OBSTRUCTIVE SLEEP APNEA (OSA)
Obstructive sleep apnea is a serious condition which is linked to a longterm increased risk of heart failure and stroke complications. It usually presents with loud snoring, daytime tiredness and fatigue, poor sleep quality and choking episodes when asleep. The patient usually does not notice these symptoms at first and more often, it tends to be detected by his sleep partner whose own sleep quality is disturbed in turn.
A good quality sleep study is important to aid diagnosis and management of OSA. The sleep study involves the patient sleeping according to his normal routine and pattern, whilst attached via several fine cables to a machine which will monitor his parameters during the night, such as oxygen saturation levels and heart rate. The sleep study can be arranged either at home or in hospital, depending on the patient’s clinical scenario, as some patients may require a much more detailed sleep study in hospital. The sleep study is able to detect number of episodes when the patient stops breathing (apnoea event) and when he does not breathe adequately (hypopnoea event). This gives an accurate reflection of the severity of OSA, to help decide what sort of treatment plan is most suitable for the patient.
Continous Positive Airway Pressure (CPAP) is the gold standard for OSA treatment. It is used to keep the patient’s airways open by preventing them from collapsing which is the underlying cause of OSA. CPAP is delivered via a specially fitted mask over the nose and/or mouth to ensure a good seal of airflow coming from a small portable CPAP machine.
Surgery for OSA usually has a supportive role for CPAP, to remove any structural level of obstruction in the nose and throat to help the airflow delivery from the CPAP machine become much more efficient. Surgically correctable causes of obstruction in the nose and throat include enlarged nasal turbinates, deviated nasal septum, postnasal space mass or adenoid tissue, floppy redundant soft palate and uvula structures, as well as bulky tongue base tissue.