Obstructive Sleep Apnea (OSA) is the most common type of sleep apnea and is caused by obstruction of the upper airway. It is characterized by repetitive pauses in breathing during sleep, despite the effort to breathe, and is usually associated with a reduction in blood oxygen saturation. These pauses in breathing called “apneas” (literally, “without breath”) typically last 20 to 40 seconds. [1]
An individual with OSA is rarely aware of having difficulty breathing, even upon awakening. It is recognized as a problem by others witnessing the individual during episodes or is suspected because of its effects on the body. OSA is commonly accompanied with snoring.
Symptoms of Sleep Apnea
A person with OSA will suffer from the effects of a poor night’s sleep often waking up tired and will continue feeling drowsy or sleepy during the day. This may result in excessive daytime sleepiness, impaired memory, concentration and cognitive functions, morning headaches, hypertension, changes in mood and sexual dysfunction. The period of sleep of a person suffering from OSA is often characterized by snoring as well as silent periods while breathing stops, followed by gasps when breathing starts again.
Symptoms may be present for years or even decades without identification, during which time the sufferer may become conditioned to the daytime sleepiness and fatigue associated with significant levels of sleep disturbance. Sufferers who generally sleep alone are often unaware of the condition, without a regular bed-partner to notice and make them aware of their symptoms.
Implications of Obstructive Sleep Apnea
OSA afflicts 32 million US adults (20%), with 10-14 million of those suffering from moderate to severe OSA (4% men, 2% women). Globally there are prevalence rates of 27% in Western Europe, 20.4% in China and 13.7% in India. [2,3]
OSA is recognized as an independent risk factor for a wide range of clinical conditions, such as atherosclerosis, hypertension, heart failure, arrhythmias, stroke, diabetes, and is accompanied by major health complications and poor quality of life factors such as headaches, depression, impaired motor/visual skills, and excessive daytime sleepiness. [4, 5, 6, 7].
The chances of developing coronary artery disease, stroke, high blood pressure, congestive heart failure and type 2 diabetes more than doubles for a person suffering from OSA [7]. The deaths of the NFL athlete, Reggie White as well as the Canadian comedian John Candy were both caused by OSA. Reggie White was believed to have died in his sleep from untreated OSA as he was not able to use a CPAP due to claustrophobia. John Candy had OSA most of his adult life and died from a heart attack. It is estimated that about 50% of individuals who have cardiovascular disease also suffer from OSA [8].
Excessive Daytime Sleepiness also increases the risk of injuries from falling asleep or having impaired cognitive function (e.g. traffic and workplace accidents). The Australian National Sleep Research Project states that sleep deprivation contributed to the human mistakes that led to the very large scale disasters, such as the Exxon Valdez oil spill disaster, the Challenger Space Shuttle disaster and the Chernobyl nuclear accident in Ukraine.
Diagnosis of Obstructive Sleep Apnea
Please refer to your health care provider if you or any in your family suspect that you may suffer from OSA. An overnight sleep study, or polysomnography, conducted in a lab or at home, is often used as a tool in the diagnostic process.
References:
- Wikipedia
- Cappuccio F.P., D'Elia L., Strazzullo P., Miller M.A. Quantity and quality of sleep and incidence of type 2 diabetes: a systematic review and meta-analysis. Diabetes Care 2010 Feb; 33(2):414-20
- Young T., Palta M., Dempsey J., et al., The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 1993; 328:1230-1235
- Kapur, V., et al., The medical cost of undiagnosed sleep apnea. Sleep, 1999; 22(6): p. 749-55
- AlGhanim N., Comondore V.R., Fleetham J., Marra C., Ayas N., The Economic Impact of Obstructive Sleep Apnea. Lung 2008; 86:7–12
- Botteman M., Health economics of insomnia therapy: implications for policy. Sleep Med. 2009 Sep;10 Suppl 1:S22-5
- Yaggi H.K., Concato J., Kernan W.N., Lichtman J.H., Brass L.M., Mohsenin V., Obstructive sleep apnea as a risk factor for stroke and death. N Engl J Med. 2005 Nov; 10;353(19):2034-41
- Walsh J.K., Engelhardt C.L., The direct economic costs of insomnia in the United States for 1995. Sleep 1999 May; 1;22 Suppl 2:S386-93
