An upper airway obstruction occurs when there is a blockage in the throat, larynx or trachea. It may be caused by: infection, enlarged tonsils, a tonsil or pharynx abscess, inflammation, epiglottitis, croup, tracheomalacia (weakness in the trachea of infants), allergic reactions, tumors, foreign bodies, trauma, chemical burn, smoke inhalation, obstructive sleep apnea (OSA) or vocal cord problems. Symptoms may include difficulty breathing, agitation/fidgeting, choking, bluish color to the skin, gasping for air, confusion, changes in consciousness, wheezing, crowing, whistling, or other unusual breathing noises. Treatment depends on the cause of the blockage, but airway obstruction is a serious medical condition and may require a 911 call or an urgent visit to the ER. It is a good idea to learn the Heimlich maneuver, which can clear food or other foreign body from the airway when patients cannot speak or breathe.
Obstructive Sleep Apnea (OSA) is a sleep disorder that occurs in children and adults when a person stops breathing for seconds or minutes, a minimum of five times per hour. Symptoms include: daytime sleepiness, loud snoring, witnessed episodes of paused breathing or gasping for air, awakening with dry mouth or sore throat, morning headache, abrupt awakening with shortness of breath, difficulty staying asleep, and/or poor focus/concentration. If Dr. Agresti suspects sleep apnea, she will suggest a sleep study, as these are the best way to diagnose OSA and can be performed by home study or an overnight stay at a sleep center. OSA is a serious problem that can increase a person’s risk of heart attack, stroke, congestive heart failure, and pulmonary hypertension, and if suspected, should be investigated.
Continuous Positive Airway Pressure (CPAP) Therapy is frequently prescribed as a treatment for Obstructive Sleep Apnea. This therapy includes a mask with a small machine attached that provides a steady stream of air into the nose, mouth and airways, preventing sleep apnea from occurring. Though some patients are very successful with this therapy, common problems with CPAP may include: leaky masks, trouble falling asleep, and a dry mouth and nose.
Uvulopalatopharyngoplasty is a surgical procedure used to treat obstructive sleep apnea and snoring, where the doctor removes the uvula, soft palate, tonsils and sometimes the adenoids to open up the airway. This procedure requires general anesthesia and takes 30-40 minutes, but recovery can take up to two weeks. In many cases, the need for CPAP mask therapy can be eliminated. However, sometimes the best treatment combines surgery and the use of CPAP mask therapy at lower pressures.
Central Sleep Apnea (CSA) is much less common and occurs when the brain fails to send a message to the muscles involved in breathing. When this occurs, a person may awaken with shortness of breath or have trouble getting to sleep or staying asleep. The most common cause of this condition is heart failure. In some cases, stroke can be a cause. People with CSA are more likely to remember awakening than the patient with Obstructive Sleep Apnea.