Obstructive Sleep Apnea

• Obstructive Sleep Apnea/Hypopnea Syndrome (OSA) is characterized by loss of pharyngeal muscle tone during sleep resulting in repeated obstruction of the upper airway
• Risk factors for OSA include obesity, congenital defects, ENT abnormalities, hypothyroidism, and family history
• Symptoms of OSA include excessive snoring, observed apneas (stop breathing during sleep), choking or gasping sensations at night, excessive daytime sleepiness, morning headaches, fatigue, and poor concentration
• Signs of OSA may include obesity, hypertension, and cardiac dysfunction
• Complications of OSA can lead to hypertension (loss of nocturnal dipping), atherosclerosis, pulmonary hypertension, DVT, arrhythmias, and strokes
• Diagnosis of OSA involves clinical suspicion and an overnight sleep study (Polysomnogram) to determine the apnea/hypopnea index (AHI)
• If AHI is:

  • > 5/hour: Mild OSA
  • 15 – 29/hour: Moderate OSA
  • ≥ 30/hour: Severe OSA
• Treatment for OSA includes therapy with continuous positive airway pressure (CPAP) devices, surgery for specific indications, treating co-morbid diseases, and avoiding hypnotic medications that may worsen OSA, especially benzodiazepines and opioids