Obstructive sleep apnea(OSA) is a condition where the soft tissues of the upper airways that is the nose,
soft palate (roof of the mouth) and pharynx (back of throat) collapse and temporarily block the air
pathway during sleep. These areas are mostly made up of soft tissue which is liable to collapse when all
the muscles relax during sleep. The occlusion, which lasts for a few seconds (10-30 seconds) , can fully
or slightly awaken the subject due to lack of oxygen and thus interrupt the normal sleep cycle. Several
episodes, minutes or hours apart occur in one night with results poor or inadequate sleep.
The night symptoms include loud snoring, awakening at night with gasping, choking, breath holding and
restless sleep. Due to interrupted sleep, daytime symptoms also occur and include excessive daytime
sleepiness, fatigue, irritability and forgetfulness amongst many others. Having some or all of the
symptoms doesn't automatically mean that someone has OSA. Loud snoring, for example, is the most
common symptom but only a small fraction of snorers have OSA(10%).
Certain conditions are associated with a higher chance of OSA and their presence in patients with above
named symptoms increases the suspicion and likelihood of OSA. These include, male gender (2x more
common), excess weight/obesity, chronic nasal blockage, narrowed airway, smoking, diabetes,
asthma and hypertension. Diagnosis is however only confirmed by a test called a Polysonography which
tests the pattern of sleep and openness of the airway during sleep.
Once diagnosed with OSA, there are several ways of addressing the problem, all ultimately aimed at
increasing the space in the upper airway for easier breathing. Depending on the identified risk factors,
simple lifestyle changes which include, sustained weight loss, stopping smoking, reducing alcohol or at
least avoiding alcohol 4-6 hours before sleep, better asthma and diabetes awareness and control and
medication for nasal blockage have been shown to be very effective in mild and moderate cases.
Other methods work at physically keeping the airway open. These include Continuous Positive Airway
Pressure (CPAP) device. This is fixed to the face like a mask and delivers air at a positive pressure and
keeps the airway open. When all else fails, surgery can be used to either remove excess tissues or
strengthen the upper airway muscles