Obstructive Sleep Apnea: Complications and how to manage the problem

When a person wakes up in the middle of his sleep to gasp for air, that person is said to have sleep apnea and there are different things that can cause this. Obstructive sleep apnea (OSA) occurs when the muscles in the throat intermittently relax to block the airways during sleep, which can cause someone to awake in order to breathe and opening the blocked airway. OSA has several risk factors and can be a very serious problem, and as such requires medical attention.

Possible Complications Of OSA

Obstructive sleep apnea is considered a serious medical condition. Complications may include;

Daytime fatigue and sleepiness

The repeated awakenings associated with obstructive sleep apnea make normal, restorative sleep impossible. People with obstructive sleep apnea often experience severe daytime drowsiness, fatigue and irritability. They may have difficulty concentrating and find themselves falling asleep at work, while watching TV or even when driving. Children and young people with obstructive sleep apnea may do poorly in school and commonly have attention or behavior problems.

Cardiovascular problems

Sudden drops in blood oxygen levels that occur during obstructive sleep apnea increase blood pressure and strain the cardiovascular system. Many people with OSA develop high blood pressure (hypertension), which can increase the risk of heart disease. The more severe the obstructive sleep apnea, the greater the risk of coronary artery disease, heart attack, heart failure and stroke.

Men appear to be at risk of heart failure, while women don’t. OSA increases the risk of abnormal heart rhythms (arrhythmias). These abnormal rhythms can lower blood oxygen levels. If there’s underlying heart disease, these repeated multiple episodes of low blood oxygen could lead to sudden death from a cardiac event.

Complications with medications and surgery

It is a concern with certain medications and general anesthesia. These medications, such as sedatives, narcotic analgesics and general anesthetics, relax your upper airway and may worsen your obstructive sleep apnea. If you have the condition, you may experience worse breathing problems after major surgery, especially after being sedated and lying on your back.

People with the disorder may be more prone to complications after surgery. Before you have surgery, tell your doctor if you have obstructive sleep apnea or related symptoms. When you show symptoms, your doctor may test you for OSA prior to surgery.

Eye problems

Some research has found a connection between obstructive sleep apnea and certain eye conditions, such as glaucoma. Eye complications can usually be treated.

Sleep-deprived partners

Loud snoring can keep those around you from getting good rest and eventually disrupt your relationships. Some partners may even choose to sleep in another room. Many bed partners of people who snore are sleep deprived as well.

People may also complain of memory problems, morning headaches, mood swings or feelings of depression, and a need to urinate frequently at night (nocturia).

Ways Obstructive Sleep Apnea Can Be Treated

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Therapies

There are several therapies that can be used to correct and treat OSA. The major ones available include:

  • Positive airway pressure – If you have obstructive sleep apnea, you may benefit from positive airway pressure. In this treatment, a machine delivers air pressure through a piece that fits into your nose or is placed over your nose and mouth while you sleep.
  • Mouthpiece (oral device) – Though positive airway pressure is often an effective treatment, oral appliances are an alternative for some people with mild or moderate obstructive sleep apnea. These devices may reduce your sleepiness and improve your quality of life. These devices are designed to keep your throat open. Some devices keep your airway open by bringing your jaw forward, which can sometimes relieve snoring and obstructive sleep apnea. Other devices hold your tongue in a different position.

Surgery or other procedures

Surgery is usually considered only if other therapies haven’t been effective or haven’t been appropriate options for you. Surgical options may include:

  • Surgical removal of tissue –¬† Uvulopalatopharyngoplasty (UPPP) is a procedure in which your doctor removes tissue from the back of your mouth and top of your throat. Your tonsils and adenoids may be removed as well. UPPP usually is performed in a hospital and requires a general anesthetic.
  • Upper airway stimulation – This new device is approved for use in people with moderate to severe obstructive sleep apnea. A small, thin impulse generator is implanted under the skin in the upper chest. The device detects your breathing patterns and when necessary, stimulates the nerve that controls movement of the tongue.
  • Jaw surgery – In this procedure, called maxillomandibular advancement, the upper and lower parts of your jaw are moved forward from the rest of your facial bones. This enlarges the space behind the tongue and soft palate, making obstruction less likely.
  • ¬†Surgical opening in the neck – You may need this form of surgery if other treatments have failed and you have severe, life-threatening obstructive sleep apnea. In this procedure, called a tracheostomy, your surgeon makes an opening in your neck and inserts a metal or plastic tube through which you breathe. Air passes in and out of your lungs, bypassing the blocked air passage in your throat.
  • Implants – This minimally invasive treatment involves placement of three tiny polyester rods in the soft palate. These inserts stiffen and support the tissue of the soft palate and reduce upper airway collapse and snoring. This treatment is recommended only for people with mild obstructive sleep apnea.

Other types of surgery may help reduce snoring and SA by clearing or enlarging air passages, including:

  • Nasal surgery to remove polyps or straighten a crooked partition between your nostrils (deviated septum)
  • Surgery to remove enlarged tonsils or adenoids

Lifestyle changes

For milder cases, your doctor may recommend lifestyle changes:

  • Lose weight if you’re overweight.
  • Exercise regularly.
  • Drink alcohol moderately, if at all, and don’t drink several hours before bedtime.
  • Quit smoking.
  • Use a nasal decongestant or allergy medications.
  • Don’t sleep on your back.

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