Recognizing Signs of Sleep Apnea

By: Mark B. Van Deusen, M.D.

Sleep apnea is a frequently undiagnosed condition in which a person has pauses in breathing during sleep. The most common type of sleep apnea, obstructive sleep apnea (OSA), occurs when a person’s upper airway causes obstruction of airflow. When airflow is interrupted, sleep becomes fragmented and less restorative, oxygen levels can drop, and carbon dioxide levels may rise in the blood.

Both children and adults can suffer from sleep apnea. Common signs of OSA include loud snoring, gasps, or pauses during sleep. Children may continue to wet the bed at an inappropriate age. Daytime fatigue and sleepiness are common symptoms in both adults and children, although some children can have hyperactivity and behavioral problems. Difficulty concentrating can be seen in both children and adults with OSA. Over time, sleep apnea can cause high blood pressure, put stress on the heart, and cause increased inflammation in the body.

Otolaryngologists (ear, nose, and throat surgeons) are trained in the evaluation and treatment of sleep apnea. Common reasons for obstruction during sleep include nasal obstruction, large adenoids and/or tonsils, and tongue or throat collapse. Obesity is also a known contributing factor. The diagnosis can be made by a thorough history and physical exam and can subsequently be confirmed with a sleep study. In the past, patients were required to stay overnight in a special sleep lab, but now the majority of sleep studies are done in the comfort of a patient’s own home.

Treatment for sleep apnea is aimed at improving airflow and oxygenation during sleep. This may include the use of a CPAP (continuous positive airway pressure) machine that delivers air pressure to overcome the obstruction. In some cases surgical procedures can be performed to decrease the amount of obstruction that occurs during sleep. For some patients, the combination of surgery and CPAP is necessary. There are also new procedures that can be performed in the office setting to help decrease the obstruction causing sleep apnea in appropriate patients.

Most patients find the treatment of their sleep apnea to be life changing. It is frequently unrecognized until a significant toll has already been taken on the patient. Early recognition and treatment in both children and adults is important for both physical and emotional well-being.