What is obstructive sleep apnea?

Getting a “good night’s sleep” is crucial, they say. If only it were that simple, we reply. This rings true for between 20-40% of the Spanish population who suffer from one or several types of sleep disorders. One of the most common types of sleep disorders is known as obstructive sleep apnea (OSA). If the overly medical term has you scratching your head trying to work out what it actually means, read on to discover what this condition entails and how you can keep it under control.

What is obstructive sleep apnea?

Obstructive sleep apnea is characterised by repeated episodes of nighttime breathing difficulties (partial or complete halt of airflow through the upper airway) during sleep. This type of apnea (temporary cessation of breathing, especially during sleep) occurs when the muscles of the throat sporadically relax and block the airways during sleep. The apnea index classifies the severity of the condition according to the number of breathing stoppages (lasting more than 1’ seconds) that occur per hour per night. According to this index, there are three levels of severity:

1. Mild: 5-15 episodes per hour
2. Moderate: 15-30 episodes per hour
3. Serious or severe: more than 30 episodes per hour

Common symptoms of this condition include loud snoring, excessive daytime tiredness and restless sleep. Other less common signs include morning headaches, insomnia, mood changes, and increased heart rate/blood pressure, among others. Repeated and loud snoring is a key indicator, but between 20-25% of those suffering from obstructive sleep apnea do not snore, so it is important to look out for other symptoms so that a proper diagnosis can be made.

What causes obstructive sleep apnea?

Under normal conditions when we sleep, the airway is open, allowing for relaxed breathing. However, at several stages of sleep, the tissues close and block the airway, in turn causing apnea. In addition to this cause, there are also other factors that can increase the risk of developing obstructive sleep apnea:

• Facial structure issues that narrow the airway. Lower jaw is shorter than upper jar
• Obesity, leading to excessively soft tissue around the airway
• Thick neck: 43 cm or more in men; 41 cm or more in women
• Decreased muscle tone
• Enlarged tonsils that block the airway
• Old age
• Blockage caused by an enlarged tongue
• Brain injury

How can obstructive sleep apnea be prevented?

• Straightforward changes to sleeping habits can sometimes make a difference. The supine position (lying on your back) has been linked to obstructive sleep apnea, so try to avoid this position, either by naturally changing the position by simply moving on to your side, or by using a snore ball (tennis ball attached to your back) so that it is physically uncomfortable sleeping on your back. Find out more about this method. 
• Quit smoking. This will reduce inflammation and fluid retention in your throat and airway.
• Avoid alcohol and sleeping pills before bedtime.

How can obstructive sleep apnea be diagnosed?

Diagnosis of obstructive sleep apnea through the Social Security is carried out using the patient’s medical history as well as clinical and/or home-based tests. The doctor will carry out an assessment based on your symptoms and via tests. He/she will examine your throat, mouth and nose to check for any abnormalities, measuring the circumference of your neck and checking your blood pressure. This general examination is standard. You may then be referred to a specialist to undergo further tests. A sleep specialist will be responsible for diagnosing your disorder (if any), determining its severity and setting a treatment plan.

Types of tests to detect obstructive sleep apnea

1. Polysomnography: This test involves connecting the patient to a piece of equipment that continuously monitors your sleep by registering your brain activity, eye movements, muscle activity, heart rhythm and blood oxygen levels. It is usually carried out at night in a controlled clinical environment.
2. Home sleep tests: The doctor may suggest home tests that measure your heart rate, blood oxygen levels, air flow and breathing patterns. If any abnormalities are detected, the doctor may prescribe some form of therapy without subjecting you to any more tests.

It is important to remember that, given that the condition does not generally require urgent care, the waiting lists for specialist referrals can be quite long through the social security.

Choosing to go down the private route via a private health insurance will undoubtedly speed up the diagnosis process and, in turn, ensure that treatment (if required) can get underway as soon as possible. Caser Health Insurance offers coverage to diagnose obstructive sleep apnea through specialist tests, including the polysomnography, from as little as €9.90/month, ensuring treatment with expert professionals and slashing waiting times that are generally encountered when public healthcare is sought. Check out the range of health insurance plans available. 

Treatment for obstructive sleep apnea

Initial action to improve obstructive sleep apnea can be taken by the patient. He/she can quit smoking, lose weight, and avoid alcohol and medications that relax muscles. Other types of treatment include:

• Continuous positive airway pressure (CPAP) – breathing machine that pumps air through a mask.
• Variable positive airway pressure (VPAP), which uses an electronic circuit to monitor the patient’s breathing.
• Nasal strips
• 30-degree elevation of the upper body.
• Sleeping on the side

There is a lack of studies to prove that surgical treatment for obstructive sleep apnea is effective, however the following, among others, may be performed:

• Septoplasty
• Tonsillectomy
• Jaw surgery
• Removing and repositioning excess tissue in the throat to open up the airways

If you're looking for a more information about common sleep disorders, discover the guide below: