Obstructive sleep apnea (OSA) is a condition of halted breathing, snoring, and waking
from sleep. It is due to airway collapse and worsens
in the face-up sleep position. About eighty percent of Americans with OSA haven’t
been diagnosed with this condition. Symptoms
are present for years before diagnosis and treatment are begun.
Those at risk for OSA include African
Americans, Mexican-Americans, Pacific Islanders, and obese people. It is more
common in men than women. Additional risk factors include smoking, sleeping
face-up, alcohol use, having a relative with OSA, history of stroke, a high
arched palate, and low thyroid levels.
Common symptoms include irregular heart
rate, short term memory deficit, morning confusion, decreased libido, daytime sleepiness,
and gasping or choking during sleep. Halted breathing could occur hundreds of
times at night at one or two times per minute. OSA sufferers are unaware that
they have this condition. They may regard themselves as “good sleepers"
because they "can sleep anytime, anywhere."
Enlarged tonsils and a soft palate decrease the upper airway
diameter. This causes the airway to collapse, which triggers snoring. People with OSA may develop high blood pressure, coronary
artery disease, diabetes, low blood oxygen levels, congestive heart failure,
stroke, and depression. They are at risk for heart attack and fatal motor
vehicle accidents.
Treatment:
CPAP (continuous positive airway pressure) home machines reduce symptoms and
improve sleep quality. For those who don’t prefer or tolerate CPAP, oral
appliances (fixed or adjustable) can help. People with no teeth and those who
have jaw (temporomandibular) arthritis should not use oral appliances. If these
are prescribed, they must fit accurately, comfortably, and remain in position throughout
the night.
Soft-palate and tongue devices: The Pillar Palatal Implant system was originally developed
for the treatment of snoring. It t has some benefit in treating mild to
moderate sleep apnea. This involves surgical placement of mesh polyethylene
implants into the soft palate muscles. These permanent implants improve snoring
by stiffening the palate and decreasing palate movement during inspiration.
Palate implants
Questions or comments? Contact Dr.
Clem at clementhanson.blogspot.com
