Obstructive Sleep Apnea & Patterns, Causes, & Treatment Options

Do You Snore Loudly?
Loud snoring can be a sign that something is seriously wrong with your breathing during sleep. Snoring indicates that the breathing passage in your throat is not fully open, and the distinctive sound of snoring comes from trying to force air through this narrowed area.

An estimated 10-30% of adults snore. In most, snoring has no serious medical consequences. For about 5 in 100 people, however, loud nightly, snoring is the first sign of a serious disorder: obstructive sleep apnea syndrome.

What is Obstructive Sleep Apnea Syndrome?
The muscles that stiffen and open the throat tend to relax during sleep in normal children and adults. This relaxation leads to slight narrowing of the throat that does not cause any problem in most people. However, in people with OSAS, this narrowing of the breathing passage is so great that breathing becomes difficult, as if they were breathing through a floppy, wet straw. The brain senses that breathing is difficult and increases the effort to breathe. Eventually this increased effort awakens the brain, which signals the throat muscles to become active again, which then reopens the breathing passage. With the breathing passage open once more the effort to breathe decreases and the person goes back to sleep. This cycle of falling asleep, throat narrowing, raised effort to breathe and then arousal from sleep tends to repeat itself throughout the night, and can disturb sleep dozens to hundreds of times each night. Most of these awakenings are so brief that they are not remembered the next morning. An individual with this pattern of obstructed breathing, brief awakenings from sleep, and daytime symptoms is said to have OSAS.

WHAT causes Obstructive Sleep Apnea Syndrome?
Since the throat muscles relax during sleep to some extent in everyone, many patients with OSAS have additional factors that contribute to their having the disorder. These include a smaller than normal jaw, large tongue, enlarged tonsils, or tissues that partially block the entrance to the breathing passage. OSAS often occurs in overweight people, as is thought that fatty tissue in the neck affects the size or shape of the breathing passage. Sometimes several of these conditions are present in the same person. Since OSAS is less frequent in younger woman, a different throat structure or certain hormones may tend to protect them from having this disease, although in later years and especially after menopause the gap between the sexes narrows. Alcohol, sleeping pills, and tranquilizers taken at bedtime also relax these muscles and can make the breathing passage more likely to close. Some people with OSAS may have worse sleep when that take a sleeping pill, or these pills can even be dangerous for them. If your health professional prescribes a sleeping pill for you, make sure to tell him or her about any symptoms of OSAS you might have. If you have OSAS you may not get enough oxygen during sleep and probably don’t sleep soundly. You may suffer from sleepiness that affects your work and/or social activities, and that could even lead to car accidents/ OSAS can also put you at risk for high blood pressure, heart failure, heart attack, or stroke. If you snore loudly on most nights, you should visit your healthcare professional. He or she may suggest evaluation at a sleep disorders center. Fortunately sleep specialists are now able to diagnose and treat these breathing disorders during sleep. Proper treatment can prevent or reverse the potentially dangerous consequences of OSAS.

What are the Warning Signs of OSAS?
In Adults:
  • Excessively loud snoring which can be heard rooms away
  • A pattern of snoring interrupted by pauses, then gasps, is a sign that breathing stops and restarts. Occasionally, patients will remember waking up short of breath or gasping, although usually there are many more stop-breathing episodes that are not recalled.
  • Falling asleep at the wrong times, such as at work or while driving.
  • Trouble concentrating, or becoming forgetful, irritable, anxious, or depressed.
  • Morning headaches or nausea, frequent trips to the bathroom to urinate and loss of interest in sex. Men may complain of impotence and women may have menstrual irregularities.
In Children:
  • Being overweight or having enlarged tonsils and/or adenoids.
  • Certain birth defects that affect the size and shape of the throat, face, or chin such as Down Syndrome
While Asleep, children with OSAS may Snore or squeak, Have difficulty breathing, Sleep fitfully and, Have daytime Hyperactivity
  • Older children who have OSAS may seem sluggish and may perform poorly in school. At times they are labeled "slow" or "lazy"
  • Some cases of Sudden Infant Death Syndrome (SIDS or crib death) may be due to OSAS, although how often this is true is still uncertain and research continues.
Since it is not normal for a child to snore loudly every night, parents should report their child’s snoring to a healthcare professional.

