The Many Fronts of Battling Obstructive Sleep Apnea

Abstract

Obstructive sleep apnea (OSA) is a breathing disorder during sleep secondary to collapsing upper airways that leads to a significant decrease or a complete cessation of airflow despite an effort to breathe. As the name suggests, an obstruction, likely caused by an inherited narrow airway, is the most common cause. But there are less known factors that may contribute to the worsening of OSA. We present a case of very severe OSA contributed by weight gain, opioid use, and anterior cervical discectomy and fusion (ACDF), in addition to a genetically narrow airway. This case highlights the importance of battling OSA on many different fronts. Our patient eventually was able to stop positive airway pressure (PAP) therapy, once the contributing factors were addressed appropriately.

Anterior Cervical Discectomy and Fusion: A Hidden Etiology of Obstructive Sleep Apnea

“…The unmodifiable factors are inherited as anatomical structural abnormalities. These include a genetically inherited narrow airway, craniofacial deformities, micro-or retrognathia, and inferior positioning of the hyoid bone [7]. The modifiable risk factors include age, weight, medication use, substance abuse, underlying cardiac, pulmonary, or endocrinological disease, as well as nasal obstruction.…”

Hidden Dangers of Severe Obstructive Sleep Apnea

“…This breathing disorder manifests as a decrease or complete cessation of airflow despite efforts to breathe while sleeping. OSA is influenced by risk factors such as male sex, advanced age, race, obesity, use of sedative medications, nasal obstruction, and underlying endocrinological disorders such as acromegaly [2]. Certain surgical procedures such as anterior cervical discectomy and fusion (ACDF) can cause new onset or worsening of existing OSA [3].…”