Obstructive Sleep Apnea (OSA): Exploring the Condition That Affects Nearly 1 in 3 Singaporeans
Research has revealed that 1 in 3 Singaporeans struggle with Obstructive Sleep Apnoea (OSA). It occurs when breathing frequently stops and starts during slumber.
Obstructive sleep apnea (OSA) is a respiratory condition characterised by temporary pauses in breathing, which arise from significant reductions in airflow through the upper airways during sleep. Airway obstruction can have a serious impact on a person’s overall health and quality of life, putting them at greater risk of contracting diseases such as congestive heart failure and stroke. Let’s take a closer look at obstructive sleep apnea, a disease that’s estimated to affect 1 billion people worldwide. In this article, we’ll cover OSA’s symptoms, causes, and consequences, as well as the methods for diagnosing and treating this sleep-related breathing disorder.
Obstructive Sleep Apnea (OSA) arises from various factors that lead to the narrowing or closure of the airway during sleep. Key causes include:
Diagnosis often involves identifying more than five apneas or hypopneas per hour, especially if observed by others or resulting in health issues. If you’re concerned about yourself or a loved one, contact Nuffield ENT and get assessed by our doctors.
The following factors contribute to your risk of getting OSA.
Obstructive Sleep Apnea (OSA) varies by severity and age group, affecting both children and adults. The distinctions between mild, moderate, and severe OSA, as well as Pediatric OSA, lie in the frequency and impact of symptoms rather than the fundamental nature of the disorder.
The severity of obstructive sleep apnea is based on a score from a scale known as the apnea-hypopnea index (AHI). This index calculates the average number of times you have episodes of apnea and hypopnea for every hour you’re asleep.
Stage of OSA | Diagnostic Criteria |
Mild obstructive sleep apnea | AHI: >30 per hour. |
Moderate obstructive sleep apnea | AHI: 15-30 per hour. |
Severe obstructive sleep apnea | AHI: 5-15 per hour. |
Recognizing and addressing the symptoms of Obstructive Sleep Apnea (OSA) is essential for reducing its health risks and enhancing quality of life. Symptoms indicative of OSA include:
Addressing these symptoms promptly can significantly improve health outcomes and mitigate the risks associated with OSA.
OSA is associated with various risks, such as elevated blood pressure, diabetes mellitus, cardiovascular diseases, and even memory issues. Here are some ways in which it is diagnosed.
When diagnosing obstructive sleep apnea (OSA), specialists typically look at:
The physical examination of a patient with obstructive sleep apnea includes an assessment of the anatomy of the throat, weight, neck circumference, and oral and throat cavity. The doctor also measures blood pressure, inspects the skin for oxygen saturation, and checks reflexes. These measures, along with home sleep apnea testing, help identify signs and factors associated with OSA, determine the stage of the condition, and facilitate the selection of the most effective treatment.
Specialists need to conduct a detailed sleep study in patients with apnea, starting with collecting a history of sleep quality. They study obstructive sleep apnea diagnosis criteria and ask questions about sleep patterns, duration, and nighttime awakenings.
Doctors may also use oxygen and breathing monitoring to detect apnea episodes and assess blood oxygen levels, which are crucial for understanding the health implications of OSA. Reduced oxygen levels during sleep can lead to various health issues, including cardiovascular diseases, cognitive impairment, and metabolic disorders.
The STOP-Bang Questionnaire serves as a practical tool for clinicians to screen for potential obstructive sleep apnea (OSA) in individuals. It includes eight dichotomous queries that reflect the primary risk elements for OSA. The acronym STOP-Bang encapsulates key indicators or characteristics often linked with the disorder:
This assessment is designed to streamline the preliminary identification process for OSA in a clinical setting.
Home Sleep Apnea Testing is a method of diagnosing sleep apnea conducted in home settings. Patients are provided with portable devices for sleep monitoring, which measure brain activity, breathing, pulse, oxygen levels, and body position. These devices offer a more comfortable and natural environment for falling asleep than polysomnography in specialised laboratories. Doctors analyse the data collected to detect the presence of apnea and determine its characteristics.
Nuffield ENT is always ready to help. If you’re struggling with the lack of sleep, schedule a consultation with our friendly team.
