Obstructive Sleep Apnea (OSA)

Obstructive Sleep Apnea (OSA) is a common sleep disorder characterized by brief interruptions of breathing during sleep. According to the National Institutes of Health, approximately 12 million Americans suffer from obstructive sleep apnea/hypopnea syndrome, otherwise known as OSA. People who have OSA repeatedly stop breathing, or experience shallow breathing during sleep. This can happen as often as 300 times a night and can disrupt a person’s quantity and quality
of sleep.

The most common symptom of OSA is excessive sleepiness.Other symptoms of OSA may include morning headaches, dry mouth, snoring, trouble concentrating, forgetfulness, or depression.

A trip to the doctor is always a good first step if you think you have a sleep problem or feel sleepy during the day. There may be underlying problems contributing to your sleepiness.

People who have narcolepsy experience uncontrollable sleep attacks, sudden, brief loss of muscle control, the inability to talk or move for brief periods of time while falling asleep or waking up (sleep paralysis) and vivid dream-like experiences while dozing or falling asleep (hypnagogic hallucinations).

The most common and debilitating symptom of narcolepsy is excessive sleepiness. People with narcolepsy often describe their excessive sleepiness as extreme exhaustion and a depressed mood, or lack of energy.

A trip to the doctor is always a good first step if you think you have a sleep problem or feel sleepy during the day.

There may be underlying problems contributing to your sleepiness.

Narcolepsy is a chronic, neurological sleep disorder, that is characterized by uncontrollable sleep attacks. According to the National Institute of Health, narcolepsy affects over 135,000 Americans. It is a chronic, neurological sleep disorder characterized by uncontrollable sleep attacks. These sleep attacks usually occur multiple times a day even when a person gets adequate sleep.
Insomnia is the inability to fall asleep or stay asleep.

Insomnia is the most common sleep complaint among Americans. According to the National Institutes of Health, insomnia affects more than 70-million Americans.

People with insomnia may have difficulty falling asleep, wake up frequently during the night or experience difficulty returning to sleep. In addition, people with insomnia may experience daytime sleepiness, irritability or have difficulty concentrating.

A trip to the doctor is always a good first step if you think you have a sleep problem or feel sleepy during the day. There may be underlying problems contributing to your sleepiness.

One of ALC's two sleep study rooms

Frequently Asked Questions About Testing for Sleep Apnea

Question:
I am about to undergo testing for sleep apnea. I’ve been told that I will be monitored from 8pm to the next morning. I am anxious about this, because I have so much trouble sleeping anyway, and I can’t imagine sleeping while I am connected to measuring devices or if someone is watching me. Would you tell me what this procedure involves and what are the chances of a correct diagnosis if I am that anxious?

Answer:
This is a very common concern. I can assure you, though, that while your sleep may be even more erratic than usual, you will almost certainly sleep long enough to obtain a valid study.

Sleep Disorder Background

Sleep studies (polysomnographs) are ordered by a doctor to test for a treatable sleep disorder such as obstructive sleep apnea (OSA), a condition in which the patient’s airway becomes blocked during sleep. The tongue, soft palate, or both, may “fall backward” blocking the airway. Breathing may become dangerously shallow or may stop altogether. (Apnea means “no breath.”) The patient wakes just enough to take a few breaths, then falls back to sleep. This can happen many times per hour, destroying the quality of sleep.

A less severe form of this problem is upper airway resistance syndrome, in which sleep is again fragmented. Unlike OSA, breathing rarely stops completely. Nevertheless, patients with upper airway resistance syndrome still suffer from extreme daytime sleepiness due to poor sleep quality.

During a polysomnograph, your brainwaves will be monitored (electroencephalogram), along with heart rate and rhythm (electrocardiogram), eye movements, blood oxygen content, muscle activity and respiratory activity. The goal of a sleep study is to learn something about sleep efficiency and whether you have breathing problems during sleep. If you do, how severe are they? Does your blood oxygen content drop to dangerous levels? Do you develop dangerous alterations in heart rhythm due to your breathing difficulties?

