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obstructive sleep apnea A disorder in which
blockage of the airways takes place during sleep
when the structures of the neck and THROATrelax,
causing BREATHINGto stop for periods of time. The
characteristic symptoms are a repeated pattern
during sleep of loud, heavy snoring followed by a
period of silence followed by gasping or snorting
and tiredness during waking hours. The snoring
indicates the structures of the throat are relaxing
and the passage for air is narrowing; the silence
indicates relaxation has reached the point at
which no air is getting through. The gasping or
snorting is a reflexive reaction to the drop in the
blood’s oxygen level; it serves to restart breathing.
The cycle results in continuous interruption of
sleep, leaving the person deprived of rest. The
repeated episodes of oxygen deprivation can cause
or contribute to numerous health problems,
including HYPERTENSION (high BLOOD PRESSURE),
ARRHYTHMIA (irregular heartbeat), PULMONARY
HYPERTENSION, and HEART FAILURE(reduced ability of
the HEARTto pump BLOOD).
Many people who have obstructive sleep apnea
are not aware that they do, though often their
partners complain about their snoring. Often the
first indication is the uncontrollable urge to fall
asleep during the day, which may occur at danger-
ous times, such as when driving. Frequent
headaches, lack of energy, and irritability are other
symptoms. The diagnostic path includes a detailed
sleep questionnaire and careful physical examina-
tion with a focus on the structures of the MOUTH
and neck. The doctor may also request a sleep lab
assessment, in which the person spends the night
under observation and with electronic monitoring
to objectively assess the sleep experience.
About 40 percent of people who have obstruc-
tive sleep apnea have obesity. When this is the

case, WEIGHT LOSS AND WEIGHT MANAGEMENTare key

to treatment. Lifestyle modifications, such as

avoiding ALCOHOLor medications that cause sleepi-

ness (such as ANTIHISTAMINE MEDICATIONS or sleep

aids), can improve the body’s ability to retain con-

trol over the muscles of the throat. Some people

benefit from surgery to remove excess tissue at

the back of the throat (uvulopalatopharyngo-

plasty). A continuous positive airway pressure

(CPAP) device to maintain pressure against the

airways and to keep them open is often an effec-

tive treatment when other approaches are not

appropriate or not successful.

See also SLEEP DISORDERS; WEIGHT LOSS AND WEIGHT

MANAGEMENT.

oral hygiene Self-care methods for maintaining

health of the TEETH, gums, and MOUTH. Oral health-

care providers recommend brushing the teeth at

least twice daily and flossing or using an interden-

tal device to clean between the teeth once daily.

People who snack throughout the day should

brush more frequently to clear away food debris

and BACTERIAthat accumulate after eating. Appro-

priate oral hygiene helps maintain the health of

the teeth, gums, and other structures of the

mouth and also reduces the risk of INFECTION in

people who have tongue, lip, or other oralPIERC-

INGS. Tooth decay and gum disease develop more

rapidly in people who have diminished saliva pro-

duction, have DIABETES, or who smoke. Further

preventive care measures include regular visits to

the dentist and dental hygienist for cleaning

and examination to detect oral health problems

such as GINGIVITIS, PERIODONTAL DISEASE, and oral

CANCER.

See also HALITOSIS; SJÖGREN’S SYNDROME; SMOKING

AND HEALTH; TOBACCO USE OTHER THAN SMOKING.

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