Diagnosis

Sleep apnea can be diagnosed and treated. Untreated sleep apnea may increase the risk for hypertension, heart attack or stroke, diabetes and work-related and driving accidents. It can also cause brain damage and result in shorter life span.

As a part of the diagnosis, the doctor will perform a physical examination by checking the mouth, nose and throat for extra or large tissues and take a medical history. He may suggest a sleep recording which is a test that is often done in a sleep disorder center or sleep laboratory.

Tests to detect sleep apnea may include :

Polysomnogram  or PSG is the most common sleep recording used to find sleep apnea. It is a painless test which records the patients brain and muscle activities, eye movements, breathing and heart rate and the amount of air passage to the lungs while they are sleeping. The patients sleep throughout the night is monitored and a sleep medicine specialist will analyze the PSG result to ensure sleep apnea.
Nocturnal polysomnography During this test, you’re hooked up to equipment that monitors your heart, lung and brain activity, breathing patterns, arm and leg movements, and blood oxygen levels while you sleep. Because treatments for other sleep disorders such as narcolepsy and insomnia differ, this test helps your doctor to arrive at an accurate diagnosis.

Oximetry : Using a small machine, this screening test records the oxygen level in the level while you are sleeping. A simple sleeve fits over one of the fingers to collect the information overnight. If you have sleep apnea, the results of this test will show drops in the oxygen level during apneas and subsequent rises with awakenings. all cases of sleep apnea cannot be detected using this test. Even if the result is normal, a polysomnogram may be recommended.

Treatment

Treatment is aimed at restoring regular nighttime breathing and relieving symptoms such as very loud snoring and daytime sleepiness. There are no medicines for the treatment of sleep apnea. For milder cases to reduce the symptoms of sleep apnea, some changes in the daily habits such as avoiding alcohol, smoking, sleeping pills etc are recommended. Weight loss can also improve the symptoms and sleeping on your side may help to keep the throat open.

Treatment for sleep apnea includes :

Continuous Positive Airway Pressure (CPAP) – It is the most common treatment for sleep apnea which may help to stop snoring. In this treatment, the patients must wear a mask over the nose while sleeping. The mask is attached to a small pump and it will blow air into the throat at a right pressure level. During sleep, the increased airway pressure keeps the throat open. CPAP may eliminate snoring and prevent sleep apnea. The condition will return if CPAP is stopped or if it is not used correctly. So before using, with the help of a technician, the CPAP equipment must be properly setup and adjusted based on the doctors order.

CPAP treatment can cause side effects and it may include irritation on skin, dry or stuffy nose, sore eyes, bloating of stomach, headaches etc. If having any side effects, consult the physician.

Dental Appliances :

In this treatment a specially designed dental appliance is used to keep the throat open. It is  recommended for people with mild sleep apnea and a number of devices are available from the dentist. In this treatment, a custom-fit plastic oral appliance will be adjusted between the patients lower jaw and tongue. It will help to keep the airway in the throat open while sleeping.  Air can then flow easily into the lungs because there is less resistance to breathing. Sometimes the treatment may cause damage to the teeth, jaw and gums. Follow up the dentist suggestions, if having any side effects.

Surgery :

In rare cases, surgery may be needed to remove excess tissue from the nose or throat that may be blocking the air passages. The type of surgery depends on the cause of the sleep apnea and some surgical options are :

Uvulopalatopharyngoplasty (UPPP)- In this surgical method, the tissue from the rear of the mouth and top of  the throat are removed. The tonsils, uvula and adenoids are usually removed and this may help in stopping throat structures from vibrating and causing snoring. UPPP may be less effective because tissue farther down the throat may still block the air passage.

Maxillomandibular advancement – This surgery is performed with the cooperation of an oral surgeon and an orthodontist. In this surgery, the upper and lower part of the jaw is moved forward from the remainder of the face bones. This enlarges the space behind the tongue and soft palate, making obstruction less likely.

Tracheostomy – Tracheostomy is performed in severe, life-threatening sleep apnea when other treatments have failed. The surgeon will make an opening in the windpipe and a metal or plastic tube is inserted through which the patient can breathe. During day, keep the opening covered and at night uncover it to allow air to pass in and out of the lungs.

Some surgery can stop snoring but is not helpful in treating sleep apnea. These may include Laser-Assisted Uvulopalatoplasty (LAUP) and  Radio frequency ablation. In LAUP, the tissues in the back of the throat are removed using a laser device. In radio frequency ablation the same procedure is done with radio frequency energy.

Other possible surgeries for sleep apnea includes:

Rebuilding the lower jaw

Surgery to treat obesity

Nasal surgery to remove polyps or straighten a crooked partition between your nostrils (deviated nasal septum)

Surgery to remove enlarged tonsils or adenoids