What is sleep apnea?
Some people think sleep apnea is nothing more than snoring, but that’s a dangerous misunderstanding. Sleep apnea is a common sleep disorder where the patient’s upper airway becomes blocked, usually by sagging tissues in the throat or the back of the tongue, and airflow ceases. When this happens the brain senses the lack of oxygen and it wakes the person to restart breathing. These interruptions can occur dozens of times every night, although the person may not consciously remember awakening. As you would assume, these sleep disturbances play a role in the person’s health. These are manifest not simply by sleepiness and a lack of concentration during the day, but they can impact other areas of the body, even the heart.
WHAT CAUSES SLEEP APNEA?
Most people don’t understand the difference between casual, occasional snoring and sleep apnea. Snoring occurs when there is resistance to airflow when a person is sleeping. The resistance causes the noise. When airway resistance increases to periods of complete blockage more than five times an hour, the patient is described as having Sleep apnea. Dr Cilento treats both snoring AND sleep apnea caused by varying degrees of airway blockage. Sleep apnea is a complex problem with complex solutions. In general, a person obstructs at three levels: The nose and sinuses, the soft palate, and the tongue base.
The causes although varied, affect these areas in varying degree:
- Throat and tongue muscles that are abnormally relaxed
- Enlarged tonsils or adenoids
- Cardiovascular problems
- Chronic sinusitis and airway inflammation
- Nasal congestion and blockage
- Family history
Are there different types of sleep apnea?
There are different types of sleep apnea, defined by the causes. Obstructive sleep apnea (OSA) is the more common form, occurring when muscles in the throat relax, blocking airflow. While, Central sleep apnea (CSA) is caused when the brain doesn’t send proper signals to the muscles that control breathing. Upper airway resistance syndrome (UARS) differs from OSA in that there aren’t pauses in breathing or decreases in breathing. And patients with UARS simply require greater effort in breathing to get past obstructions. Another form of sleep apnea is Complex sleep apnea syndrome. This sleep apnea is categorized as a person having both OSA and CSA.
The obstructive form of sleep apnea occurs when the muscles in the back of the throat relax. These muscles support all of the surrounding tissues such as the tonsils and the side walls of the throat. When the muscles relax, the airway narrows or closes. Your brain senses this inability to breath and briefly wakes you from sleep to reopen the airway. These lapses in sleep can be so brief you don’t even remember them. These actions can involve a snorting, choking, or gasping sound and can repeat the pattern up to 30 times per hour all night.
In central sleep apnea, your brain doesn’t tell your breathing muscles to do their job. Consequently, you make no effort to breathe for a short period of time. You then awaken with shortness of breath or have difficulty even falling asleep.
How does sleep apnea develop?
Certain factors play a role in a person’s being more likely to develop sleep apnea, being a man, for instance. These are risk factors for obstructive sleep apnea:
- Neck circumference — People with thicker necks often have narrower airways (men 17 inches and larger, women 15 inches and larger).
- Obesity — Obese people have four times the risk of sleep apnea. Fat deposits around the upper airway can add to obstruction.
- Narrowed airway — Some people simply have a naturally narrow throat, or have enlarged tonsils or adenoids.
- Men — Men are twice as likely to have sleep apnea.
- Age — Sleep apnea is more common in older adults.
- Family history — Sleep apnea runs in families.
- Smoking — Smokers are three times more likely to have OSA.
- Alcohol or sedatives — These substances relax the throat muscles.
sleep apnea Symptoms
These are the common symptoms that a person suffers from sleep apnea:
- Loud snoring (more prominent with obstructive sleep apnea)
- Daytime sleepiness or lethargy
- Awakening with shortness of breath (central sleep apnea)
- Episodes of breathing cessation witnessed by another person
- Waking up with a headache in the morning
- Excessive daytime sleepiness
- Waking up with a dry mouth or sore throat
- Difficulty staying asleep
- Attention problems
- Impotence or Erectile dysfunction
You’ll be asked to complete a sleep history, usually helped by someone who shares your bed or someone in your household. We likely will also refer you to a sleep disorder center, if it looks like you’re a good candidate. There you will be monitored overnight as you sleep. You may also use a home test, which is a simplified version that measures your heart rate, blood oxygen level, airflow, and breathing patterns while you sleep.
can i prevent or stop sleep apnea?
Obstructive sleep apnea can sometimes be limited by certain prevention strategies:
- Lose weight — Even a slight weight loss can relieve constriction in your throat. Getting to your ideal, healthy weight may be all you need to do to open up your airway.
- Treat Sinusitis and Allergies- Many people have ongoing allergy and chronic sinus issues that are causing breathing difficulties and nasal obstruction. This may progress to snoring and even sleep apnea if left untreated.
- Exercise — Moderate activity, such as brisk walking, for 30 minutes a day can relieve some symptoms.
- Avoid alcohol, sleeping pills, and tranquilizers — These all relax the muscles in the back of the throat, allowing the sagging that leads to sleep apnea.
- Sleep on your side or abdomen, not your back — Sleeping on your back can cause your tongue and soft palate to rest against the back of your throat, blocking your airway. There are some commercial devices that vibrate when you roll onto your back in sleep.
- Don’t smoke — Smokers are three times more likely to have OSA.
