WHAT IS OBSTRUCTIVE SLEEP APNEA?
Obstructive Sleep Apnea (OSA) is the most common type of sleep apnea in the US. Typically the uvula, soft palate, tonsils, or tongue will collapse into the back of the throat during deep, especially REM, sleep, and in supine position causing moderate to severe obstruction. This will be evident by snoring combined with choking and even gasping for breath while sleeping. During the obstruction episode, the level of oxygen in the body drops to below normal and this increases stress on all parts of the body, especially the brain and heart. Men may also be 2 to 3 times more likely to experience sleep apnea than women.
HOW DO I KNOW IF HAVE OSA?
Typically the first sign of OSA is snoring. If you or your partner notices that you stop breathing during sleep or appear to be gasping or choking during sleep and wake up with a gasp, then most likely you have OSA. Because you are still making efforts to breathe but having obstruction in the nose and throat, this condition is called Obstructive Sleep Apnea. There may be arousals from sleep as well and you may not feel well rested and perhaps have daytime sleepiness, fatigue or early morning headaches. You may feel that you are not getting enough sleep. Children with OSA may go on to develop ADHD.
Moderate to severe sleep apnea significantly increases the risk of high blood pressure, heart attacks and heart disease, strokes, accidents, memory impairment, and loss of concentration due to lack of sleep, among other adverse health effects. There is a higher risk of day time tiredness and fatigue or sleepiness in people with OSA with increased risk of motor vehicle accidents or when operating machinery. All individuals are warned not to drive or operate machinery if they are sleepy.
DIAGNOSING & TREATING OBSTRUCTIVE SLEEP APNEA
If you suspect that you or your partner have obstructive sleep apnea, the first step is to talk to a board-certified otolaryngologist who specializes in sleep medicine such as Dr. Khetarpal. Your doctor will probably perform a series of tests to determine if you have sleep apnea including endoscopy and a sleep study.
Once Obstructive Sleep Apnea has been diagnosed, there are various treatment options available to patients which include a weight-loss plan, if indicated, and a autoPAP (Automatic Positive Airway Pressure), oral appliance or surgery. Some patients cannot tolerate CPAP or an oral appliance and your doctor may suggest surgery. Because the obstruction occurs either in the nose (Level I obstruction), or may be related to the soft palate and uvula (Level II obstruction) and quite often due to either the tonsils, tongue and throat muscle collapse (Level III obstruction), surgery is performed to improve the nasal passages and the throat airway or to have the tongue move forward during each inspiration with an implanted hypoglossal nerve stimulator. Every treatment option is designed to improve the airway either in or behind the nose, in the throat, or behind the tongue. In a significant majority, after a patient begins CPAP, their sleep improves and they have more energy to exercise and be more productive throughout the day. Depending on your results, Dr Khetarpal will discuss the best treatment option for you. In most situations, a deviated nasal septum with enlarged inferior turbinates is found and septoplasty and turbinate reduction may be recommended. fOr those intolerant to autoPAP or oral appliance therapy, hypoglossal nerve stimulator or alternative surgery may be recommended, if the individual meets the criteria.
WHY CHOOSE DR. KHETARPAL?
Dr. Khetarpal was trained in New York with additional research and clinical training fellowships at the prestigious Harvard Medical School-affiliated hospitals including Massachusetts Eye and Ear Infirmary and Brigham and Women's hospital. He is amongst the first few surgeons in the country to offer Image-Guided In-Office Comprehensive Sinus Surgery and PIVA™ Painless IV Anesthesia Balloon Sinuplasty. He also conducted clinical research on sinusitis and allergic rhinitis with the approval of the Western Institutional Review Board that oversaw this research. His interest in sleep disorders, particularly snoring and Obstructive Sleep Apnea compelled Dr. Khetarpal to obtain Board Certification in Sleep Medicine so that he could provide a consistently high quality of care for these patients. He was also amongst the first Otolaryngologists in the country to start using sublingual immunotherapy or drops for allergy patients
Dr. Khetarpal presented 3 research papers on Recurrent Acute Rhinosinusitis at the International Meeting of Rhinology in Chicago, in June 2019. There are very few sinus specialists in private practice conducting sinus or allergy research in the US. He is one of those few.
In addition to his extensive knowledge and experience, Dr. Khetarpal is known for his patience and compassionate care. He practices in Houston and The Woodlands and is accepting new patients. Schedule an appointment with Dr. Khetarpal to determine if you have obstructive sleep apnea and to get the personalized care you need to sleep better, breathe easily, and wake up feeling refreshed.
I went in for headaches, dizziness, lack of sleep, migraines, chronic fatigue. Dr. Khetarpal recommended surgery and it could not have gone better. The staff was extremely helpful, and recovery was a breeze. 4 hours post-surgery I was sitting with my fiance discussing wedding plans. I did not experience any pain post-operation and bleeding was minimal after the surgery. It only had a small drip for the 3 hours following the operation. I would absolutely recommend him to anyone.
