What Are The Causes of Obstructive Sleep Apnea And What Can Be Done About Them?
- Posted on: Sep 25 2018
Obstructive Sleep Apnea, also known as OSA, is a very common disorder where the upper airway collapses during sleep. This collapse prevents the movement of air in to the lungs causing a drop in the blood oxygen levels. The drop in the oxygen creates arousals from deep sleep to light sleep leaving the patient unrestored and tired during the day. It also causes many health issues such as cardiac arrhythmia, heart attack, hypertension, diabetes, and weight gain. Frequently, the patient with OSA snore loudly so the bed partner is also disrupted at night.
Risk Factors for OSA
You may have been told you have OSA based upon a sleep study but may not have been told the reason why.
OSA is muti-factorial, meaning it has many causes. Typical factors that contribute to OSA include:
- Nasal and sinus blockage
- Long floppy soft palate and uvula
- Large tongue base
- Tonsil enlargement
- Large neck circumference
Nasal and Sinus Blockage
Nasal and sinus blockage actually cause the airflow through the nose to become faster and more turbulent. This fast and turbulent air reaches the back of the throat and cause vibration of the soft palate and actually stretches the uvula long in to the airway. The rapid and turbulent air also creates a suction current that sucks the tongue base back in to the airway. Nasal and sinus issues such as septal deviation, allergic turbinate swelling, nasal polyps, chronic sinusitis, and sinus outflow narrowing all worsen snoring and sleep apnea.
Soft Palate and Uvula
As the soft palate and uvula become stretched and long over time, typically from nasal and sinus blockage, it hangs down in to the available airway. This contributes to OSA and also creates loud snoring.
Some people naturally have a large tongue. This can run in families. Also other people may have a normal tongue but the jaw is small relative to the tongue size and therefore the tongue will crowd the available airway. Gaining weight also enlarges the tongue base as fat can accumulate in this location.
Large tonsils crowd the available airway as well and can worsen OSA. This may also be associated with chronic tonsil stone formation and halitosis.
Large Neck Circumference
The physical finding that best correlates with OSA is a large neck circumference. A neck that is very muscular or thickened from weight gain literally squeezes the airway closed limiting the cross-sectional diameter and creating OSA.
Lastly, obesity worsens OSA by enlarging the tongue, increasing the neck circumference, and creating belly fat that makes the diaphragm have to work harder to move the airflow through the airway.
OSA Treatment Options
OSA can be treated with Continuous Positive Airway Pressure (CPAP), which creates a positive pressure in the airway to prevent collapse. Unfortunately many patients cannot tolerate this form of therapy.
We have created customized solutions for patients with OSA who cannot tolerate CPAP, by addressing the factors most important for them.
- Advanced Balloon Sinuplasty procedures, in our office under IV sedation, can correct the anatomical factors in the nose and sinus to reduce snoring and OSA.
- Modern, minimally invasive, palatoplasty allows us to trim the uvula and inject a specialized stiffening agent to the soft palate to make it higher, tighter, and stiffer. This also improves snoring and OSA.
- Customized oral appliances, created by sleep dentists, can help hold the jaw and tongue base forward at night to reduce snoring and OSA.
- Tonsillectomy can be performed to help open the airway as well in cases where that is contributing to the snoring and OSA.
- Lastly obesity is a direct byproduct of the OSA, as the OSA causes hormonal changes to insulin, growth hormone, testosterone, and cortisol. As we work on the other factors it will help the patient lose weight and keep it off.
Schedule a Consultation
If you have been diagnosed with OSA and cannot tolerate CPAP come see us for a thorough evaluation of the options available to treat the OSA. Call us today at (512) 601-0303 to schedule your consultation.
Posted in: Sleep Apnea