If you treat these conditions, sometimes the obstruction and snoring are alleviated.
Dr. Ben Cilento Patient Testimonials
Finally – I can breathe!!! Wish I had seen Dr Cilento sooner!After years of being unable to breathe and dealing with congestion, I went to see Dr Cilento. After having the sinus procedure to eliminate my issues, I can finally breathe. Dr Cilento and his Staff provide excellent attention and care for their patients. He is very detailed and explains everything. He will answer all questions that you or your family have. The procedure was completed on an out-patient basis, painless and after care was easy to follow.
I highly recommend Dr Cilento!
Sleep Apnea treatment in Spring TX
Treatment for sleep apnea starts with lifestyle changes such as losing weight, limiting alcohol consumption, or quitting smoking. From there, the next options are breathing systems such as CPAP, BALLOON sinuplasty and nasal procedures to help restore normal nasal breathing, UPPP or palatal surgeries, Inspire Therapy, or oral appliance therapy. Severe cases may require surgery as the patient is in danger of developing serious medical conditions such as high blood pressure and heart problems and even early death.
What is CPAP?
The most popular treatment for obstructive sleep apnea is called continuous positive airway pressure (CPAP). This is a breathing system that uses air pressure to keep the upper airway passages open. The patient wears a mask over his or her nose during sleep. The mask delivers air pressure that is somewhat greater than the air pressure in the bedroom. This difference in pressure keeps the airway passages open, preventing snoring and apnea.
your Inspire Sleep Therapy with dr. ben Cilento
Inspire Therapy is a new approach. Dr. Cilento implants a device that the patient turns on when he or she goes to bed. The device delivers a mild stimulation to key airway muscles to help keep them open while the person is asleep. The person doesn’t feel a thing, but the airway stays open, allowing uninterrupted sleep.
There are certain qualifications a patient must meet to be eligible for the Inspire Sleep Therapy. Dr. Cilento will discuss these with you.
oral appliance therapy at Texas sinus & Snoring
Oral appliance therapy uses what is akin to a sports mouth guard or an orthodontic retainer. Worn only during sleep, the oral appliance supports the jaw in a forward position to help maintain an open upper airway.
Sleep Apnea Surgery
As a premiere sinus and sleep surgeon in Houston, Dr Cilento has a methodical approach to tackling even the toughest of snoring problems. In general, A comprehensive physical exam and history will be performed at your first visit. All patients will be assessed for the presence of reversible causes of nasal obstruction. Even if a patient wishes to use CPAP, a patent nasal airway is a must. Dr. Cilento offers many surgeries to help maximize nasal airflow:
- Nasal Valve Reconstruction — The nasal valve stenosis is caused by narrowing of critical structures in the nose. Cartilage on each side of the nose may weaken and collapse on one or both sides when a person is breathing in. This is known as nasal valve collapse. Nasal valve reconstruction surgery corrects this problem and returns proper airflow.
- Turbinoplasty- The turbinates are the radiators of the nose and are responsible for warming and moistening of the air we breathe. They also react to allergens, irritants and bacteria and viruses and swell to block the nose. Removal is not a good idea so we have several ways of shrinking the size of these structures permanently.
- Septoplasty — The septum is the structure in the nose that separates the two nostrils. For some patients, their septum can become crooked or misaligned, making one nostril larger than the other. This can inhibit proper airway function. Septoplasty evens out both nostrils by repositioning the septum. This places both nostrils in the proper position and improves airflow.
- Balloon sinuplasty- The presence of Chronic sinusitis can cause severe and persistent nasal obstruction. For those who qualify, balloon sinuplasty may be required to help open blocked sinuses and nasal airflow outtracks.
Severe Sleep Apnea Treatment
Once the nose is maximized, attention is turned to the area of the Palate and oropharynx. If a patient’s sleep apnea is moderate to severe and is impacting their quality of life adversely, Dr. Cilento offers several surgeries to improve the airflow in this area. Surgery is usually an option if other sleep apnea treatments have failed to improve the patient’s symptoms.
- UPPP/Uvulopalatopharyngoplasty — This surgical procedure removes excess tissue in the throat, widening the airway. UPPP also seeks to improve the movement of the soft palate to help the airway remain open during sleep. Outcomes are improved if the patient still has their tonsils for removal with the palate trimming.
- Snoreplasty- If a patient does not have sleep apnea but still has a considerable amount of snoring, it is possible to trim the palate and stiffen the palate enough to stop the noise.
- Hyoid suspension- the hyoid bone is located just above the adams apple and connects all the tongue muscles together. If we suture it to the adams apple below and stabilize it, the patients breathing is improved.
- Tongue base coblation- sometimes the tongue base is stiffened and reduced in sized by locally applying energy to help shrink it.
- Oral Appliance- sometimes the answer to tongue base contributions to sleep apnea is simple. We will often discuss sleep appliances to help move the tongue base forward. These appliances can be custom made to help position the lower jaw forward, thus pulling the tongue out of the way.
Schedule Your Sleep Apnea Consultation with Dr. Ben Cilento
If you have any questions and concerns regarding our sleep apnea procedure with Dr. Ben Cliento in Spring, TX, you can schedule a consultation or call us at 346-413-9313