By Martine Cicconi

Do you snore loudly? Are you tired all day despite spending 8-10 hours in bed? Do you fall asleep unexpectedly while working, watching TV or driving? Do you have high blood pressure or feel depressed? If so, you may be one of the 30 million Americans suffering from obstructive sleep apnea.

Affecting approximately 24 percent of American men and 9 percent of American women, obstructive sleep apnea is among the most common chronic illnesses in the country, yet it is underdiagnosed. Obstructive sleep apnea is estimated to be responsible for 50,000 preventable deaths each year, usually caused by heart attacks, strokes and accidents.

Discovered in 1965, obstructive sleep apnea is marked by a termination of airflow at the nose and mouth lasting 10 seconds or longer during sleep. Sufferers of obstructive sleep apnea often have a smaller than normal airway - characterized by a small jaw and/or large tongue - which can make breathing difficult. When a person is awake, the throat muscles contract during breathing, moving out of the airway and allowing air to pass unobstructed. But during sleep, throat muscles are more relaxed and can fail to move out of the way of incoming air.

For people with obstructive sleep apnea, the intake of air can push the relaxed throat closed, restricting the airflow. Unable to breathe, the sleep apnea sufferer will wake up briefly, resume breathing and return to sleep.

These intervals of wakefulness are brief and often not recalled by the sleeper. People with severe obstructive sleep apnea can wake up 400 to 500 times per night, which can seriously hinder daytime alertness and compromise one’s ability to perform daily tasks.

Obstructive sleep apnea can also cause serious health problems. Almost all sleep apnea episodes coincide with a drop in blood oxygen, with longer apneas resulting in larger drops in oxygen levels. Most patients with sleep apnea also have high blood pressure and irregular heartbeats. In very severe cases, cardiac abnormalities that begin during sleep eventually occur during the day as sleep apnea becomes chronic. Such cardiac abnormalities can ultimately lead to heart attacks and strokes.

Early in the study of sleep apnea, the only treatment option was tracheostomy, or the surgical creation of a small hole at the base of the neck to allow air to pass freely to the lungs during sleep. During the day, the incision was capped, allowing the patient to breathe and speak normally. At night, the cap was removed to allow the patient to breathe while sleeping. Though successful, the treatment was invasive and often rejected by patients.

Today there are new treatment options available. The continuous positive airway pressure (CPAP) method operates by preventing the throat from collapsing during the intake of air. Sleep apnea sufferers wear a nasal mask each night that allows unrestricted air to flow to the lungs. The CPAP is considered the most effective non-surgical treatment for sleep apnea.

Surgery remains an option for patients with severe obstructive sleep apnea who cannot tolerate the CPAP method. Many ear nose and throat specialists perform uvulopalatopharyngoplasty (UPPP), although its efficacy has been questioned. This procedure involves the removal of the uvula, soft palate and tonsils.

To make the UPPP more effective, doctors at the Stanford University Sleep Clinic have developed a new treatment called the “Phase One” approach. This combines the UPPP with a procedure that moves the tongue forward, increasing the size of the airway.

Although the Phase One procedure is relatively new, it has been effective in 60 to 70 percent of cases and is a relatively inexpensive surgery requiring only a two-day hospital stay.

Another new treatment for obstructive sleep apnea is using radio frequency energy to bombard the uvula, palate and tongue to shrink them and enlarge the airway. The treatment is brief, does not require hospitalization and causes minimal post-treatment pain.

Treatment methods have become more palatable to sleep apnea sufferers, and can improve and prolong life.

Martine Cicconi is a Stanford University student.