Sleep Apnea Test

Rose here….good evening everyone. As you know from my previous article I have been talking to my sister, Apnea. Apnea was given her name because our mother, Polysomno Pickwickian (Poly for short), suffered from Obstructive Sleep Apnea especially during her pregnancy with her. Obstructive Sleep Apnea (OSA) may be a common form of sleep apnea, but the constant repetitive episodes of cessation of breath due to her large tonsils and the pressure on her lungs due to her pregnancy; she experienced excessive daytime sleepiness, morning headaches, dry mouth and heartburn. Poly, born in the 20th century, complained to her doctor, William Osler about her symptoms and Poly was the first person to be diagnosed with a sleep apnea test.

Dr. William Osler coined sleep apnea the ‘Pickwickian Syndrome’ and wrote a paper that became the well known Pickwick Papers, an accurate clinical picture of adult obstructive sleep apnea syndrome…..and everyone thought he named it after Charles Dickens.

Dr. Osler found that the cessation of breath is associated with the reduction in blood oxygen saturation when the airway becomes obstructed by excess tissue, large tonsils, large tongue and/or sometimes the jaw or nasal passages can be a factor. Other symptoms include; loud snoring, depression, insomnia, frequent nighttime urination, overweight, high blood pressure and rapid weight gain. Some symptoms are not even recognized by the patient and their bed partner/spouse is the only one aware that there is a sleep apnea problem.

Major life threatening risks are heart attacks, strokes, impotence, erratic heartbeat and heart disease if OSA is untreated. Also, you might experience drowsiness when you are awake making it dangerous to drive or operate machinery. Fortunately for my mother her symptoms dissipated after Apnea was born and her tonsils were removed.

It was many years after Dr. Osler’s Pickwick Papers that a machine was invented to monitor and diagnose sleep apnea. Since my mother was the first person diagnosed with sleep apnea the sleep apnea test was called polysomnography. There are two types of sleep apnea tests; one an overnight test that involves monitoring the brain waves, muscle tension, rapid eye movement, breathing and oxygen level in the patient’s blood, the second test is a home monitoring test where a patient takes a polysomnograph home, is instructed how to use it and returns the next morning. These are painless test and might be covered under your health insurance.



If you are like Poly some treatment involves lifestyle changes or minor surgery. Other lifestyle changes are; losing weight and/or just sleeping on your side. If these changes aren’t enforced the patient’s sleep apnea will worsen as they age.

Some patients will use an oral mouth device to help keep the airways open by bringing the jaw forward, elevating the soft palate or preventing the tongue from falling back and obstructing the airway. There are many oral mouth devices on the market today

If the patients has severe sleep apnea it is recommended that they are treated with a C-PAP or continuous positive airway pressure machine that with a nose mask keeps the airway open and unobstructed by blowing air into their nose.

Other severe sleep apnea is caused by facial deformities and can be corrected by surgery. Some of these deformities are; a small jaw causing a small opening at the back or their throat, deviated septum, large tonsils and/or adenoids. All of these can be corrected with minor surgery.

Other surgeries include:

Prior to 1980, a tracheotomy was performed where a small hole was cut into the neck and a tube with a valve was inserted to eliminate obstructions. This procedure is only performed today as a last resort to alleviate the patient from respiratory distress or other major medical complications.

Today the uvulo-palato-pharyngoplasty is preformed for those that cannot tolerate the C-PAP. The uvulo (the skin that dangles in the back of your throat) is removed along with any excess tissue. If you are considering this surgery please discuss the risks involved. Statistics show that the procedure helps 50% of those who have had it and due to scar tissue some may still need to use the C-PAP.

For those with a small jaw which causes the tongue to obstruct the airway a mandibular myotomy is preformed. This surgery involves cutting a piece of bone from the jaw to which the tongue muscles are attached. The bone is pulled outward, rotated 90 degrees and reattached thus pulling the tongue forward and eliminating the air obstruction. This surgery requires a high trained, experienced surgeon in both ENT surgery and maxillofacial surgery.

There are two other surgeries; a LAUP or laser assisted uvuloplasty (removes the uvula) and a somnoplasty aka RF or radiofrequency (shrinks the uvula) that improve airflow and eliminates snoring. Also there is a new treatment that has been approved by the FDA, in which radiofrequency reduces the tongue. This RF treatment to the tongue involves inserting a needle and heating the inner tissues to 158 to 176 degrees causing the tissue to shrink. Since this procedure is new it may not be covered by health insurance.

Luckily for my mother the only thing she had to have done was have her tonsils removed, but in the 20th century it was still considered a major surgery. If it wasn’t for Dr. Osler she would have never been diagnosed with sleep apnea with a sleep apnea test. Today the polysomnography is used to diagnose, or rule out, many types of sleep disorders including narcolepsy, restless legs syndrome, REM behavior disorder, parasomnias, and of course sleep apnea.
Good Day,
Rose Sheepskill