Encyclopedia of Health and Medicine

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obstructive sleep apnea A disorder in which
blockage of the airways takes place during sleep
when the structures of the neck and THROAT relax,
causing BREATHING to stop for periods of time. The
characteristic symptoms are a repeated pattern
during sleep of loud, heavy snoring followed by a
period of silence followed by gasping or snorting
and tiredness during waking hours. The snoring
indicates the structures of the throat are relaxing
and the passage for air is narrowing; the silence
indicates relaxation has reached the point at
which no air is getting through. The gasping or
snorting is a reflexive reaction to the drop in the
blood’s oxygen level; it serves to restart breathing.
The cycle results in continuous interruption of
sleep, leaving the person deprived of rest. The
repeated episodes of oxygen deprivation can cause
or contribute to numerous health problems,
including HYPERTENSION (high BLOOD PRESSURE),
ARRHYTHMIA (irregular heartbeat), PULMONARY
HYPERTENSION, and HEART FAILURE (reduced ability of
the HEART to pump BLOOD).
Many people who have obstructive sleep apnea
are not aware that they do, though often their
partners complain about their snoring. Often the
first indication is the uncontrollable urge to fall
asleep during the day, which may occur at dangerous
times, such as when driving. Frequent
headaches, lack of energy, and irritability are other
symptoms. The diagnostic path includes a detailed
sleep questionnaire and careful physical examination
with a focus on the structures of the MOUTH
and neck. The doctor may also request a sleep lab
assessment, in which the person spends the night
under observation and with electronic monitoring
to objectively assess the sleep experience.
About 40 percent of people who have obstructive
sleep apnea have obesity. When this is the
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case, WEIGHT LOSS AND WEIGHT MANAGEMENT are key
to treatment. Lifestyle modifications, such as
avoiding ALCOHOL or medications that cause sleepiness
(such as ANTIHISTAMINE MEDICATIONS or sleep
aids), can improve the body’s ability to retain control
over the muscles of the throat. Some people
benefit from surgery to remove excess tissue at
the back of the throat (uvulopalatopharyngoplasty).
A continuous positive airway pressure
(CPAP) device to maintain pressure against the
airways and to keep them open is often an effective
treatment when other approaches are not
appropriate or not successful.
See also SLEEP DISORDERS; WEIGHT LOSS AND WEIGHT
MANAGEMENT.
oral hygiene Self-care methods for maintaining
health of the TEETH, gums, and MOUTH. Oral healthcare
providers recommend brushing the teeth at
least twice daily and flossing or using an interdental
device to clean between the teeth once daily.
People who snack throughout the day should
brush more frequently to clear away food debris
and BACTERIA that accumulate after eating. Appropriate
oral hygiene helps maintain the health of
the teeth, gums, and other structures of the
mouth and also reduces the risk of INFECTION in
people who have tongue, lip, or other oral PIERC-
INGS. Tooth decay and gum disease develop more
rapidly in people who have diminished saliva production,
have DIABETES, or who smoke. Further
preventive care measures include regular visits to
the dentist and dental hygienist for cleaning
and examination to detect oral health problems
such as GINGIVITIS, PERIODONTAL DISEASE, and oral
CANCER.
See also HALITOSIS; SJÖGREN’S SYNDROME; SMOKING
AND HEALTH; TOBACCO USE OTHER THAN SMOKING.