Wednesday, December 08, 2004

The Rebel Doctor, on sleep apnea

...the obstructive kind.

(Sullivan, take note!)

Obstructive sleep apnea (OSA) is a disease characterized by episodes of complete or partial collapse of the upper airways during sleep. It has been estimated that 2-4% of the adult population has it. Symptoms of OSA include loud snoring, daytime sleepiness, and apneas (breathing pauses) witnessed by a bed partner. Risk factors for OSA include obesity, an abnormal jaw structure, and having a crowded oropharynx (the area around the tonsils).
OSA has long-term health risks, including hypertension.

The usual treatment for OSA in adults is continuous positive airway pressure (CPAP):
http://familydoctor.org/791.xml.

OSA is becoming increasingly more common in children. It used to be that most cases of OSA in children were due to adenotonsillar enlargement; the OSA could usually easily be cured by surgically removing the adenoids and tonsils. Now obesity is causing many cases of pediatric OSA and there are a lot of children on CPAP. This article http://news.bbc.co.uk/2/hi/health/4059357.stm discusses OSA in obese children.

OSA, in both adults and children, is usally diagnosed by an overnight polysomnogram (sleep study). Airflow, depth of sleep, and blood oxygen levels are closely monitored during a polysomnogram. Polysomnograms are a little different in children as compared to adults (for example, different criteria for measuring breathing pauses). Unfortunately, many sleep labs lack experience in diagnosing and treating childhood OSA.

If you suspect that you or a family member has OSA, you should discuss referral to an accredited sleep center with your primary care doctor. This site can help you find an accredited sleep center: http://www.aasmnet.org/listing.asp
Click for Eugene, Oregon Forecast