Obstructive Sleep Apnea (OSA) Syndrome– Sleep Apnea

Respiration is the process of receiving oxygen from the atmosphere and emitting carbon dioxide from the body system. The respiratory system is used for the function of respiration. This system is comprised of the upper and lower respiratory tracts. The respiratory tract is divided into the upper airways and lower airways. The upper airways or upper respiratory tract includes the nose and nasal passages, paranasal sinuses, the pharynx, and the portion of the larynx above the vocal cords. The lower airways or lower respiratory tract includes the portion of the larynx below the vocal cords, trachea, bronchi and bronchioles. The lungs can be included in the lower respiratory tract or as separate entity and include the respiratory bronchioles, alveolar ducts, alveolar sacs, and alveoli. During sleep, the muscles which control the upper respiratory tract relax. If their relaxation is significant, the respiratory tract is narrowed and this causes the annoying snoring. If it becomes overly narrowed, then there is the likelihood of obstruction of the pharynx, resulting in the partial or even total pause of the respiration. This can last 10 seconds or more, while during the sleep it might occur dozens or even hundreds of times. The lack of air during these obstructive incidents causes the decrease of oxygen in the blood, as a result of which the brain becomes active and thus sleep is constantly interrupted.

How does it affect our body and our life?

“I wake up in the morning as though I haven’t slept…”, “I cannot concentrate…”, “I easily forget…”, “I feel sleepy all the time…”

What are the symptoms of Sleep Apnea?

At nighttime…

• Heavy snoring
• Awakenings with panting, with a feeling of shortness of breath or with a feeling of choking

At daytime

  • Sleepiness
  • Morning headache
  • Fatigue
  • Muscle pains
  • Loss of concentration
  • Memory problems
  • Behavioural disorders
  • Stress
  • Sleeping at inappropriate hours
  • Irritability

 Which dysfunctions and illnesses are related to Obstructive Sleep Apnea?

  • Fibromyalgia
  • Gastric problems / disorders of the stomach
  • Erectile dysfunction
  • Saccharin diabetes
  • Weight control problems
  • High arterial tension
  • Arrhythmias
  • Myocardium infarction
  • Cerebral vascular incidents
  • High cholesterol and triglycerides
  • Depression 

What are the main factors that cause predisposition for Obstructive Sleep Apnea?

  • Obesity
  • Problems of nasal obstruction or narrowness (e.g. inflammations, allergies, polypuses, neoplasms, Nasal turbinate hypertrophy and scoliosis of the nasal diaphragm)
  • Gender – In men, sleep apnea appears 7-10 times more often relative to women
  • Age: In older people, mainly over the age of 40, the muscle tone of the tissues is gradually lost as a result of which the respiratory tracts relax excessively
  • Alcohol consumption is a cause of the relaxation of the muscles of the respiratory tract
  • Smoking causes swelling to the tissues of the pharynx and over-secretion of gastric fluids
  • Increased neck and waist perimeter
  • Menstruation after menopause
  • Craniofacial abnormalities and facial deformities
  • Crouzon, Down & Pierre Robin Syndromes


Obstructive Sleep Apnea and Children

It can be diagnosed from the first year of age up to adolescence. It is more frequent in children between the ages of two and eight years old.

Why is it caused?
The main reasons which cause Obstructive Sleep Apnea to children are the hypertrophic tonsils and the adenoid vegetations.

Boys or girls?
In children, Obstructive Sleep Apnea is presented with the same percentages in girls and in boys.
The following video shows a case of a three years old child with severe form of apnea.

Which are the incidences?
Obstructive Sleep Apnea is in many cases responsible for the impaired performance of the child at school, as sleepiness prevents it from concentrating, while it is also linked to increased percentages of behavioural disorders such as hyperactivity, learning difficulties, disintegration problems of attention and communication.

How is the diagnosis done?
For the correct diagnosis of the disease, a visit to a specialized pneumonologist is required. The investigation can be initially done with overnight oximetry, meaning the recording of the oxygen of the blood during sleep.  The best and most integrated method is the Polysomnography Sleep Study (Polysomnography).  In a quiet, specially designed room, during his /her sleep the patient is examined with the use of a contemporary polysomnographer and under the supervision of specialized medical personnel. During the Polysomnography Sleep Study, continuous measurements and observations are done, such as electrocardiogram, electroencephalogram, electromyogram, observation and recording of the movements of the thorax, abdomen, eyes, limbs and of the whole body in general. The flow of air in the nose and the mouth, during the inhalation and exhalation, the respiratory effort and the levels of saturation of oxygen in the blood are also recorded. The results of the Polysomnography Sleep Study will also determine the method of the required treatment.

How is Obstructive Sleep Apnea treated?

Mild form of Obstructive Sleep Apnea
The patient wears a special Herbst type orthodontic mechanism, during sleep. The mechanism gradually pushes the mandible forward, thus helping in the opening of the respiratory tract resulting in easier breathing.

Moderate and severe forms Obstructive Sleep Apnea
A very effective way of treatment of Obstructive Sleep Apnea is with the supply of a continuous flow of air with the CPAP (Continuous Positive Airway Pressure) device. The device is placed next to the bed and through a small opening it continuously, gently and silently supplies air under pressure. Thus the airways are maintained open, breathing is smooth and the sleep is not interrupted.

Special cases
In selected cases special surgical techniques are implemented. For instance, if the skeleton of the face of the patient is the cause of the problem, then dealing with the problem requires the help of an oral and maxillofacial surgery. For example, if the problem is located in the hypoplasia of the maxilla and of the mandible, then their movement to the proper position creates sufficient space for the respiratory tract, thus solving the problem.

Changing habits
It is worth noting that, the change of habits of a patient is especially significant for the more effective treatment of Obstructive Sleep Apnea.  The meticulous nutrition and exercise will help in the decrease of body weight in case of obesity. The avoidance of alcohol consumption, the reduction or the quitting of smoking, are also actions which will significantly help in the treatment when they are implemented combined with the methods which were described above.

Who should I consult?

The diagnosis and complete treatment of Obstructive Sleep Apnea is taken on by a specialised medical team which is comprised of special medical experts: Pneumonologist,  Oral and Maxillofacial Surgeon and Orthodontist

For the instances of Obstructive Sleep Apnea which occur due to the hypertrophy of the tonsils or due to problems of the nasal cavity, the collaboration with an Ear Nose and Throat (ENT) doctor is required.


Interesting Statistics but scary as well!

Snoring – In people over the age of 40 – 60% men, 40% women

Obstructive Sleep Apnea– In people over the age of 40 – 6% men, 4% women

The above percentages rise up to even 25% in people who are 65 years old.

  • More than 35% of patients with Obstructive Sleep Apnea also suffer from arterial hypertension increasing the risk of a heart decease
  • 83% of people who have hypertension have Obstructive Sleep Apnea as well
  • 70% of people with an infarction of the myocardium have Obstructive Sleep Apnea
  • A person that suffers from Obstructive Sleep Apnea is seven times more likely to be involved in a car accident due to impaired concentration than a person that sleeps adequately.
  • Most patients with Obstructive Sleep Apnea have not been diagnosed

Click HERE to watch our VIDEO

Click HERE to see our Obstructive Sleep Apnea CASES

Useful link: http://pneumoncy.com/

Do you think that you may suffer from Obstructive Sleep Apnea Syndrome?
Call us at 25761010 or e-mail us at info@ccmfc.com