Sleep Apnea

About Sleep Apnea

Obstructive sleep apnea OSA is a sleep disorder characterized by repeated episodes of upper airway collapse during sleep, leading to pauses in breathing apneas or reduced airflow hypopneas. It has been estimated to affect nearly 1 billion people worldwide and is severely underdiagnosed. The AHI apnea hypopnea index measures severity: mild 5 to 15 events per hour, moderate 15 to 30, severe over 30. Risk factors include obesity BMI over 30, male sex, age over 40, large neck circumference over 17 inches, family history, smoking, alcohol use, nasal congestion, and anatomical features recessed jaw, large tonsils. Symptoms include loud snoring, witnessed breathing pauses reported by bed partner, gasping or choking during sleep, excessive daytime sleepiness, morning headache, dry mouth or sore throat on waking, difficulty concentrating, irritability, and depression. The STOP BANG questionnaire screens for OSA. Diagnosis requires polysomnography sleep study in a lab or home sleep apnea test. Untreated OSA increases risks of hypertension, heart attack, stroke, heart failure, atrial fibrillation, type 2 diabetes, and motor vehicle accidents from drowsy driving. The gold standard treatment is continuous positive airway pressure CPAP, which delivers pressurized air through a mask to keep the airway open. CPAP is highly effective but adherence is often poor. Alternatives include mandibular advancement devices oral appliances, weight loss, positional therapy, and surgery UPPP, maxillomandibular advancement, hypoglossal nerve stimulation Inspire.