Obstructive Sleep Apnea Treatment in Corpus Christi, TX

Obstructive sleep apnea (OSA) is a chronic sleep disorder characterized by repetitive episodes of partial or complete upper airway collapse during sleep. Each collapse causes a reduction (hypopnea) or cessation (apnea) of airflow that lasts at least 10 seconds, producing oxygen desaturation, arousal from sleep, and fragmentation of normal sleep architecture. OSA affects an estimated 24 percent of middle-aged men and nine percent of middle-aged women, with prevalence increasing substantially with age and obesity. Despite its frequency, it is estimated that 80 percent of individuals with moderate to severe OSA remain undiagnosed. At Corpus Christi ENT Sinus & Allergy, Dr. Todd M. Weiss provides comprehensive evaluation and a full spectrum of treatment options for obstructive sleep apnea.

What Causes Obstructive Sleep Apnea?

During sleep, the muscles that maintain upper airway patency including the genioglossus (tongue), soft palate, and pharyngeal walls relax. In susceptible individuals, this relaxation, combined with the negative pressure generated by breathing, causes the airway to narrow or collapse. Anatomical factors that predispose to OSA include:

  • Obesity — the most important modifiable risk factor; excess pharyngeal adipose tissue narrows the airway
  • Enlarged tonsils and adenoids — particularly important in children
  • Retrognathia or micrognathia — a recessed or small lower jaw that crowds the tongue into the pharynx
  • Craniofacial abnormalities — including Down syndrome, Pierre Robin sequence, and other conditions
  • A long, floppy soft palate or enlarged uvula
  • Macroglossia — an enlarged tongue
  • Nasal obstruction — from deviated septum, turbinate hypertrophy, or nasal polyps; increases negative pharyngeal pressure

Symptoms of Obstructive Sleep Apnea

Nocturnal Symptoms

  • Loud, habitual snoring — often the first symptom reported by a bed partner
  • Witnessed apneas — observed cessation of breathing during sleep
  • Gasping or choking arousals
  • Restless sleep and frequent position changes
  • Nocturia — waking repeatedly to urinate
  • Diaphoresis — sweating during sleep
  • Gastroesophageal reflux — nocturnal reflux is exacerbated by OSA

Daytime Symptoms

  • Non-restorative sleep — waking unrefreshed despite adequate sleep duration
  • Morning headaches — from hypercapnia (elevated carbon dioxide) during sleep
  • Irritability, mood disturbance, and depression
  • Decreased libido
  • Cognitive impairment: difficulty concentrating, poor memory, and executive dysfunction
  • Excessive daytime sleepiness (EDS) — the hallmark symptom; may present as falling asleep at meetings, watching television, or driving

Cardiovascular and Systemic Consequences

Untreated moderate to severe OSA is strongly associated with:

  • Systemic hypertension — OSA is a leading secondary cause of resistant hypertension
  • Motor vehicle and workplace accidents from impaired vigilance
  • Atrial fibrillation and other cardiac arrhythmias
  • Coronary artery disease and myocardial infarction
  • Stroke — both ischemic and hemorrhagic
  • Type 2 diabetes and insulin resistance
  • Pulmonary hypertension
  • Non-alcoholic fatty liver disease
  • All-cause mortality — meta-analyses demonstrate elevated mortality risk in untreated severe OSA

Diagnosis

Polysomnography (PSG)

In-laboratory polysomnography is the gold standard diagnostic test for OSA. It records multiple physiologic parameters simultaneously during sleep, including electroencephalography (brain waves), electro-oculography (eye movements), electromyography (muscle tone), airflow, respiratory effort, oxygen saturation, heart rate, and body position. The key diagnostic metric is the Apnea-Hypopnea Index (AHI) the average number of apneas and hypopneas per hour of sleep. OSA severity is classified as: mild (AHI 5 to 14.9), moderate (AHI 15 to 29.9), or severe (AHI 30 or greater).

Home Sleep Apnea Testing (HSAT)

For patients with a high pre-test probability of uncomplicated OSA without significant comorbidities, a portable home sleep apnea test may be appropriate. HSAT is less comprehensive than PSG but is more accessible and cost-effective for appropriate candidates.

Treatment Options

Continuous Positive Airway Pressure (CPAP)

CPAP is the first-line treatment for moderate to severe OSA and highly effective for all severities. By delivering a continuous stream of pressurized air through a mask interface, CPAP acts as a pneumatic splint that maintains upper airway patency throughout the sleep cycle. When used consistently (at least four hours per night on 70 percent of nights), CPAP normalizes the AHI, eliminates oxygen desaturation, improves daytime sleepiness, reduces blood pressure, and lowers cardiovascular risk. Despite its efficacy, long-term adherence is a significant clinical challenge, with approximately 30 to 50 percent of patients ultimately unable to use CPAP consistently.

Oral Appliance Therapy (MAD)

Mandibular advancement devices (MADs) are custom-fitted oral appliances that reposition the lower jaw and tongue forward during sleep, enlarging the retrolingual and retropalatal airway spaces. They are indicated for mild to moderate OSA and as an alternative to CPAP for patients with CPAP intolerance. Efficacy is lower than CPAP but adherence is typically higher.

Positional Therapy

Approximately 50 to 60 percent of OSA patients have position-dependent OSA predominantly occurring in the supine (back-sleeping) position. Positional devices, vibrating alerts, or specialized pillows that discourage supine sleeping can reduce AHI significantly in this subgroup.

Weight Loss

For obese patients, weight reduction is one of the most effective OSA treatments. A 10 percent reduction in body weight is associated with a 26 percent reduction in AHI. Bariatric surgery in severely obese patients with OSA can produce substantial and durable improvement.

Surgical Treatment

Surgical intervention is indicated for patients who: fail or are intolerant of CPAP, have an identifiable and correctable anatomical obstruction, or have OSA caused by a specific structural abnormality amenable to correction. Surgical options include:

  • Uvulopalatopharyngoplasty (UPPP): removes and repositions excess retropalatal soft tissue; most effective for retropalatal obstruction with tonsillar hypertrophy
  • Septoplasty and turbinate reduction: improves nasal airflow, enhances CPAP tolerance, and reduces nasal contribution to OSA
  • Maxillomandibular advancement (MMA): surgical repositioning of the upper and lower jaws to permanently enlarge the entire upper airway; the most effective surgical procedure for OSA, with success rates exceeding 85 percent
  • Hypoglossal nerve stimulation (Inspire): an implantable device that stimulates the hypoglossal nerve during sleep to maintain tongue muscle tone; FDA-approved for adults with moderate to severe OSA who fail CPAP
  • Adenotonsillectomy: first-line surgical treatment for pediatric OSA; highly effective

Schedule an Appointment Today

If loud snoring, daytime fatigue, or witnessed pauses in breathing are affecting you, an evaluation can identify whether sleep apnea is the cause. Call us at (361) 320-6130 or connect with us online to schedule a sleep apnea evaluation.

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