Obstructive sleep apnea, a condition that interferes with or halts breathing during sleep, can lead to moderate or even severe medical conditions from hypertension to depression. And it is a condition that is common among the American population.

When we are awake and conscious, we are aware of our breathing process and can control the rate and rhythm of breathing. However, during sleep breathing is controlled by the respiratory brain centers and is a totally involuntary action that cannot be controlled.

In sleep apnea, there is interference in the normal regular breathing process during sleep, leading to an interruption in breathing during sleep.

With obstructive sleep apnea, some part of the lumen of the respiratory tract is narrowed to such an extent that it partially or completely collapses and the breathing process in interfered with or comes to a halt.

Besides affecting the quality of life, obstructive sleep apnea gives rise to a number of moderate to severe medical conditions like hypertension, angina, nocturnal cardiac arrhythmias, myocardial infarction, stroke, emotional probelms, depression, mood disorders, poor memory, and irritability not to mention daytime drowsiness that affects the ability to effectively work, drive or operate any kind of equipment.

Obstructive sleep apnea is a comon condtion, affecting about four per cent of American adults - about one in 25 people. While the condition has a high prevalence among the general population, 80 per cent of people with the disorder are left undiagnosed because many people are either unaware of their problem or neglect the condition.

Obstructive sleep apnea, which can affect any age person even children, is seen more in overweight individuals but it may also be seen in individuals of normal weight who have other anatomic conditions like enlarged tonsils and adenoids, macroglossia (enlarged tongue), or abnormal positioning of the maxilla and mandible. Recent studies have also shown that obstructive sleep apnea is frequently seen in patients suffering from congestive heart failure.

Signs and symptoms of obstructive sleep apnea include the following:
• loud snoring that is usually unnoticed by the patient but disturbs the bedroom partner
• gasping and choking noises during sleep
• disrupted sleep with frequent awakenings
• frequent nightmares (especially children)
• dry mouth, sore throat or headache after waking up in the morning
• excessive daytime sleepiness
• high blood pressure

Physical examination and weight measurement can provide some information about the possiblity of obstructive sleep apnea but there are other tests that should be conducted to confirm the condition. The primary test to evaluate obstructive sleep apnea is the Nocturnal Polysomnography (overnight sleep study) which involves monitring of different events during sleep like eye movements, chest wall movements and EEG.

Treatment of obstructive sleep apnea largely depends on the severity of the condition and varies from one individual to another. Generally speaking, conservative measures for mild cases include the following:
• weight loss therapy is important treatment in the case of overweight patients and can improve symptoms in many patients
• sleeping in lateral positions (sleeping on your side)
• avoid alcohol four to six hours before bedtime
• quit smoking
• avoid sleep medications

In more severe case of obstructive sleep apnea, the condition requires specific treatment which includes the following measures:
• Nasal continuous positive airway pressure which is a nasal mask worn during sleep to keep the airway patent by providing positive air pressure into the airway.
• Oral and dental appliances to manipulate the jaw bone in such a way that it enlarges the posterior airspace.
• Oral surgery that involves widening the airway by removing excess soft tissue from the throat or by removing enlarged tonsils and adenoids if they are the cause of the problem.
• Laser assisted removal of soft tissue.

Most patients with obstructive sleep apnea can be treated effectively with one of these treatments, although, some people may require more than one modality of treatment.