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Obstructive Sleep Apnea Hypopnea

Kathryn Patricelli, MA

What is Obstructive Sleep Apnea Hypopnea?

A person with this disorder has involuntary pauses in breathing during sleep. When the involuntary pauses occur, air cannot flow in or out of their nose or mouth. These pauses in breathing last at least 10 seconds in adults or 2 breaths in children. A person with this condition will be very tired during the day since they are not getting refreshing sleep.

Symptoms include either #1 or #2 below:

  • 1 - a sleep study test finds that a person has at least 5 episodes of total absence of airflow or reduced airflow per hour during sleep and they have one of the following:
    • nighttime breathing problems including snoring, snorting, gasping, or breathing pauses during sleep
    • daytime sleepiness or feeling unrefreshed even though they had opportunity for enough sleep
  • 2 - a sleep study test finds 15 or more episodes of total absence of airflow or reduced airflow per hour during sleep regardless of whether the person has any other symptoms.

People with this condition may also show symptoms of heartburn, morning headaches, dry mouth, and reduced sexual desire or arousal issues.

The condition can be mild, moderate or severe depending on how many episodes of absent or reduced airflow are present.

How common is Obstructive Sleep Apnea Hypopnea?

This is a very common disorder, which affects 1-2% of children, 2-15% of middle-age adults, and more than 20% of the elderly. It is most common in adults that are 40-60 years of age. Often, someone has been a loud snorer for many years, but it gets more severe and they finally see a doctor and learn they have this condition.

Males are 2 to 4 times more likely to have the condition than females, but these differences are reduced in older age.

What are the risk factors for Obstructive Sleep Apnea Hypopnea?

The biggest risk factors for this condition are being male and being overweight. Those with a parent, brother or sister with the condition have twice the risk of developing the disorder, so there does seem to also be a genetic risk factor.

What other disorders or conditions often occur with Obstructive Sleep Apnea Hypopnea?

Several medical conditions commonly occur with this disorder including heart disease, stroke, diabetes, coronary artery disease and high blood pressure. These medical conditions can increase the risk anywhere from 30% to 300%. Up to 1/3 of the people with this condition also show signs of depression and in many cases it is at moderate to severe levels. Men with the disorder may be more likely to have depression as well.

How is Obstructive Sleep Apnea Hypopnea treated?

There are several treatments available including lifestyle changes, breathing devices and surgery.

If a person has a mild version of this disorder, lifestyle changes may be used. This includes avoiding alcohol and medicines that make you sleepy, losing weight, sleeping on your side instead of your back (helps keep the throat open), using nasal sprays or allergy medicines, and quitting smoking.

Adults with a moderate or severe condition will most often be treated with a CPAP (continuous positive airway pressure). A CPAP machine has a mask that fits over your mouth and nose, or just over your nose, and the machine blows air into the throat. The air pressure helps keep the airway open while sleeping.

Surgery can also be an option to widen breathing passages, and usually involves shrinking, stiffening, or removing excess tissue in the mouth and throat or resetting the lower jaw.

Surgery to remove the tonsils, if they're blocking the airway, can also be helpful for some children with the disorder.

 

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