Obstructive sleep apnea

In obstructive sleep apnea, the airway closes again and again while you sleep. Each closure stops your breathing for a few seconds, lowers your oxygen and forces your brain to wake you briefly so you can breathe again. These are awakenings you don’t remember, but they break up your sleep hundreds of times a night: that is why you wake up tired even after sleeping “eight hours.”

Leaving it untreated has consequences: high blood pressure, higher cardiovascular risk, drowsiness while driving, and problems with concentration and mood. The good news is that it is diagnosed with a simple test you can do in your own bed, and today there are several effective treatments, chosen according to the cause of the obstruction and your preferences.

• Loud snoring with pauses that others notice
• Unrefreshing sleep and daytime sleepiness
• Headache on waking and dry mouth
• Waking up with a choking sensation
• Difficulty concentrating, irritability and poor performance
• Excessive daytime sleepiness
• Getting up several times at night to urinate

• A narrow airway due to anatomy: palate, tongue, tonsils, small jaw
• Nasal obstruction
• Excess weight and obesity
• Age, male sex and menopause in women
• Alcohol, sedatives and sleeping on your back, which make it worse

Dr. Irina examines the nose, mouth and throat and performs a nasal and airway endoscopy to see where the airflow narrows. If she suspects sleep apnea, she orders a home sleep test (respiratory polygraphy), which she interprets herself. In selected cases she performs a drug-induced sleep endoscopy (DISE) in the operating room or orders an in-lab polysomnography.

The home test records your breathing, oxygen, snoring and position during a normal night, and Dr. Irina interprets it personally to explain the result and grade the apnea. With that, and with what she saw on examination, she defines the treatment.

1. 01Home sleep test
   Respiratory polygraphy done in your own bed and interpreted by Dr. Irina herself: it records breathing, oxygen and snoring during the night to confirm and grade sleep apnea.
2. 02CPAP
   A machine that keeps the airway open with air pressure during sleep. Dr. Irina prescribes it, adjusts the pressure and provides follow-up so you adapt well and use it consistently.
3. 03Snoring and sleep apnea surgery
   Pharyngoplasty and nasal surgery to widen the airway when the anatomy calls for it. Sleep endoscopy helps locate where it closes.

Dr. Irina has a subspecialty in sleep-disordered breathing and approaches sleep apnea from both sides: the medical one, with CPAP, oral appliances and general measures, and the surgical one, with nasal and palate surgery when the anatomy calls for it. Her role is to help you choose a treatment you can keep up over time, because sleep apnea is controlled with consistency, and to support you until you sleep well.