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FACTs TO KNOW ABOUT OSA

What is Obstructive Sleep Apnea?

Obstructive Sleep Apnea (OSA) occurs when air is blocked from entering the lungs during sleep. For air to get to the lungs it must first go through the “upper airway” (airway). The airway includes the nose, mouth and parts of the mouth behind the tongue that cannot be seen without special instruments.

The airway is similar to a tube, and some parts have the tendency to collapse (see the diagram at right). The area behind the tongue in the diagram shows a common site of collapse. When it occurs behind the tongue air cannot get from the nose or mouth into the lungs. To prevent collapse, there are muscles in the airway that keep the airway open.

During the day these muscles work completely. However, when a person sleeps, these muscles relax. Normally the airway stays open even when the airway relaxes. In people with OSA, the airway collapses or is close to collapsing when the airway muscles relax. The diagram to the right depicts the cycle of OSA.

What causes OSA?

The Role of Weight

  • Putting on weight increases the tendency for the airway to collapse. The reasons are not completely known.

  • Fat can accumulate in the tissues surrounding the airway, just as fat accumulates in other parts of the body. The accumulation of fat can change the shape of the airway rendering it more likely to collapse.

  • Thus, it is not surprising that some studies have found that persons with a large neck are at higher risk for sleep apnea. Typically men with a neck size of approximately 17 inches or higher and woman with a neck size of approximately 16 or higher may be a risk for OSA.

Jaw/Facial Structure

  • Certain jaw or facial structures or attributes, such as a recessed chin may cause OSA. The shape of the jaw is important. When the jaw is small, the tongue sits further back in the mouth. This increases the tendency for the tongue to pinch off airflow during sleep.

Alcohol and Medications

  • Alcohol and some medications relax airway muscles.

  • Drinking alcohol can worsen or tip someone into obstructive sleep apnea.

Extra Tissue

  • Extra tissue in the back of the throat, such as large tonsils or uvula can partially block the airways.

  • This condition is more prevalent in children.

Sleep Position

  • When lying on your back, gravity pulls the tongue toward the back of the mouth. This, too, increases the tendency for the tongue to pinch off airflow during sleep. Some people have obstructive sleep apnea or have more severe sleep apnea on their back.

Smoking

  • Smoking irritates the tissues of the upper airway, and can cause them to swell. Swollen tissues increase the chances of physically narrowing the airway.

Who suffers from sleep apnea?

  • Sleep apnea affects over 18 million Americans

  • All chronic sleep disorders combined affect over 40 million Americans

  • Sleep apnea is as common as diabetes or asthma

  • >10% of people with sleep apnea have been diagnosed

  • Poor sleep is a leading cause of depression

  • 80% of drug resistant hypertensive patients have sleep apnea

  • 73% of type II diabetics

  • 50% of congestive heart failure patients

  • 40% of all hypertensive patients

  • 30% of coronary artery disease patients

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