Does your bed partner complain that you snore loudly or gasp for air in the middle of the night? Have you been nudged awake or kicked to the couch because your loved one can’t sleep? These are telltale symptoms of obstructive sleep apnea, and if you suspect you may have the condition, the person lying beside you may be your best ally.
Courtney Chou, MD, a sleep surgeon and an Assistant Professor of Otolaryngology at the Icahn School of Medicine at Mount Sinai, urges people to take this feedback seriously.
“Bed partners are an important referral source,” says Dr. Chou. “People with sleep apnea are often unaware of nighttime symptoms like snoring or interruptions in their breathing. And many either do not experience daytime symptoms, like drowsiness and difficulty concentrating, or think something else is to blame.”
What is obstructive sleep apnea?
Affecting as many as 22 million people in the United States, obstructive sleep apnea (OSA) is a serious sleep disorder that causes your breathing to repeatedly start and stop throughout the night. The condition occurs when the muscles of the upper airway relax and block the flow of air, which prevents your body from getting the oxygen it needs and causes you to wake up repeatedly during the night.
These nighttime disruptions can negatively affect the sleep of the OSA sufferer and can put a significant strain on relationships. In fact, frustrated companions are often the reason patients eventually visit a doctor.
“Bed partners end up suffering tremendously,” she adds. “They may struggle to fall asleep or stay asleep. Some couples end up sleeping in separate rooms.”
How do I know if my snoring is obstructive sleep apnea?
Consistent snoring, pauses in breathing, or gasping for air in the middle of the night are common symptoms of the condition and should be evaluated by a physician. If left untreated, sleep apnea can lead to serious complications. For instance, individuals with OSA are more likely to have high blood pressure, stroke, heart disease, and diabetes.
That being said, it is hard to make a diagnosis from symptoms alone. To know for sure, Dr. Chou explains, you need a sleep study. In the past, patients had to stay overnight at a sleep center for testing. But today, for most patients, a sleep study is performed at home using minimally invasive equipment, sometimes requiring only a special finger and wristband gadget that is connected to a smartphone. Home sleep tests record the number of times your breathing is interrupted throughout the night, revealing if you have OSA and, if so, how severe it is.
“I believe a lot of my patients would have come in sooner if they knew about home sleep studies,” explains Dr. Chou. “I have done it myself, and it was easy and comfortable. I don’t think anyone should be nervous about having a sleep study.”
How is obstructive sleep apnea treated?
If you are diagnosed with sleep apnea, there are three types of treatments that can help. Dr. Chou likes to start with the least invasive treatment.
- CPAP (continuous positive airway pressure) therapy has long been the gold standard treatment for OSA. This is a machine that uses air pressure to keep the airway open throughout the night. Patients wear a mask while sleeping—placed over the nose or both the nose and mouth—that connects to this device. Although several options and models are available, research shows that only half of patients can tolerate sleeping with the mask.
- Oral appliances are an alternative to CPAP machines or are sometimes used in conjunction with a CPAP device. Oral appliances are worn in the mouth to reposition your lower jaw while you sleep. These appliances are made by a dentist and molded specifically to fit your teeth.
- Surgery is recommended when noninvasive therapies fail to provide relief or patients struggle to successfully use CPAP, oral appliances, or both. There are numerous options that open, reshape, enhance, or stimulate the upper airway and eliminate symptoms like snoring and breathing interruptions.
What are the surgical options to treat sleep apnea?
The type of surgery required depends on the severity of your symptoms, the severity of the condition, and your unique anatomy. Dr. Chou works closely with patients to decide what procedure is right for them.
- Soft tissue procedures—Dr. Chou likes to compare the upper airway to a house. With soft tissue surgeries, the goal is to make more room by throwing out furniture or making it smaller. This may involve nasal, palate, or tonsil surgery, which creates more room in the passageways for air to flow.
- Skeletal surgeries—With skeletal surgeries, the goal is to make the house bigger by building it out as you would by adding a new room. These more extensive operations include widening or forward movement of the jaws and chin advancement. The goal of these surgeries is to improve the position, balance, and movement of the upper airway.
- Neurostimulation/Hypoglossal Nerve Stimulator—Inspire ™ therapy is a newer therapy that has been approved by the United States Food and Drug Administration. It stimulates the base of the tongue to expand the airway. Like a pacemaker, the device is surgically implanted into your chest and connected by a wire to the upper airway. You can control the device using a remote device. Mount Sinai’s Division of Sleep Surgery was one of the early adopters of Inspire therapy.