Continuous Positive Airway Pressure (CPAP) is a standard severe obstructive sleep apnea treatment. The device consists of a pump connected to a mask that fits snugly over the patient’s nose or nose and mouth. During sleep, CPAP maintains constant pressure in the upper airway, preventing tissue collapse and ensuring unobstructed breathing. CPAP not only reduces loud snoring and morning fatigue but also lowers the risk of cardiovascular complications associated with apnea.
Bilevel Positive Airway Pressure (BiPAP) represents an advanced form of respiratory therapy. The device also consists of a pump and mask, but unlike CPAP, BiPAP provides two pressure levels for inhalation and exhalation. This allows patients to breathe more comfortably, especially beneficial for those experiencing difficulty exhaling. BiPAP is widely used for severe cases of apnea and in patients with other respiratory disorders. This therapy method can be adjusted according to the patient’s needs, providing a more personalised approach to treatment.
Automatic Positive Airway Pressure (APAP) is a modern treatment method for sleep apnea, combining the advantages of CPAP and BiPAP. The device automatically adjusts the pressure level in the airway based on the patient’s needs, dynamically adapting it during sleep. It more accurately maintains airway patency, particularly useful during changes in body position or sleep stages. APAP is more comfortable for the patient, providing effective apnea treatment and minimising potential side effects.
If conservative treatment is of little help or not helpful, doctors offer surgical intervention to patients. Let’s consider each type of surgical treatment for the pathology in more detail and highlight its essential characteristics.
This often involves correcting septal deformities, reducing the size of nasal turbinates, and removing polyps to improve airway patency. The intervention aims to eliminate obstacles that may obstruct the upper airways, especially in the nasal area.
Typically, it involves removing tonsils and adenoids, especially in children, to improve breathing. This procedure, known as tonsillectomy and adenoidectomy, reduces the likelihood of airway blockage during sleep and decreases apnea frequency.
The essence of the intervention is to remove obstacles in the back of the throat and pharynx. This may include strengthening or reconstructing tissues.
Involves creating an opening in the trachea directly below the throat to provide direct access to air. It is used for severe cases of apnea when other treatment methods are ineffective. Tracheostomy ensures unobstructed airflow, bypassing the upper airways, and may be a temporary or permanent solution depending on the severity of the case and other indications.
This surgical manipulation, known as genioglossoplasty, aims to improve the space in the back of the throat. It involves redistributing or increasing the volume of soft tissues, reducing the likelihood of apnea recurrence.
Central Sleep Apnea (CSA) and Obstructive Sleep Apnea (OSA) are distinct disorders, differing mainly in their causes and mechanisms, yet both significantly impact sleep quality and overall health. Here’s how you can differentiate between the two.
Оbstructive sleep apnea diagnosis criteria | Central Sleep Apnea | Obstructive Sleep Apnea |
Cause | Closure of the upper airways | Absence of brain signal for breathing |
Mechanism | Physical obstruction of airways | Disruption of central respiratory control |
Snoring | Characterised, often by pronounced snoring | Usually absent or mild |
Diagnosis | Polysomnography (PSG) examination | Polysomnography (PSG) detecting central apneas |
Treatment | Typically involves CPAP and surgical methods | Often requires BiPAP or adaptive devices, treating the underlying cause |
Prognosis | Complications such as arterial hypertension, stroke are possible | Associated with more serious conditions and necessitates individualised treatment approach |
High blood pressure
Heart disease
Heart attack
Stroke
Type 2 diabetes
FAQ
Yes, the condition may be recognised as a disability if it significantly restricts everyday activities and work capacity.
Genetics can influence the anatomical features of the upper airways, increasing the risk of developing OSA.
The condition can lead to daytime sleepiness, fatigue, reduced concentration, and efficiency. Memory and mood problems may also arise.
No, while not always curable, treatments like CPAP devices, surgery, or lifestyle modifications can manage symptoms effectively.
If left untreated, obstructive sleep apnea could lead to serious health problems, including cardiovascular diseases, high blood pressure, or stroke.
Encourage your loved one to adhere to medical advice, help them to set up a calm sleeping environment, and promote healthy lifestyle choices.
Yes. ENT specialists are skilled in treating airway issues, making them invaluable for diagnosing and managing OSA.
Seek medical help if you experience loud snoring, prolonged pauses in breathing during sleep, or daytime sleepiness.
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