Let’s focus on the brain waves for a moment. The brain, itself, is little more than a lump of neurons (nerve cells), blood vessels and cells that serve a supportive function for the neurons. Neurons communicate with one-another and the rest of the body by electrochemical impulses. A tiny electrical charge is conducted down the length of a neuron. Whenever an electrical charge moves, electromagnetic waves are emitted. An electroencephalogram (EEG) measures the electromagnetic waves emitted by the brain as a result of neuronal electrical activity.

Sleep is more complex than most people realize. It can be described as consisting of alternating REM (rapid eye movement) and NREM (non-REM) phases. NREM sleep is further divided into four stages based on the type of brain waves detected by EEG. By measuring eye movements and EEG, a sleep study can thus characterize how much time you spend in these phases of sleep.

This is significant for two reasons. By measuring the time spent in different phases of sleep, we can determine sleep efficiency. Measurement of EEG and eye movement answers a more obvious concern -- and this speaks directly to your concern: Will I sleep at all during the test? You can’t fake the EEG patterns typical of deep sleep, and you can fake REM only with difficulty and practice. Thus, the sleep study will certainly demonstrate whether you slept at all during the study.

Keep this in mind when your doctor tells you the results of the study. It is fairly common for a patient to tell me, “That study was a real waste. I didn’t sleep at all!” But that’s only the patient’s subjective opinion; the sleep study tells a different story. How could a patient be so incorrect? Unless you dream (and remember your dream), you are conscious only of your waking moments. If your sleep is highly fragmented, these waking moments will be scattered throughout the night, giving you the impression that you “never” slept. The truth of the matter may be that you slept all night -- but poorly!

Shift Work Sleep Disorder (SWSD) is a sleep disorder that affects people who frequently rotate shifts or work at night. About 20% of the full-time workforce are shift-workers, meaning they work more than half their hours outside the traditional work window of 6 a.m. to 6 p.m. Working nights or rotating shifts puts people at risk for chronic sleep disruption and shift work sleep disorder (SWSD).

Shift work sleep disorder (SWSD) can be characterized by excessive sleepiness when performing nighttime work and insomnia during daytime sleep opportunities.2 The body’s natural sleep-wake cycle tells the body to sleep at night and be awake during the day.

A trip to the doctor is always a good first step if you think you have a sleep problem or you don’t feel alert at night. There may be underlying problems contributing to your sleepiness.

Restless Legs Syndrome (RLS) is a sleep disorder characterized by unpleasant sensations in the legs and the irresistible urge to move the legs that occur when lying down or sitting for long periods of time.

According to the National Sleep Foundation, nearly 12 million Americans have restless legs syndrome, a sleep and movement disorder. Characterized by an unpleasant sensation in the legs, people who suffer from restless legs syndrome (RLS) have the urge to move their legs in order to relieve the sensation.

People who have RLS experience sensations in the leg described as tingling, crawling, creeping or pulling in the calf area. The feelings usually occur when they sit or lie down for long periods of time.

To relieve the sensations in the legs, people with RLS have the urge to move their legs, making it difficult for them to relax and fall asleep. A result of RLS can be daytime sleepiness.

The best way to be alert is to get the right amount of good sleep. One of the best ways to be alert is to get the right amount of sleep. Experts say you need 6 to 10 hours of quality sleep daily. You’ll know you’re getting enough good sleep if you feel refreshed and energized when you wake up.

The National Sleep Foundation has provided the following tips and strategies to help you get the sleep you need:

• Avoid caffeine, nicotine and alcohol in the late afternoon and evening.
• Don’t nap during the day - it can affect your ability to sleep at night.
• Exercise regularly, but do so at least three hours
before bedtime.
• Establish a regular, relaxing bedtime routine that will allow you to unwind and send a “signal” to your brain that it’s time to sleep.
• Avoid exposure to bright light before bedtime.
• Consider your sleep environment - make it as pleasant, comfortable, dark and quiet as you can.
• If you can’t go to sleep after 30 minutes, don’t stay in bed tossing and turning - get up and involve yourself in a relaxing activity such as listening to soothing music or reading.
• Associate your bedroom with sleep.

A trip to the doctor is always a good first step if you think you have a sleep problem or feel sleepy during the day. There may be underlying problems contributing to your sleepiness.