EAR, NOSE & THROAT UPDATE
OBSTRUCTIVE SLEEP APNEA STEALS AWAY A GOOD NIGHT’S SLEEP

By Jeffrey Raval, MD
Face it. We all need a good night’s sleep. But people suffering from obstructive sleep apnea find it hard to remember the sensation of a night of deep and restful z’s.

Instead, a person with obstructive sleep apnea gets the equivalent rest of someone who is trying to sleep but is shaken awake every 20 minutes. Because of their fitful night spent trying to sleep but failing, they awake feeling exhausted. They frequently report headaches. They actually can have difficulty concentrating during the day because of their fatigue. An worse yet, it’s how they feel all of the time. In the worst cases, obstructive sleep apnea can lead to depression.

Obstructive sleep apnea takes routine snoring to the next most destructive level. It’s caused by the tissue in the back of the throat blocking off the airway. That happens because when we fall asleep, all of our muscles relax, including those in the throat.

For the person with obstructive sleep apnea, their oxygen level drops and their carbon dioxide level builds up. The brain will actually startle them into waking up rather than to stop breathing altogether.

Obstructive sleep apnea happens more to men that women and increases with age. Obese people, especially, suffer from obstructive sleep apnea because the more fat in the neck, the narrower the airway gets.

The first course of treatment is lifestyle change. Lose weight and exercise. Patients who can’t lose weight can wear a CPAP (Continuous Positive Airway Pressure) mask while sleeping. The mask literally blows air into the throat. As you can imagine, the CPAP is uncomfortable and most patients just can’t tolerate the mask.

Another option is to have a mouth guard constructed by an oral surgeon that effectively moves the tongue forward and thus keeps the airway open enough to draw in air.

Prior to any treatment, physicians prescribe a sleep study to determine absolutely that a patient is experiencing true obstructive sleep apnea. The patient checks into a sleep clinic that scientifically monitors his/her sleep patterns throughout the night.

Surgery shrinks and removes the redundant tissue in the back of the throat sometimes including tonsils, opening up the airway. A radio frequency probe is used to shrink the palate and even the back of the tongue in some cases. Recovery usually takes two weeks during which time the throat is far too sore to eat much, so most patients lose 10 to 15 pounds, a boost for dieting especially for those who are overweight, causing obstructive sleep apnea in the first place.

Although the success rate of surgery is good, it’s not 100 percent. Weight loss and exercise are the two biggest factors to overcoming obstructive sleep apnea.

Maybe it’s time to wake up to the fact that obesity takes a toll 24/7, even while you doze.

Jeffrey Raval, MD is a graduate of the University of Michigan Medical School and did his residency and internship at the Department of Otolaryngology at Washington University Barnes Jewish Hospital. He completed his fellowship in Facial Plastic and Reconstructive Surgery in the Department of Otolaryngology, is double board certified by the American Board of Facial Plastic Surgery and Otolaryngology/Head and Neck Surgery. He is Section Head of Otolaryngology at Swedish Hospital in Englewood and maintains his practices – Raval Facial Aesthetics and Rocky Mountain Laser Aesthetics – in Denver’s Cherry Creek North District.