These problems usually appear slowly and progress over many years, so that you may not even recognize the symptoms. Family members, employers, or coworkers may be the first to recognize a pattern of excessive sleepiness and/or changes in mood or behavior, and should encourage a visit to a healthcare professional.

WHAT Happens If I Am Not Treated for OSAS?
The most common complaint of people with OSAS is excessive sleepiness. The sleepiness is most often felt when the person is sitting still or inactive. Driving and automobile can be difficult because of unwanted sleep, and people with OSAS have more automobile accidents due to dozing or inattention. Untreated OSAS has other consequences for health and well-being besides sleepiness. Some of these are High blood Pressure, Heart Attack, Stroke, and Depression. Medical Science is learning that OSAS can reduce or eliminate these risks. In many cases the patient feels the benefits, such as reduced sleepiness and better mood, quickly after treatment begins.

What Will Treatment Offer ME?
If you are diagnosed with OSAS you may benefit from general measures.
  • Weight Loss: Even small amounts of weight loss may improve breathing during sleep, making sleep more restful and lessening daytime sleepiness.
  • Avoid Alcohol within four hours of bedtime: Alcohol depresses breathing and makes OSAS episodes more frequent and severe. Alcohol also appears to trigger OSAS in people who would otherwise merely snore.
  • Avoid Sleeping Pills: Sleeping Pills depress breathing, relax the muscles of the throat, and generally make OSAS worse. Exceptions may be necessary for people who are bothered by frequent awakenings that are not due to OSAS episodes. Seek out a healthcare professional’s advice if you use sleeping pills and have OSAS.
  • Take all drugs with care: Medications prescribed for headaches, anxiety, and other common problems can affect sleep and breathing.
  • Sleep Lying on one side or your stomach. Some people suffer from OSAS only when lying on their backs. Pillows placed behind the back or a tennis ball attached to the back of pajamas will prevent back-sleeping throughout the night.
  • Medications to relieve nasal stuffiness may be helpful in reducing snoring and may help OSAS slightly. Consults your healthcare professional for advice.
How to Sleep Well:
  • These guidelines can help most people sleep better, as well as many individuals with different types of sleep disorders.
  • Maintain a regular wake time, even on days off work and on weekends.
  • Try to go to bed only when drowsy
  • If you are in bed and are not drowsy, and unable to fall asleep for about 20 minutes, leave your bedroom and engage yourself in a quiet activity somewhere else. Return to bed only when you are sleepy. Repeat this process as often as necessary throughout the night.
  • Use your bedroom only for sleep, sex, and times of illness.
  • If you have trouble sleeping at night, don’t nap during the daytime. If you do nap, try to do so at the same time every day and for no more than an hour. Mid-afternoon (no later than 3:00 pm) is best for most people.
  • Establishing relaxing pre-sleep rituals such as a warm bath, light bedtime snack, or ten minutes of reading.
  • Keep a regular schedule. Regular times for meals, medications, chores, and other activities help keep the brain’s inner clock running smoothly, allowing you to sleep more easily and soundly.
  • Avoid large meals before bedtime.
  • Avoid caffeine (coffee, tea, soda pop with caffeine, cocoa or chocolate) within six hours of bedtime.
  • Don’t drink alcohol when sleepy. When you are sleepy, even a small dose of alcohol can affect activities like driving. Do not drink alcohol while taking sleeping pills or certain medications. Don’t use alcohol to make you fall asleep at night. While alcohol may help you to fall asleep faster, it severely affects the quality of sleep later in the night and may even keep you from sleeping through the night.
  • Avoid tobacco close to bedtime or during the night.
  • Sleeping pills should be used only conservatively.
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