An ENT’s Guide to Obstructive Sleep Apnea
We’re all chasing better rest. From herbal teas and nighttime routines to white noise machines and tracking apps, quality sleep is now a key part of the wellness conversation. But for people with sleep apnea, even the most disciplined efforts can fall short. The real issue lies beneath the surface.
At the LifeBridge Health ENT Sinus & Allergy Center, Dr. Alpen Patel helps patients get to the root of disrupted sleep. With dual training in ENT care and sleep medicine, he offers a well-rounded approach to diagnosing and treating sleep apnea, addressing both the anatomy and the science behind better sleep.
What Is Sleep Apnea?
Sleep apnea is a common disorder marked by repeated pauses in breathing during sleep. These interruptions can disrupt sleep cycles, reduce oxygen levels, and, if left untreated, contribute to long-term health concerns.
There are three types:
- Obstructive Sleep Apnea (OSA): The most common form, OSA occurs when soft tissues block the upper airway.
- Central Sleep Apnea (CSA): A less common neurological condition, CSA occurs when the brain fails to send the correct signals to the breathing muscles.
- Mixed or Complex Sleep Apnea: A combination of OSA and CSA, this type typically develops during treatment for obstructive sleep apnea.
Obstructive sleep apnea is by far the most common. Its severity is based on how many times breathing pauses or slows each hour:
- Mild: 5-15 pauses
- Moderate: 15-30 pauses
- Severe: 30 or more pauses
What Are the Symptoms of Sleep Apnea?
You might already know the hallmark signs of this sleep disorder:
- Loud snoring
- Dry mouth or sore throat upon waking
- Morning headaches
- Daytime sleepiness or fatigue
- Difficulty concentrating
But other sleep apnea symptoms are less obvious and often misattributed to stress, aging or other medical issues:
- Frequent nighttime urination (in men)
- High blood pressure
- Irritability or mood swings
- Memory problems
If any of these symptoms sound familiar, start by talking with your primary care provider. They can help identify possible causes and refer you to a specialist like Dr. Patel if sleep apnea is suspected.
What Are the Long-Term Effects of Sleep Apnea?
“Undiagnosed or untreated obstructive sleep apnea can lead to a range of serious health conditions,” Dr. Patel explains.
The disorder puts extra strain on the brain, heart and other organs, raising the risk of early death if left unmanaged. Common complications include:
- Cardiovascular issues: High blood pressure, heart failure, atrial fibrillation and stroke
- Metabolic conditions: Insulin resistance and type 2 diabetes
- Mental health concerns: Mood disorders, memory loss and cognitive decline
Even in mild cases, poor-quality sleep can have a lasting impact on energy, focus and overall well-being.
How Is Sleep Apnea Diagnosed?
Several specialists, including pulmonologists, neurologists and ENT physicians trained in sleep medicine, can diagnose and treat sleep apnea. Each brings a unique perspective.
At the LifeBridge Health ENT Sinus & Allergy Center, Dr. Patel approaches diagnosis with a combination of physical evaluation and sleep testing, starting with a close look at the airway.
A Physical Examination
“The disease affects the upper airway,” Dr. Patel explains. “That’s an area that ENTs are very comfortable with.”
He considers anatomical structures from the tip of the nose through the throat, including the:
- Nasal septum
- Turbinates
- Palate
- Uvula
- Tonsils and epiglottis
- Jaw and tongue
While OSA stems from structural blockages, anatomy isn’t the only factor that can affect breathing.
Considering Allergies
In some patients, allergies and chronic nasal congestion can worsen snoring and airway obstruction. If allergies are suspected, Dr. Patel may recommend testing and treatment for that as well.
Home Sleep Testing
If physical signs point to obstructive sleep apnea, the next step is usually a home sleep test.
“Over the last couple of years, home sleep tests have really improved in terms of their quality and accuracy when compared to the gold standard of in-lab sleep studies,” Dr. Patel says.
Depending on the device, a home test may involve a finger probe, chest strap or small nasal or mouthpiece worn overnight. Most tests are conducted over one to three nights and monitor sleep patterns, breathing changes and oxygen levels. For patients already using a CPAP machine, they can also help determine how well it’s working.
As a board-certified sleep medicine physician, Dr. Patel personally reviews each study to confirm a diagnosis and create a treatment plan.
What Are the Treatment Options?
For many patients with moderate to severe OSA, continuous positive airway pressure (CPAP) therapy is the gold standard. CPAP machines gently push air into the airway to keep it open during sleep.
But CPAP therapy isn’t always easy to stick with. Some people struggle with the fit, noise, dry mouth or hassle of regular use.
“Those patients who want a good night’s rest—especially those patients who have moderate or severe sleep apnea—are the ones who should seek additional care if the CPAP is not working for them,” explains Dr. Patel.
Fortunately, there are alternatives and complementary options:
- Weight loss support (nutrition, exercise and medications)
- Positional therapy (avoiding back sleeping)
- Oral appliance therapy (custom mouthguards)
- Nasal or upper airway procedures to address structural issues
- Inspire® implant (a nerve-stimulating device for qualifying patients)
“More than ever before, we have choices,” Dr. Patel says.
What About Sleep Apnea in Children?
Sleep apnea looks different in kids. Instead of excessive sleepiness, children are more likely to become hyperactive or distracted.
Watch for:
- Behavioral problems or learning difficulties
- Mouth breathing or nasal congestion
- Snoring or breathing pauses at night
In many cases, enlarged tonsils or adenoids are the cause. Surgery is often recommended and effective for children with sleep apnea, even more so than for adults.
Ready to Sleep Better?
If you suspect you or a loved one may have sleep apnea, don’t wait to get answers. Diagnosis is the first step to feeling better.
Dr. Patel and the team at the LifeBridge Health ENT Sinus & Allergy Center are here to help.
About Dr. Alpen Patel
Dr. Patel has more than 20 years of experience caring for patients with ear, nose and throat (ENT) concerns. He began his career in academic medicine, launching allergy and sinus centers at The George Washington University and Emory University. Since moving to Maryland with his wife in 2009, he has continued to care for patients of all ages.
Dr. Patel treats the full spectrum of ENT conditions, from hearing loss and thyroid problems to head and neck cancer, but he has a special interest in nasal and sinus issues, including allergies, sinus infections, nasal congestion and nasal polyps. He is also board-certified in sleep medicine. As one of Maryland’s few sleep surgeons, he provides home sleep studies and Inspire® implant surgery for obstructive sleep apnea.
He joined LifeBridge Health for the opportunity to deliver high-quality, patient-centered care at a system dedicated to community service.