Obstructive Sleep Apnea (OBPS)

Proven content

OBPS – Obstructive sleep apnea is a condition characterized by the occurrence of multiple episodes (apnea) during sleep or shortening of this breathing. About one hundred thousand people suffer from this condition in Poland. Apnea lasting more than 10 seconds and occurring earlier than ten times in an hour is considered dangerous.

Obstructive sleep apnea – what is it?

OBPS is the most common breathing disorder that occurs during sleep. It is estimated that about 100 people in Poland suffer from them (about 4-10% of men and 2-4% of women). Most often, apnea occurs in adults, although there are cases in children. This is usually due to an enlarged tonsil or a curvature of the septum of the nose. In women, however, obstructive sleep apnea occurs most often after the menopause. Other factors increasing the risk of ailments are obesity and a large circumference of the neck (fatty tissue deposited on the neck automatically compresses the throat and reduces its lumen).

Apnea doesn’t always have to worry you. It can also occur in healthy people. Apnea that lasts more than 10 seconds and occurs more than 10 times an hour is considered pathological.

Is sleep apnea making your life difficult? Check out the offers of facilities in your area that offer various methods of snoring treatment.

Remember! Sleep apnea occurs even in healthy people, for example when falling asleep.

So far, scientists have failed to establish a specific cause of obstructive sleep apnea. However, people with OSA are often found to have certain changes (abnormalities) that may contribute to the onset of the disease. These include:

1. changes in the area of ​​the nose (nasal septum deviation, turbinate hypertrophy, polyps),
2. changes in the throat area (enlarged palatine tonsils, enlarged tongue, elongated soft palate),
3. craniofacial defects (e.g. small, retracted mandible).

Who is most likely to experience obstructive sleep apnea?

Obstructive sleep apnea is observed in middle-aged men, most often obese, complaining of snoring and excessive daytime sleepiness. OSA is much less common in women. This is due to the different structure of the upper respiratory tract in men and women (in women the lumen of the upper respiratory tract is wider). The protective role of female sex hormones (mainly estrogens) is also important.

There are two basic types of apnea: central and obstructive. The latter type of apnea is caused by the soft parts of the throat collapsing when you inhale. With each inhalation, the lumen of the upper airways narrows more and more until it is completely closed. The most common cause of central apnea is brain damage (e.g. following trauma, inflammation, or cancer). The brain’s neurons do not send the correct impulses to the respiratory muscles in the chest and abdomen. When airflow cannot flow through the respiratory tract and the body is running out of vital oxygen, an impulse is sent to wake up or move from a deeper to a shallower phase of sleep. As a result, the muscle tone of the throat increases and air can again pass through the lumen of the respiratory tract. A person with apnea may wake up from sleep up to several hundred times during the night. Therefore, in the morning she is tired.

What are the symptoms of obstructive sleep apnea?

In people with OSA there are:

1. Morning headaches, which usually disappear a few or several minutes after waking up.
2. Daytime sleepiness that is difficult to control. It may also fall asleep against your will. Falling asleep most often occurs when performing monotonous activities, such as reading the newspaper or watching TV. This is especially dangerous for people driving vehicles or working with mechanical devices.
3. Feeling tired during the day. A dream that does not give you rest.
4. Sometimes – lowering libido and sexual potency.

What symptoms can my loved ones observe?

1. Very loud and irregular snoring.
2. Occurrence of apnea during sleep (breathing is not heard, chest movement cannot be seen).
3. Getting up to the bathroom at night (nocturia).
4. Bedwetting.
5. Restless sleep.

Recognizing obstructive sleep apnea

During the interview, the doctor will ask you to complete a questionnaire regarding the observed symptoms. OBPS can be finally confirmed after execution polysomnographic examination. This is a study performed in a hospital setting. While you are asleep, electrodes attached to your body record the work of the brain, eyeballs and the activity of the muscles of the chest and abdomen. Polysomnography is most often carried out in special, acoustically muted rooms, where you can sleep peacefully. The sensors attached to the patient also allow you to monitor:

1. the amount of oxygen in the blood (then the electrode is placed on the right finger),
2. limb movements,
3. heart rate (EKG)
4. snore,
5. patient’s sleep phase (EEG and EEA),
6. air flows through the nose and mouth.

The limitation of polysomnographic examination is its low availability and high cost. For this reason, a somewhat simpler study was invented – polygraphy. It is based on monitoring the above-mentioned factors in addition to examining brain function. Therefore, it is a less precise test, especially in differentiating OSA from other ailments. However, in typical cases, it allows you to make a proper diagnosis and implement treatment. This examination, unlike polysomnography, can be performed at the patient’s home.

How To Treat Obstructive Sleep Apnea?

People who do not treat OSA are more likely to suffer from hypertension and ischemic heart disease; they are also more likely to suffer from cardiac arrhythmias and strokes.

Choosing the right treatment largely depends on the cause of the disease. If the cause of the apnea is, for example, a curvature of the nasal septum or polyps, an effective method is them operational removal. The device that creates positive airway pressure (so-called nCPAP) is considered to be the most effective method of treatment. During sleep, the patient has a plastic tube in his mouth. Thanks to this, the soft parts of the throat do not collapse. Already after the first night of using nCPAP, you notice a significant improvement in the quality of sleep. Sometimes orthodontic appliances are also used, which are only worn during sleep. So far, no drug has been found that would effectively eliminate the occurrence of sleep apnea.

For whom is CPAP treatment indicated?

1. patients with obstructive sleep apnea who have AHI ≥5 and present daytime symptoms of the disease or comorbidities, e.g. a history of stroke;
2. patients with OBPSAHI ≥15, regardless of symptoms.

Orthodontic treatment is also initiated in some patients. It consists mainly in the use of a special device that extends the mandible, which the patient uses at night. Thanks to this method, the lower jaw is slightly extended in relation to the upper jaw, which consequently increases the tension in the throat muscles during sleep, which eliminates snoring and apnea. Braces are used in patients with mild to moderately severe sleep apnea or all those who do not respond to CPAP treatment.

Conservative treatment is primarily:

1. nicotine withdrawal,
2. avoiding alcohol consumption (even in small amounts),
3. maintaining an appropriate body weight (preventing overweight / obesity),
4. practicing physical activity,
5. taking care of the regular rhythm of sleep, i.e. going to bed and getting up at the same times,
6. sleeping on your side may bring some improvement,
7. avoiding the use of nasal sprays or ointments designed to supposedly stop snoring. In fact, such preparations can have dire consequences for the patient.

How Much Does Sleep Apnea Treatment Cost?

Can obstructive sleep apnea be prevented?

Yes! Of course it is possible. OBPS prophylaxis should primarily concern:

1. weight reduction,
2. avoiding the “on the back” position during sleep (it may be helpful to sew a tennis or golf ball into the back of pajamas),
3. refrain from drinking alcohol before going to bed.

Text: Matylda Mazur

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