Ask the Doctor: Jay Puangco, M.D.

Q. What is sleep apnea and what are the treatment options?

A. Obstructive sleep apnea (OSA) is a potentially life-threatening sleep disorder that causes breathing to repeatedly stop and start during sleep. While sleeping, our mouth’s swallowing muscles relax more than they do during waking hours. This doesn’t cause problems for most people, but for those individuals with a small airway, this relaxation can obstruct and narrow the airway thus interfering with breathing, leading to OSA. Alcohol, sleeping pills, and tranquilizers taken at bedtime also reduce muscle tone and can make the airway more likely to narrow and even collapse.

The warning signs of OSA include very loud snoring that may disturb others’ sleep. A pattern of snoring interrupted by pauses, then gasps, reveals that the sleeper’s breathing stops and restarts. Adults with OSA have unrefreshing sleep, and can fall asleep at inappropriate times, such as at work, at the movies or while driving. Most patients with OSA have trouble concentrating and can become forgetful, irritable, anxious or depressed.

These problems typically develop over many years. Sometimes OSA symptoms go unnoticed, or their significance is downplayed. Family members, employers, or co-workers may be the first to recognize a pattern of inattentiveness or excessive daytime sleepiness.

One common effective therapy for OSA is called continuous positive airway pressure (CPAP). Pressure from an air compressor helps air pass through the mouth and nose via a small mask that is worn over the nose and mouth, during sleep. This gentle pressure holds the airway open and allows for normal sleep and breathing. A formal overnight sleep study at one of our sleep centers is required to establish a diagnosis and to set the optimal CPAP level.

For patients who are unable to use CPAP, Hoag is the first in Orange County to offer an innovative new treatment option called Inspire® Upper Airway Stimulation therapy. Approved by the FDA, Inspire therapy is a small, fully implantable system that continuously monitors your breathing patterns during sleep. It requires no mask or oral appliance and is designed to work with your body’s anatomy. Based on your unique breathing patterns, the system delivers mild stimulation to key airway muscles, keeping the airway open.

Inspire therapy is clinically proven to reduce sleep apnea events in patients with moderate to severe OSA. One of our sleep physician experts will help determine the right individual treatment for you.