Sleep apnea is a common sleep disorder that disrupts breathing during sleep, leading to chronic fatigue and reduced quality of life. This fatigue can make concentrating, staying productive, or enjoying daily activities harder.
While commonly associated with adults, sleep apnea can also affect children, though its symptoms and causes often differ. In adults, it is frequently linked to lifestyle factors such as obesity, smoking, or alcohol use, presenting classic signs like loud snoring, breathing pauses, and daytime fatigue. In contrast, childhood sleep apnea is more typically caused by enlarged tonsils or adenoids, and children might not exhibit the same noticeable symptoms as adults.
How Is Sleep Apnea Diagnosed in Adults?
To diagnose sleep apnea, the doctor will assess your symptoms (like snoring, gasping for air, or daytime fatigue) and risk factors (such as obesity or family history). Additionally, diagnostic tests may be performed to confirm the diagnosis. These may include:
- Sleep Apnea Test (Home Sleep Apnea Testing): This is a simplified test you do at home. It monitors your breathing patterns, blood oxygen levels, and heart rate to check for sleep apnea. HSATs are less comprehensive than lab tests, but are great for initial screening.
- Polysomnography: Considered the "gold standard" for diagnosis, polysomnography is an overnight study conducted in a sleep lab. It comprehensively monitors multiple body functions, including brain waves (to identify sleep stages), heart rate, breathing patterns, and blood oxygen levels, providing essential data to diagnose obstructive sleep apnea (OSA) and determine its severity.
- Oximetry: This test measures your blood oxygen levels. It is often included in a polysomnography or used alone to detect oxygen desaturation during sleep, which can indicate potential apnea episodes.
- Physical Examination: A physical exam helps identify anatomical factors that might contribute to sleep apnea, such as a narrow airway, large tonsils, or obesity. This aids in the diagnostic process.
What Are the Non-Surgical Treatment Options for Sleep Apnea?
Lifestyle Modifications
Lifestyle changes are often the first line of defence in managing sleep apnea, particularly for individuals with mild to moderate cases or those with specific risk factors like obesity. These modifications target underlying contributors to airway obstruction and can significantly reduce the severity of symptoms.
- Weight Loss: Excess weight, especially around the neck, is a major risk factor for OSA as it increases pressure on the airway, causing it to collapse during sleep. Losing weight can lower the Apnea-Hypopnea Index (AHI) by reducing fat around the airway.
- Avoiding Alcohol and Sedatives: Alcohol and sedatives can relax throat muscles, worsening airway obstruction and sleep apnea symptoms.
- Sleeping Position Changes: Many people with OSA experience worse symptoms when sleeping on their back, as gravity causes the airway to collapse. Positional therapy, like sleeping on your side or using devices to prevent back sleeping, can reduce apnea events and improve sleep quality.
CPAP Therapy (Continuous Positive Airway Pressure)
CPAP therapy is widely used for treating moderate to severe OSA due to its high efficacy in preventing airway collapse. It uses a machine to deliver a steady stream of air through a mask over the nose or mouth, keeping the airway open during sleep. This prevents apneas and maintains oxygen levels, thereby improving sleep quality and reducing symptoms like daytime sleepiness and cardiovascular risks.
Oral Appliances for Sleep Apnea
Oral appliances provide a non-invasive alternative to CPAP, particularly for patients with mild to moderate OSA or those who cannot tolerate CPAP.
Mandibular advancement devices (MADs) are custom-fitted oral appliances designed by a dentist to move the lower jaw and tongue forward, thereby preventing airway collapse during sleep. These devices cover the teeth and are adjusted to find the optimal jaw position, which is often confirmed through a sleep study.
Medications & Other Non-Invasive Options
While no medications directly cure OSA, certain drugs and therapies can manage symptoms or address underlying conditions contributing to the disorder.
- Medicine for Sleep Apnea: Certain medications may be prescribed to reduce daytime sleepiness and improve alertness. When combined with diet and exercise, it curbs appetite, aids weight loss, and addresses a key risk factor.
- Oxygen Therapy: Supplemental oxygen therapy may be used for selected patients to maintain blood oxygen levels during sleep. However, it is not a primary treatment for OSA.
When Is Surgery Needed for Sleep Apnea in Adults?
Surgery may be considered for adults with sleep apnea when other treatment options, such as CPAP therapy or oral appliances, have not been effective or well-tolerated. It is usually recommended for patients with anatomical abnormalities contributing to airway obstruction, such as enlarged tonsils, a deviated septum, or excess tissue in the throat. Common surgical treatments for sleep apnea include:
- Uvulopalatopharyngoplasty (UPPP): This procedure involves removing excess tissue from the soft palate, uvula, and sometimes the tonsils to widen the upper airway and reduce obstruction during sleep.
- Genioglossus Advancement: This surgery repositions the genioglossus muscle (a major tongue muscle) by advancing its attachment to the lower jaw. This prevents the tongue from collapsing backwards and blocking the airway during sleep. It is often used for patients with tongue-based obstruction.
- Palatoplasty: This procedure reshapes or stiffens the soft palate to reduce airway collapse. It is typically recommended for mild OSA cases and can be performed as an outpatient procedure with minimal recovery time.
- Laser Treatment for Sleep Apnea: Laser-assisted uvulopalatoplasty (LAUP) uses laser technology to remove or shrink excess tissue in the throat, such as the uvula or soft palate, to improve airflow. It is less invasive than UPPP but may require multiple sessions and is generally used for mild to moderate cases.
How to Find the Best Sleep Apnea Doctor or Clinic for Adults
Here are some tips on how to find the best sleep apnea doctor or clinic for adults:
- Get Referrals: Start by asking your family doctor for recommendations. You can also ask family members, friends, or colleagues who have received treatment for sleep apnea.
- Research Credentials: Look for doctors who are experienced in sleep medicine or ENT. This ensures that they have specialised training and experience in treating sleep disorders.
- Check Reviews and Ratings: Look up potential doctors' or clinics' reviews and ratings online. This can give you an idea of other patients' experiences.
- Location and Convenience: It is important to find a doctor or clinic that is easily accessible for regular appointments.
- Ask About Treatment Options: Different doctors may have different approaches to treating sleep apnea. Be sure to discuss your preferences and concerns with the doctor.
If you are struggling with sleep apnea, please contact our clinic to schedule a consultation. Dr Barrie Tan specialises in the management of sleep disorders and can personalise your treatment for optimal outcomes.
