstructive sleep apnea (OSA), which is more common, is caused from a collapse in one's airway. To best assist with defining the sleep disorder, a sleep study is required.

Symptoms of Sleep Apnea

The most common symptom of sleep apnea, snoring, is present in approximately 60 percent of men and 50 percent of women older than 60. Simple or primary snoring is not dangerous medically, though it can cause significant social problems between partners. Thankfully, the MetroHealth Department of Otolaryngology is capable of improving or eliminating primary snoring. Because snoring may be a symptom of OSA, we need to investigate the possibility of this dangerous disease state prior to executing snoring relief.

Even though only four percent of men and two percent of women have OSA symptoms, OSA's impact is broader, affecting a total of nine percent of men and four percent of women. The symptoms of OSA include daytime sleepiness, loud or persistent snoring, observed apneas (when someone witnesses the patient stop breathing during sleep) or choking, morning headaches, and poor cognitive function. Obesity is the most common risk factor for developing OSA. Patients with untreated OSA are at considerable risk for an adverse cardiovascular event, such as high blood pressure, heart attack and stroke. The life expectancy of a patient with untreated OSA is considerably shorter than that of the normal population.

Managing Sleep Apnea

Treatments for OSA include:

• Reduction of risk factors (e.g., weight reduction)
• Medical therapy
• Surgical therapy

Medical therapy typically involves continuous positive air pressure (CPAP), which is a mask that fits over the nose to blow in air and "pneumatically splint" the airway open. CPAP is an effective treatment that will eliminate the symptoms of OSA. Unfortunately, some patients have trouble tolerating CPAP, in these cases surgical options are available. A tracheostomy will bypass the obstruction, and alleviate OSA, however this is a cosmetically unappealing option. Depending on the patient's anotomical makeup, we are often able to trim the palate, remove the tonsils, and possibly operate on the nose and jaw to minimize the collapse that may take place.

Patients with the symptoms of OSA are encouraged to undergo an evaluation to rule out this disease. Your primary care physician can arrange for a sleep study, or the Department of Otolaryngology or Division of Pulmonary Disease at the MetroHealth Medical Center can be of assistance.