Obstructive Sleep Apnea (OSA)

Obstructive Sleep Apnea (OSA) is one of the most common sleep disorders, affecting millions of adults and children worldwide. OSA occurs when the muscles and tissues of the upper airway relax repeatedly during sleep, causing partial or complete blockage of airflow. These breathing interruptions may occur dozens or even hundreds of times throughout the night.

Although loud snoring is most commonly associated with sleep apnea, OSA is far more than a nuisance. Repeated oxygen drops and fragmented sleep can contribute to excessive daytime fatigue, poor concentration, memory problems, mood changes, high blood pressure, heart disease, stroke, atrial fibrillation, type 2 diabetes, and increased risk of motor vehicle and workplace accidents.

At The Medical Group of New Jersey, our goal is to restore healthy sleep, improve daytime function, and reduce long-term health risks associated with untreated sleep apnea.

Symptom Onset & Initial Evaluation

Many people live with sleep apnea for years before receiving a diagnosis. Because symptoms occur during sleep, family members or bed partners are often the first to notice signs that something may be wrong.

Common symptoms of sleep apnea include:

Loud or disruptive snoring
Pauses in breathing during sleep
Gasping, choking, or snorting during sleep
Morning headaches
Dry mouth upon awakening
Excessive daytime sleepiness
Difficulty concentrating
Memory problems
Mood changes or irritability
Decreased work performance
Falling asleep while reading, watching television, or driving

Sleep apnea can affect individuals of all ages and body types, although certain factors increase risk, including obesity, large neck circumference, family history, advancing age, nasal obstruction, smoking, alcohol use, and certain facial or airway structures.

Evaluation

During your initial visit, your sleep specialist will review your sleep habits, symptoms, medical history, medications, and risk factors. Standardized screening tools may be used to evaluate daytime sleepiness and assess the likelihood of sleep-disordered breathing.

A physical examination often includes evaluation of airway anatomy, nasal passages, tongue position, tonsil size, and other factors that may contribute to airway obstruction.

Diagnosis

Accurate diagnosis is essential because treatment often varies based on the severity and type of sleep apnea present.

Home Sleep Apnea Testing (HSAT)

Many people can undergo sleep testing from the comfort of their own home. Home sleep apnea testing records airflow, breathing effort, oxygen levels, and heart rate during sleep. This option is often appropriate for patients with symptoms strongly suggestive of obstructive sleep apnea and few complicating medical conditions.

Overnight Polysomnography (Sleep Study)

For a more comprehensive evaluation, an overnight sleep study may be performed in an accredited sleep laboratory. Polysomnography continuously monitors:

Brain activity
Breathing patterns
Oxygen levels
Heart rhythm
Muscle activity
Eye movements
Sleep stages
Leg movements

This testing provides detailed information about sleep quality, breathing abnormalities, and other sleep disorders.

CPAP Titration Studies

If sleep apnea is diagnosed, additional testing may be performed to determine the optimal pressure settings needed for CPAP or other positive airway pressure devices.

Additional Evaluation

Some people may require further assessment of contributing conditions, such as:

Nasal obstruction
Enlarged tonsils
Obesity
Heart disease
Pulmonary disease
Neurologic disorders

At The Medical Group of New Jersey, our specialists carefully evaluate the severity of sleep apnea and any underlying contributing factors to create a personalized treatment plan.

Treatment

Effective treatment not only improves sleep quality but can also significantly reduce cardiovascular risk, improve energy levels, enhance concentration, and improve overall quality of life.

Positive Airway Pressure (PAP) Therapy

CPAP remains the gold-standard treatment for moderate to severe obstructive sleep apnea. A CPAP delivers a gentle stream of air through a mask worn during sleep, preventing airway collapse and maintaining normal breathing throughout the night.

Benefits of PAP therapy often include:

Improved daytime alertness
Better sleep quality
Reduced snoring
Lower blood pressure
Improved cardiovascular health
Better mood and concentration

For patients requiring specialized support, alternative devices such as AutoPAP (APAP) or BiPAP may be recommended.

Oral Appliance Therapy

For selected patients with mild to moderate sleep apnea or those unable to tolerate CPAP therapy, custom oral appliances can reposition the jaw and tongue to maintain airway patency during sleep. These devices are fitted by specially trained dental professionals and may provide excellent symptom control for appropriate candidates.

Weight Management

Excess weight contributes significantly to airway narrowing and sleep apnea severity. Even modest weight loss can improve breathing during sleep and reduce symptoms. Our team may recommend nutritional counseling, structured exercise programs, medical weight-loss therapy, GLP-1 medications when appropriate, or bariatric surgery consultation for qualifying patients.

Positional Therapy

Some people experience worsening sleep apnea when sleeping on their back. Positional therapy techniques may help reduce airway obstruction and improve sleep quality.

Surgical Treatment

When non-surgical therapies are ineffective or poorly tolerated, surgical intervention may be considered. Surgical procedures include tonsillectomy, nasal surgery, uvulopalatopharyngoplasty (UPPP), maxillomandibular advancement, and hypoglossal nerve stimulation (Inspire® therapy). Our sleep specialists collaborate closely with ENT and sleep surgery experts to determine whether surgical treatment may be beneficial.

Ongoing Management & Prevention

Sleep apnea is typically a long-term condition requiring ongoing follow-up and monitoring. Regular visits allow your physician to evaluate treatment effectiveness, address equipment issues, and adjust therapy as needed.

Long-term management may include:

PAP compliance monitoring
Mask fitting and equipment adjustments
Repeat sleep testing when indicated
Weight management support
Monitoring cardiovascular risk factors
Treatment of contributing airway conditions

With proper treatment and follow-up, most patients experience substantial improvements in sleep quality, daytime energy, cognitive function, and overall health.

Related Specialties

Sleep Medicine