Tossing, turning, struggling to breathe, gasping for air and snoring throughout the night are not anything to be taken lightly! While snoring is simply an annoying noise, bothersome to the bed partner of the snorer, sleep apnea is a serious illness that occurs when your breathing becomes labored and obstructed repeatedly throughout your sleep time, sometimes stopping completely and then starting back up again. Because sleep apnea is disruptive of a deep and comforting sleep, it can leave you feeling sleepy during the day and can also be dangerous for your health and particularly cardiac and respiratory systems. Therefore it is important to seek treatment. Sleep apnea, often times ignored and underdiagnosed, can lead to serious adverse health consequences and is known as a “silent killer” if left untreated. You can schedule an appointment to see Dr. Michel Babajanian, an Otolaryngologist and ENT who serves patients in the greater Los Angeles area, specializes in the diagnosis and treatment of snoring, disordered breathing and obstructive sleep apnea.
Sleep apnea is a common, potentially serious sleep disorder in which your breathing slows or stops during sleep. As your brain recognizes a lack of oxygen, it stimulates respiration, causing you to wake slightly. There are three main types of sleep apnea:
The correct diagnosis of sleep apnea requires a full night sleep study (aka polysomnography) under the supervision of a Board Certified Sleep Medicine Doctor who specializes in performing and interpreting the information obtained through a full night of sleep either at a sleep laboratory or at home. During such sleep study many parameters including blood oxygen levels, heart rate, number of times per hour of cessation of breathing or shallow breathing, number of awakenings during the night of sleep and other indices are measured and analysed to arrive at an accurate diagnosis of presence of absence as well as severity of sleep apnea.
Sleep apnea is a very common condition which has traditionally been under diagnosed and ignored by the medical community and family members alike. More recent convincing evidence over several decades of observation and many studies have proven detrimental consequences of sleep apnea including not only serious heart and lung disease and arrhythmias but also fatal motor vehicle accidents, workplace accidents and other injuries caused by sleepiness of the affected individual. Although chronic loud snoring is a telltale sign of sleep apnea in general, not everyone who has the condition snores all the time. Other signs and symptoms include:
Yes. If you have sleep apnea, you may have a higher risk of developing:
If you are diagnosed with sleep apnea, your treatment options depend on your specific diagnosis and any identifiable areas of airway obstruction in the nose, throat and voice box. Weight loss to bring the Body Mass Index (BMI) to less than 25, significant change of lifestyle, avoidance of heavy use of alcohol and smoking as well as sleep medications and sedatives are at the center of any treatment for sleep apnea and snoring. Obstructive sleep apnea is most often treated with Continuous Positive Airway Pressure (CPAP). This therapy involves a device, which acts as an air pump and opens your airway by applying adequate amount of positive pressure, which is delivered through a nasal mask during sleep. Essentially when you stop breathing, the pum senses the cessation of airflow and kicks in by pumping equivalent of a breath with accurately measured pressure into the patient’s nasal or throat airway. Although CPAP is the primary treatment modality for moderate to severe sleep apnea, it is not a panacea and is not tolerated well by all individuals. Rate of compliance with use of CPAP drops dramatically when the patient is awakened by the device and its malfunction in delivering adequate breath into the airway and by claustrophobic individuals. Patients with deviated nasal septum and nasal obstruction generally do not tolerate CPAP well and may be helped by corrective nasal surgery to facilitate the use of the much needed CPAP apparatus. Oral appliances are another option for patients with obstructive sleep apnea. These devices are designed to move your jaw forward to keep your throat airway open. The success rate varies a great deal in curing sleep apnea and also there are problems with use of the oral prostheses such as TMJ pain caused by forced abnormal position of the jaw. For patients who have trouble sleeping with a mask or an oromandibular advancement prosthesis, there are several other treatment options the appropriateness of each depends on careful clinical evaluation, determination of area(s) of airway obstruction and review of the sleep study results. Fiberoptic nasal and laryngeal examination, a simple and noninvasive examination tool easily performed at Dr. Babajanian’s office is an important and simple method for such evaluation.
When surgery is deemed necessary due to anatomic reasons or failure of conservative therapy such as CPAP many options are available including: