Obstructive Sleep Apnea (OSA)

Obstructive sleep apnea (OSA) is a disorder in which a person temporarily stops breathing during sleep. It can happen perhaps hundreds of times throughout the course of the night. The gaps in the breathing are known as apneas. The word apnea means the absence of breath. An obstructive apnea episode is defined as the absence of airflow for at least 10 seconds. Sleep apnea is almost always associated with snoring, disturbed sleep, and daytime sleepiness. Usually, people with the condition do not know they have it. Obstructive sleep apnea occurs when the tissues in the upper airways come too close to each other temporarily blocking the flow of air. It is defined as five or more episodes of apnea or hypopnea per hour of sleep in adults who have

excessive daytime sleepiness.
There are other types of Apnea.

Central sleep apnea is not as common as OSA. It is caused by a problem in the central nervous system, most often a failure in the brain to signal the airway muscles to breathe. In cases, oxygen levels drop suddenly and usually the patient wakes with a start. Unlike those with obstructive sleep apnea, people with central apnea remember their awakenings. They experience less sleepiness in the daytime compared to people with obstructive sleep apnea. The causes of central sleep apnea include heart disease and heart failure. Mixed sleep apnea is when both central and obstructive happen at the same time. The third and last type of apnea is Upper airway resistance syndrome (UARS). It is a condition where people snore, wake up frequently throughout the course of the night, and have excessive daytime sleepiness. Nevertheless, they do not have breathing abnormalities characterized with obstructive sleep apnea. They also do not display reduction in blood oxygen levels. Unlike apnea, upper airway resistance syndrome is more common in women than men. But it is treated the same way as those of sleep

apnea.
Obstructive sleep apnea is a relatively common disorder in the United States. It affects people of all ages, but it’s more frequent or popular among middle-aged and elderly. OSA has been associated with different disadvantageous clinical outcomes such as cardiovascular disease including specifically cardiac disease and stroke, hypertension, and non-insulin-dependent diabetes and other metabolic abnormalities, increased likelihood of motor vehicle and other accidents, and decreased quality life. Although OSA is relatively common; it hasn’t been clear how prevalent it is. According to the Wisconsin Cohort Study, a potential natural history study of adults of 30 to 60 years old reported that about 10% had proof of OSA, back when the study began in 1988. Another study by the name of Sleep Heart Study, adults over 40 years who were not being treated for abnormal breathing found that 17% had evidence of obstructive sleep apnea when they were chosen for the study in the 1990s. The 2005 National Sleep Foundation Poll showed that 1 in 4 American adults are at high risk of developing OSA and could have the benefit of getting examined for the condition.
All muscles in the body relax during sleep. People without obstructive sleep apnea do not experience blockage in the airways. However in people with the condition, the airways become temporarily blocked or narrowed during sleep, reducing air pressure as well as preventing air from flowing normally into the lungs. They experience repetitive cycles of upper airway obstruction and recurrent nighttime arousals. It is often due to anatomic anomalies of the nasopharyngeal or mandibular areas which cause the narrowing of the respiratory passages, declined pharyngeal muscle tone that diminish the cross-sectional area of the airway, and insufficient neuromuscular responses to airway obstruction. In adults, people with OSA suffer from obesity. The narrowing is often aggravated because by the space filled with loose areolar tissue around the pharynx is occupied by fat. Even though this is the case, obesity is not always present with obstructive sleep apnea. A significant number of adults with normal body weights have a diminished muscle tone causing airway collapse and sleep apnea. The primary symptom of the condition in adults is excessive daytime sleepiness. Usually, the adult with a severe long term OSA will fall asleep for brief periods throughout or during activities during the day. Occasional, it occurs when the individual is having conversations.
Hypoxia is associated with the condition may cause alteration or change in the neurons of the hippocampus and the right frontal cortex.

Hypoxia refers to the absence of oxygen supply. Using neuro-imaging, research disclosed proof of hippocampal atrophy in people suffering from obstructive sleep apnea. It is found that more than 25% of obstructive sleep apnea cases, this issue results in irreparable problems in mentally manipulating non-verbal information as well as in executive functions and working memory regardless of years spent during continuous positive airway pressure (CPAP) treatment. Hippocampal atrophy is a form of brain damage that impacts or affects both memory and special navigation. It is often associated with memory loss conditions such as dementia and Alzheimer’s

disease.
People with minimal muscle tone, increased soft tissue around the airway, and structural features or characteristics that give rise to a reduced airflow are at risk of OSA. Men with an increased mass in the torso and neck have an increased risk at developing obstructive sleep apnea, more so around middle age and later. Unlike men, obstructive sleep apnea is not common in women. Nevertheless, the cause may be due to the differential levels of progesterone. The popularity in post-menopausal women is as high as those of men in the same age range. Women are more likely to develop OSA during pregnancy. Genes also play a part in obstructive sleep apnea. Individuals with a family history of the condition are more likely to develop it themselves. Smoking can also increase the chances of getting OSA. The reason for this is because the chemical irritants in smoke tend to inflame the soft tissue of the upper airway and develop fluid retention. This can cause blockage or reduction of the upper airway. The exacerbation of OSA can occur due to the consumption of alcohol, sedatives, or other medications that promotes sleep. Most of the drugs are muscle relaxants.
Diagnosis of OSA is significantly more popular among people in relationships. This is because they are aware of the condition in which the person is in and therefore inform them, because individual who experience it are unaware that they have it. Because it involves noisy snoring, it can be disruptive to bed partners and also affect their quality of sleep. Like the person with the condition, the spouse can also experience sleeplessness and fatigue. AHI, the number of the hourly apnea and hypopnea episodes during sleep, when combines with determinations of obstruction, is the main measurement used to diagnose OSA. It can be measured by polysomnography (PSG) in a sleep laboratory or by portable monitors in other places. AHI can vary from night to night or between settings and doesn’t take into report symptoms, comorbidities, or results from treatment.
The diagnosis of the condition is based on a combination of an individual’s history and tests. The current diagnostic standard in clinical practice is PSG. The formal diagnosis of sleep apnea required a comprehensive, technologist-attended sleep study with multichannel PSG in specialized sleep labs. Laboratory-based PSG records a variety of neurophysiologic and cardiorespiratory signals that read by trained technologists and interpreted by sleep physicians after a diagnostic sleep study has been completed.