Obstructive Sleep Apnea (OSA) | Causes, Risk Factors, Signs & Symptoms, Complications, Diagnosis, Treatment

Obstructive Sleep Apnea (OSA) is a very common condition involving decreased airflow due to obstruction and in the presence of respiratory effort. Obstructive Sleep Apnea is caused by too much relaxation or collapse muscles and tissues in the neck and throat, including the tongue, which can lead to partial or near complete obstruction. OSA can lead to a variety of signs and symptoms, including daytime somnolence and fatigue. In this lesson, we discuss the risk factors for getting OSA, the signs and symptoms, how it’s diagnosed and how it’s treated.

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Obstructive sleep apnea is as common as adult diabetes, affecting four (4) percent of men and two (2) percent of women. According to the National Institute of Health, obstructive sleep apnea affects twelve million Americans. Other researchers have estimated that thirty (30) million Americans are affected.

The term apnea is used to describe a pause in breathing during sleep of ten (10) or more seconds. There are various classes of sleep apnea central, obstructive, and mixed, the most common form is obstructive sleep apnea. Obstructive sleep apnea is characterized by numerous breathing pauses during sleep that lead to the arousal of the brain and/or a reduction in the amount of oxygen in your blood. When you are asleep, the breathing pause is terminated by the brain’s arousal as a result of a loss of oxygen in the blood. When the brain is aroused, the termination of the apnea occurs because of an increase in muscle activity in the tongue and tissues of the airway as a result of you arousing or waking slightly. You then return to sleep and the breathing pause occurs again. This pattern is repeated until you awaken for the day.

These breathing pauses occur because of a blockage in the upper airway, usually when the soft tissue in the upper airway (rear of the throat) collapses. This is referred to as an occluded or obstructed airway. These breathing pauses can occur hundred of times each night, but must occur at least five times per hour for a diagnosis to be made by your healthcare provider. Learn more:

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Mount Sinai sleep surgeons (Lin, Chou, Tsai) perform a large number of hypoglossal nerve stimulators for obstructive sleep apnea. In order to be a candidate for this procedure, the primary area of obstruction should be the back of the tongue, or tongue base. There is a device in the chest much like a pacemaker with a stimulator lead that wraps around the hypoglossal nerve and a sensing lead in the intercostal muscles. When a patient breathes in, the sensing lead communicates with the stimulation lead, causing the tongue to protrude and relieving the anatomic obstruction. Other treatment for sleep apnea includes cervical pillows, mouthguards, CPAP (continuous positive airway pressure), and maxillomandibular advancement among others.

For more information, go to:
https://www.mountsinai.org/care/ent/services/sleep-surgery
The Mount Sinai Otolaryngology Surgical Video Series was edited by Dr. Zachary Schwam.
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The FDA has approved a new implantable device to help treat people suffering from sleep apnea. ‎The new device stimulates a nerve that controls the airway to keep it open during sleep. Patients are able to turn the system on and off using a handheld remote. CBS News’ Danielle Nottingham reports.
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There’s nothing like a good night’s sleep. But for people with obstructive sleep apnea, decent shut eye is hard to get. They often snore and repeatedly stop breathing during the night. This not only causes daytime sleepiness, but also other health issues. More on risks of sleep apnea and what you can do about it from Mayo Clinic.
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