What is Obstructive Sleep Apnea?
OSA is a common condition, in which the upper airway repeatedly collapses during sleep. If left untreated, this condition has been associated with an increased risk of high blood pressure, heart attack, depression, uncontrolled diabetes, and stoke.
What Causes the Airway To Collapse During Sleep?
- Extra tissue in the back of the airway such as large tonsils
- A decrease in the tone of the muscles holding the airway open
- The tongue falling back and closing off the airway
Some of the Possible Signs and Symptoms of OSA:
- Snoring, interrupted by pauses in breathing
- Gasping or choking during sleep
- Restless Sleep
- Excessive sleepiness or fatigue during the day
- Crowded airway
- High blood pressure
- Large neck size (greater than "17" in men; greater than 16" in women)
Screening For an OSA Before Bariatric Surgery
In an article on best practices for anesthesia and pain management after weight loss surgery, the authors identified that greater than 50% of patients undergoing surgery had OSA. The American Society of Anesthesiologist pre-operative guidelines indicates the need for screening patient’s pre-surgery for OSA.
Question to Help Assess a Patient's Risk For OSA
- Do you snore?
- Do you ever stop breathing during sleep?
- Do you feel sleepy during the day?
- Has anyone identified that you gasp, snort or pause your breathing while sleeping?
- Do you have a history of high blood pressure?
If a patient answer yes to two or more of the "at risk" questions, follow-up with more detailed and objective testing performed in a sleep center or sleep lab.
The sleep study (known as a polysomnogram) will diagnose whether the patient has OSA and indicate the best treatment for it.
The Benefits of Treating OSA
Clinical studies have shown that treatment of OSA may:
- Lower blood pressure
- Reduce daytime sleepiness and increase daytime energy
- Reduce the potential risk for heart attack, stroke, and heart disease
Treatment of OSA
Positive Airway Pressure (PAP) is a gold standard treatment for OSA. Continuous Positive airway pressure (CPAP) is the most commonly used PAP therapy. CPAP therapy provides a continuous flow of air pressure through the nose to prevent airway collapse, allowing the patient to breathe freely while sleeping. CPAP therapy is noninvasive and can alleviate the symptoms of OSA when used as prescribed.