Snoring and Sleep Apnea
Dr. Donald Sesso is one of only 6 surgeons in the US with triple board certification in Otolaryngology, Sleep Apnea Surgery and Sleep Medicine.
Snoring and Sleep Apnea Audio Introduction
Do you or your partner snore? Are you constantly tired? Is your energy level low? You may have sleep apnea! Click to hear more.
Specialists in Snoring and Sleep Apnea
At BergerHenry ENT, we have one of the foremost experts in the field of sleep apnea. Dr. Donald Sesso, known as Philadelphia’s Snoring Doctor, (pictured) is one of only 6 surgeons in the country to hold triple board certification in Otolaryngology, Sleep Apnea Surgery and Sleep Medicine. His extensive training at Stanford University Medical Center and years of experience have given him the expertise to offer every available treatment option for snoring and sleep apnea problems. Dr. Sesso is a strong believer that one surgical or medical solution does not fit everyone. Each treatment plan must be tailored to the patient based on specific physical exam findings, body mass index and sleep study test results. Dr. Sesso has the best understanding of these complex sleep disorders, extraordinary treatment experience with thousands of patients, and knows how to communicate a complicated problem in an easy-to-understand manner.
Snoring, What Is It Exactly?
Snoring is simply an obstruction to the free flow of air through the back of your mouth and nose. This area is the collapsible part of the airway where your tongue and upper throat meet the soft palate and uvula. When these structures strike each other and vibrate, you are snoring.
What Causes Someone to Snore?
- Long, soft palate and/or uvula
- Excessive bulkiness of throat tissue (large tonsils, obesity, cysts or tumors)
- Obstructed nasal airways (a stuffy or blocked nose)
- Deformities of the nose or nasal septum (such as a deviated septum)
- Poor muscle tone in the tongue and throat
Is Snoring Serious?
Yes, when snoring is severe it can be serious. Snoring disturbs your sleeping patterns and deprives you of appropriate rest. Your snoring may be a significant problem for someone else as well. When left untreated, snoring can cause long-term health problems, including sleep apnea.
What Is Sleep Apnea?
The word “apnea” literally means “without breath.” There are three types of apnea. Obstructive sleep apnea is the most common. It is caused by a blockage of the airway, usually when the soft tissue in the rear of the throat collapses and closes during sleep. Central sleep apnea is caused by a blockage in the airway. However, in central sleep apnea, the brain fails to signal the muscles to breathe. Mixed sleep apnea, as the name implies, is a combination of the two. With each apnea event, the brain briefly arouses people with sleep apnea in order for them to resume breathing, but consequently sleep is extremely fragmented and of poor quality.
When left untreated…
Sleep apnea can cause high blood pressure and other cardiovascular disease, weight gain, memory problems, impotency and headaches. Untreated sleep apnea may also cause job impairment and vehicle accidents. Fortunately, sleep apnea can be diagnosed and treated. Both medical and surgical options are available.
What Is Obstructive Sleep Apnea (OSA)?
Obstructive sleep apnea (OSA) occurs when the airway completely or partially collapses repeatedly during sleep. When the airway is blocked, the oxygen levels in the body drop causing the person to wake up long enough to begin breathing normally again. These awakenings, also referred to as arousals, are often very brief. In fact, they may only last a few seconds, and the majority of affected patients’ are often not aware that these awakenings occur during sleep. This pattern repeats during the night, and someone with severe sleep apnea may wake up hundreds of times each night. Even though the awakenings are usually very short, they fragment and interrupt the sleep cycle. This sleep fragmentation can cause significant levels of daytime fatigue and sleepiness, which is a common symptom of sleep apnea. Thus, even if a patient with OSA sleeps for the appropriate length of time, they still have a poor quality of sleep.
OSA Affects Both Men and Women
OSA is estimated to occur in approximately 18 -50 million Americans; with prevalence estimated at 9 to 24% of adult men, and 4 to 9% of women. Unfortunately, at least 80 percent of such patients go untreated. The prevalence in children is estimated to be 1-3%. OSA is a treatable condition; however, if left untreated, it is associated with serious medical conditions. OSA has been linked to cardiovascular diseases, specially high blood pressure, cardiac arrhythmias, heart attack and stroke. Snoring and sleep apnea are also associated with a higher risk of accidents, impaired work performance and strained interpersonal relationships.
A typical OSA patient is a middle age, over-weight male; however anyone can develop OSA. In fact, women and children remain significantly undiagnosed due to the bias that only overweight men can have OSA. Symptoms can vary from person-to-person, and do not always correlate with the severity of OSA. Common symptoms of OSA in adults may include:
- Daytime fatigue and/or sleepiness
- Pauses in breathing
- Choking or gasping during sleep
- Dry mouth/sore throat in morning
- Morning headaches
- Night sweats
- Sexual dysfunction
- Poor concentration and attention. Poor performance at work or school
- Memory problems
- Anxiety /Depression
Risk Factors for OSA
- Obesity. Fat deposition in the tongue, throat, chest and abdomen can obstruct breathing. However, just because someone is overweight does not mean they have OSA. The opposite is also true: many thin people have OSA.
- Family history of OSA. If you have family members with sleep apnea, you may be at increased risk. Our airway and cranial facial features (jaw structure) may be inherited from our parents and can have an impact on the likelihood of developing OSA.
- Nasal congestion. OSA occurs twice as often in those with chronic nasal congestion at night, regardless of cause.
- Enlarged tonsils or adenoids. In children, OSA is most often associated with enlarged tonsils and/or adenoids. Adults may also have a narrowed upper airway due to enlarged tonsils. In addition, adults may have an enlarged tongue, small jaw structure (under bite) or long palate that can obstruct their airway.
- Older age, male gender. OSA is more common in adults over the age of 65 years. Men also have a greater risk of developing OSA as compared to women. However, post-menopausal women have a higher rate of OSA than younger women.
- Neck circumference. A large neck can narrow the airway, and increase the likelihood of OSA. Higher risk of OSA is associated with a neck circumference greater than 17 inches for men and 15 inches for women.
- Smoking, alcohol or tranquilizers. Smokers are nearly three times more likely to have OSA, and alcohol or tranquilizers can relax the muscles in your upper airway and predispose it to collapse.
- High blood pressure (hypertension) and diabetes. OSA is more likely in people who have hypertension and up to three times more common in those with diabetes.
OSA In Children
While snoring in adults does not always indicate the presence of OSA, snoring or noisy breathing is abnormal in children. OSA is often overlooked in kids because the symptoms of OSA can be different in children than they are in adults. Not all children with OSA snore, and when they are tired they rarely nap, instead they become hyperactive (and may mimic those children with attention deficit-hyperactivity disorder) or develop behavioral problems. These behavioral problems may manifest themselves as irritability, lack of concentration, easy distractibility, and hyperactivity which can lead to problems at school. Some children with OSA are improperly diagnosed with attention deficit-hyperactivity disorder (ADHD). Additionally, many children with OSA are not overweight. Common symptoms of sleep apnea in children may include:
- Daytime cognitive and behavior problems, including problems paying attention, easy distractibility, aggressive behavior and hyperactivity
- Mouth breathing
- Bed wetting
- Excessive daytime sleepiness
For Diagnosis and Treatment Options for Snoring and Sleep Apnea, Please Continue to Page 2.