During sleep, the muscles at the base of the throat relax, causing obstruction of the airway, with extremely loud snoring and labored breathing. When complete blockage of the airway occurs, breathing stops. The obstruction to breathing prevents patients from reaching deeper stages of sleep, causing the symptoms of daytime drowsiness. Obstructive sleep apnea occurs most frequently in obese middle-aged men. Contributing factors may include use of alcohol or sedatives before sleep, anatomically narrowed airways, and massively enlarged tonsils and adenoids. Sleep apnea affects at least 2% of females and 4% of males in our society (Young et al., 1993). The classical presentation of obstructive sleep apnea in the adult is the presence of snoring shortly after falling to sleep. The snoring proceeds at a regular pace for a period of time, often becoming louder, but then is interrupted by a silent period during which no breathing is taking place (this is called apnea). The apnea is then interrupted by a loud snort and gasp when breathing resumes and then the snoring begins again. This pattern may recur repetitively and frequently throughout the night. During the apneic periods the oxygen level in the blood falls dramatically. Persistent low levels of oxygen (hypoxia) causes the daytime sleepiness. Excessive daytime sleepiness increases the risk for driving accidents, poor job performance, unhappy social relationships, and depressive symptoms (Hudgel, 1989). Serious physical, emotional, and social problems can arise if the apnea is left without treatment for an extended period of time. .
Treatment of Sleep Apnea.
The objective of treatment is to keep the airway open to prevent episodes of apnea during sleep. Weight management and the avoidance of alcohol and sedatives at bedtime may achieve the desired results in some individuals. If these measures are unsuccessful in stopping sleep apnea, continuous positive airway pressure involving the use of a specially designed mask worn over the nose and mouth at night, may be prescribed by a physician.
