Diagnosis and Treatment of Obstructive Sleep Apnea

By Dr. James Forester | Aug 7, 2023 | Sleep Apnea
diagram of sleep apnea

Globally, 5 to 10% of us suffer with obstructive sleep apnea, the most common sleep disorder. With this condition soft tissues, including the tongue and soft palate, relax and block the airway, so breathing stops. When the brain notices the body isn’t breathing, it wakes the body just enough to reinitiate breathing. Then another episode occurs. Patients who stop breathing for 10 or more seconds, five or more times per hour, can be diagnosed with OSA. 

However, some patients stop breathing for up to a minute or more during an apneic episode, and experience 30 or more episodes per hour. This indicates severe OSA. When a person cannot achieve deep, restful sleep nightly, sleep deprivation occurs. Negative effects can be seen in all facets of life: relationships, work, and recreation. Thus, obstructive sleep apnea destroys quality of life. 

Are you at risk for obstructive sleep apnea?

A sleep study will reveal whether or not you suffer from obstructive sleep apnea. However, the following attributes put a person at greater risk for this sleep disorder:

  • Being overweight
  • Being male (AMAB)
  • Being age 45-64 years
  • Being from black, Hispanic, or Asian descent
  • Being a smoker
  • Being diabetic
  • Abusing alcohol, sedatives, or tranquilizers
  • Having asthma
  • Having a narrow airway
  • Having a family history of sleep disorders
  • Suffering from chronic nasal congestion

Symptoms of Sleep Apena

If you notice any combination of these symptoms, you might suffer from obstructive sleep apnea:

  • Loud, chronic snoring
  • Sleeping partner notices that you stop breathing during the night
  • Awaking gasping, choking
  • Morning headache or migraine
  • Morning dry mouth, sore throat
  • Falling asleep during low-energy activities
  • Feeling tired after sleeping all night
  • Daytime drowsiness
  • Decline in work performance, school grades
  • Moodiness, mood swings, irritability
  • Impotence, decreased sex drive

Comorbidities of OSA

A comorbidity simply means health conditions that are present in combination. Obstructive sleep apnea is often reported in people who suffer from:

  • Obesity
  • High blood pressure
  • Heart disease
  • Other cardiac issues
  • History of stroke
  • COPD, asthma
  • Diabetes
  • GERD, acid reflux
  • Metobolic disorders
  • Depression
  • Glaucoma

Risks with Untreated OSA

An article published on the John’s Hopkins website states that people with untreated OSA are at a heightened risk of developing cardiovascular and metabolic health conditions, as well as suffering a stroke. In addition, the excessive sleepiness of OSA patients can result in accidents while driving or on the job. At worst, OSA can result in death, often from a heart attack that occurs during sleep.

Because of loud snoring and the prevalence of apneic episodes (stops in breathing), an OSA sufferer’s roommate or spouse is often the first to notice the sleep disorder. OSA can hinder relationships because not only the patient, but also the bedmate ultimately suffer from sleep deprivation, which causes irritability and moodiness. Sleep apnea has been known to cause marital problems. A couple may have to sleep in separate bedrooms.

Obstructive Sleep Apnea Treatment Options

CPAP Machine

The standard treatment for OSA is the use of a CPAP machine, which stands for continuous positive airway pressure machine. While this treatment is effective and has nominal side effects (dry mouth, runny nose, weakened throat muscles), many people detest the device. Thirty to 50% of patients won’t use a prescribed CPAP machine.

CPAP requires that the patient sleep on his back while wearing a facemask throughout the night. The mask delivers a continual stream of air by way of a tube connected to a compressor unit. Modern CPAP machines are much quieter and the masks are more comfortable than in past generations. Still, patients report:

  • Poor mask fit (custom masks are available)
  • Inability to wear the mask through the night
  • Feeling claustrophobic
  • Feeling of drowning when condensation in the tube falls into the throat during sleep
  • Dry mouth, dry eyes
  • Morning headache
  • Shortness of breath
  • Nasal congestion
  • Difficulty going to sleep
  • Skin irritation or pressure sores from mask
  • Problems tolerating forced air
  • Swallowing air, causes bloating and belching (aerophasia)

CPAP maintenance requires that the mask, tube, and humidifier be cleaned and water changed daily. The mask and tubing must be replaced as needed. A self-cleaning device can be purchased. Not cleaning the machine properly or regularly can allow germs to enter the body and cause frequent illnesses like lung, sinus, throat, and ear infections.

OSA Oral Appliance from Dr. Martin

If you have OSA or snore loudly while sleeping, an oral appliance known as a snore guard or sleep guard will help. A sleep guard holds the tongue in the proper position, while placing the lower jaw in a slightly forward position. This keeps soft oral tissues from blocking airflow, which results in snore-free, unhindered breathing all night long.

After using the sleep guard nightly for months, you should notice symptoms subside. You should feel more alert and rested during the day, as well. Moodiness and depression may subside, and your risk for heart attack and stroke will be greatly reduced.

A sleep guard is a one-time investment. Cleaning is easy, as is transporting the device when you travel. Best of all, you won’t feel claustrophobic, and you can sleep in any position you like.

Diagnosing Obstructive Sleep Apnea

Treatment for OSA can begin only after diagnosis. You can go to a sleep lab and stay overnight for a sleep study or opt for a home sleep study. For the home sleep study, you’ll be provided with a special machine and instructions. The machine will record important information about your sleep quality, and a sleep physician can read the reports to diagnose OSA. 

If you suffer from the symptoms identified above or believe you’re at a greater risk of having OSA, call Lifetime Smiles today to book a consultation with Dr. James G. Forester. As a dental sleep medicine provider, Dr. Forester will prescribe an oral appliance that’s easy to use, clean, and maintain, and that’s effective for eliminating your snoring while keeping your airway clear for healthy breathing all night long.