Snoring and Sleep Apnea

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Snoring and sleep apnea are common yet serious conditions that can affect sleep quality, overall health, and well-being. While snoring can be benign, it may also indicate obstructive sleep apnea (OSA), a condition in which breathing repeatedly stops and starts during sleep due to airway obstruction. At WAISS, we provide comprehensive evaluation and treatment options for patients experiencing sleep-related breathing disorders.

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Understanding Snoring

Snoring occurs when airflow through the mouth and nose is partially blocked, causing vibrations in the throat tissues. It is a widespread condition that may be harmless in some individuals but can also be an early indicator of a more serious problem such as OSA.

Causes of Snoring

•    Obesity: Excess fat around the neck can constrict the airway.

•    Nasal Congestion: Blocked nasal passages from allergies or infections can lead to snoring.

•    Alcohol and Sedatives: These substances relax throat muscles, increasing airway obstruction.

•    Sleep Position: Sleeping on the back can cause the tongue and soft tissues to collapse into the airway.

•    Anatomical Factors: Enlarged tonsils, a long soft palate, or a deviated septum can contribute to snoring.

 

When Snoring Indicates Sleep Apnea

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Not all snoring is linked to sleep apnea, but loud, persistent snoring accompanied by choking, gasping, or daytime fatigue may be a sign of OSA. Sleep studies are essential to differentiate simple snoring from sleep apnea.

Understanding Sleep Apnea

Sleep apnea is a serious sleep disorder characterized by repeated interruptions in breathing during sleep. The most common type is obstructive sleep apnea (OSA), where the airway becomes physically blocked.

Risk Factors for OSA

•    Obesity

•    Family History of OSA

•    Male Gender (Higher Prevalence)

•    Advancing Age

•    Smoking and Alcohol Use

•    Large Neck Circumference (>17 inches in men, >16 inches in women)

•    Enlarged Tonsils or Adenoids (especially in children)

 

 

Health and Psychosocial Implications of Sleep Apnea

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Untreated sleep apnea can lead to severe health consequences, including:

•    Cardiovascular Diseases: Increased risk of hypertension, heart disease, and stroke.

•    Daytime Fatigue and Impaired Concentration: Leading to workplace and driving accidents.

•    Diabetes: OSA is linked to insulin resistance and type 2 diabetes.

•    Mood Disorders: Depression, anxiety, and irritability are common in patients with untreated OSA.

•    Decreased Cognitive Function: Memory loss and difficulty concentrating due to poor sleep quality.

 

Evaluation and Sleep Studies

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A sleep study (polysomnography) is the gold standard for diagnosing OSA. Sleep studies can now be conducted in a sleep laboratory or at home (home sleep apnea testing, HSAT).

How Sleep Studies Are Performed

•    In-Lab Polysomnography (PSG): Conducted overnight in a specialized sleep center, PSG monitors brain activity, oxygen levels, heart rate, respiratory effort, and limb movements.

•    Home Sleep Apnea Test (HSAT): A more convenient alternative for selected patients, HSAT measures oxygen levels, airflow, and breathing patterns at home.

 

Understanding Sleep Study Results

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The severity of OSA is classified based on the Apnea-Hypopnea Index (AHI):

•    Normal: AHI < 5 events per hour

•    Mild OSA: AHI 5–15 events per hour

•    Moderate OSA: AHI 15–30 events per hour

•    Severe OSA: AHI > 30 events per hour

 

Treatment Options for Snoring and Sleep Apnea

Non-Surgical Treatments

1. Lifestyle Changes

•    Weight Loss: Reduces fat deposits around the airway, decreasing obstruction.

•    Positional Therapy: Encourages sleeping on the side to prevent airway collapse.

•    Avoiding Alcohol and Sedatives: Prevents excessive relaxation of throat muscles.

2. Continuous Positive Airway Pressure (CPAP) Therapy

•    The most effective treatment for moderate to severe OSA.

•    Uses a machine to deliver pressurized air via a mask, keeping the airway open during sleep.

•    Significantly improves sleep quality, daytime alertness, and cardiovascular health.

3. Oral Appliance Therapy

•    Custom-fitted dental devices reposition the jaw and tongue to maintain an open airway.

•    Effective for mild to moderate OSA or those intolerant to CPAP therapy.

4. Surgical Treatments

Surgical interventions are considered when non-surgical therapies fail or when anatomical factors contribute to airway obstruction.

1. Uvulopalatopharyngoplasty (UPPP)

•    Removes excess soft tissue in the throat, widening the airway.

•    Most effective in selected patients with soft palate collapse.

2. Inspire Therapy (Hypoglossal Nerve Stimulation)

•    An implantable device that stimulates airway muscles to prevent collapse.

•    Activated by a remote control during sleep.

3. Tongue Advancement Procedures

•    Genioglossus Advancement (GA): Moves the tongue muscle attachment forward, preventing airway collapse.

4. Maxillomandibular Advancement (MMA)

•    Chin Advancement (Genioplasty) and Orthognathic Surgery

•    Moves the upper and or the  lower jaw forward, enlarging the airway and reducing obstruction.

•    One of the most effective surgical options for severe OSA.

Choosing the Right Treatment

The choice of treatment depends on the severity of sleep apnea, patient preference, and anatomical factors. At WAISS, we provide expert diagnosis and individualized treatment plans to help patients achieve restful sleep and improved health.

Contact us today to schedule a consultation and explore the best treatment options for snoring and sleep apnea.