Obstructive Sleep Apnea (OSA)

Obstructive Sleep Apnea (OSA) is a condition where the upper airway becomes narrowed or blocked during sleep, reducing or temporarily stopping airflow. This leads to decreased oxygen levels in the blood, causing the patient to wake up to breathe.

Symptoms of Obstructive Sleep Apnea

• Loud snoring – This is the most common symptom, and the snoring usually gets louder over time as OSA affects the patient.
• Stopping breathing during sleep, observable by someone close to the patient – People close to the patient may notice intermittent pauses in breathing during sleep, especially when the snoring stops and is followed by deep gasping sounds. 
• Frequent awakenings during the night  – Patients may wake up frequently to catch their breath, leading to interrupted sleep. 
• Excessive daytime sleepiness – Due to insufficient sleep at night, patients often feel very sleepy during the day, may frequently doze off, or have difficulty working or driving. 
• Morning headache – The lack of oxygen during the night can cause patients to wake up with headaches in the morning. 
• Memory impairment or decreased concentration  – Insufficient sleep affects memory and concentration, causing issues in these areas.
• Mood changes – Patients may feel irritable, stressed, or depressed due to inadequate sleep. 
• Frequent nighttime urination –  Patients may experience frequent urination during the night (nocturia). 
• Waking up with a dry mouth and throat

Causes and Risk Factors

• Overweight or obesity
• Abnormal airway structure, such as a short jaw or large neck
• Alcohol consumption
• Use of sleeping pills
• Increasing age
• Genetics

Impact of Obstructive Sleep Apnea

• OSA increases the risk of the following conditions:
• High blood pressure
• Heart disease and irregular heartbeat
• Diabetes
• Car accidents or workplace accidents due to sleepiness
• Memory deterioration
• Stroke
• Mood disorders

Diagnosis

• History taking and Physical examination
• Sleep study (Polysomnography) to measure blood oxygen levels, airflow, and heart function

Treatment

• Behavioral changes such as weight loss, avoiding alcohol, and sleeping pills
• Using a CPAP (Continuous Positive Airway Pressure) machine to help keep the airway open during sleep
• Surgery in cases of structural airway abnormalities
• Using oral appliances to support the airway

Prevention

• Maintaining a healthy weight
• Avoiding alcohol and sleeping pills
• Sleeping on your side to help reduce airway obstruction if sleep apnea is related to sleeping position
• Consulting a sleep specialist if experiencing snoring, excessive daytime sleepiness, or insomnia

Health Article by Wananwat Danworapong, M.D.
Neurologist specializing in epilepsy and sleep medicine, Neuroscience Center, Bangkok Pattaya Hospital