Friday, August 22, 2014

Obstructive sleep apnea

Table of Contents

Alternative Names

Sleep apnea - obstructive; Apnea - obstructive sleep apnea syndrome; Sleep-disordered breathing; OSA


Treatment

The goal is to keep the airway open so that breathing does not stop during sleep.

The following lifestyle changes may relieve symptoms of sleep apnea in some people:

  • Avoiding alcohol or sedatives at bedtime
  • Avoiding sleeping on the back
  • Losing weight

Continuous positive airway pressure (CPAP) is now regarded as the first-line treatment for obstructive sleep apnea in most people. CPAP is delivered by a machine with a tight-fitting face mask.

Many patients cannot tolerate CPAP therapy. Good follow-up and support from a sleep center can often help overcome any problems in using CPAP. For information on this treatment, see: CPAP.

Some patients may need dental devices inserted into the mouth at night to keep the jaw forward.

Surgery may be an option in some cases. This may involve:

  • Uvulopalatopharyngoplasty (UPPP) -- to remove excess tissue at the back of the throat (this has not been proven to work well)
  • More invasive surgeries -- to correct abnormal structures of the face in rare cases when patients have severe sleep apnea or treatment has not helped
  • Tracheostomy -- to create an opening in the windpipe to bypass the blocked airway if there are physical problems (rarely done)
  • Surgery on the nose and sinuses

Surgery to remove the tonsils and adenoids may cure the condition in children; it does not seem to help most adults.


Expectations (prognosis)

With treatment, the symptoms of sleep apnea should be totally corrected.


Complications

Because of daytime sleepiness, people with sleep apnea have an increased risk of:

  • Motor vehicle accidents from driving while sleepy
  • Industrial accidents from falling asleep on the job

Untreated obstructive sleep apnea may lead to, or worsen, cardiovascular disease, such as:

  • Heart arrhythmias
  • Heart failure
  • High blood pressure
  • Sexual dysfunction
  • Stroke

Calling your health care provider

Call your health care provider if:

  • You have excessive daytime sleepiness
  • You or your family notice symptoms of obstructive sleep apnea
  • You have this condition, and symptoms do not improve with treatment or new symptoms develop

Seek immediate medical attention or call your local emergency number (such as 911) if you experience the following signs of a medical emergency:

  • Decreased consciousness
  • Extreme sleepiness
  • Hallucinations
  • Personality changes
  • Persistent confusion


Review Date: 09/15/2010
Reviewed By: Denis Hadjiliadis, MD, Assistant Professor of Medicine, Division of Pulmonary, Allergy and Critical Care, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)