Obstructive sleep apnea

Obstructive sleep apnea (OSA) is a common health problems affecting both adults and children. It is often under diagnosed especially in female and senior population. Snoring presents in almost all patients with OSA. Additional symptoms include daytime somnolence, sleep disturbances, decreased work performance and concentration. If untreated, it can lead to cardiopulmonary complications such as hypertension and pulmonary hypertension. In children it is often related to adenotonsillar hypertrophy, hence tonsillectomy and adenoidectomy are curative. Patients can also present with nasal obstruction and narrowing of the nasal passages due to deviated septum, nasal polyps, hypertrophic nasal turbinates, or sinusitis. Sleep study remains the gold standard for diagnosing OSA. It measures the duration and frequency of pauses of breathing, as well as oxygen concentration and other abnormal brain activities. In young children, parental observation is often recommended due to difficulties of obtaining a meaningful sleep study. Mainstay of treatment for OSA in adult population is CPAP device. It provides positive pressure ventilation to "re-open" the collapsed airway. Sleep surgery is considered for patients who are unable to tolerate CPAP and severe cases involving jaw advancement or definitive tracheostomy airway. Weight loss management is also paramount for improving the severity of OSA. Excerpt from Community health talk at the Sunset Church of San Francisco. March 15, 2013.