Obstructive sleep apnea (OSA) is defined as an episode of airflow interruption during sleep, characterized by normal breathing effort but no airflow, lasting longer than 10 seconds (approximately two breaths) and with a minimum of five such episodes per hour. Obstructive sleep apnea occurs only during sleep and not during wakefulness.

Obstructive sleep apnea results from a complex interaction between nerves, muscles and certain predisposing structural anatomic factors. There is a normal relaxation in muscle tone during sleep but with any combination of the above factors in susceptible individuals, the airway closes. The brain then senses a reduction in oxygen and an increase in carbon dioxide and sends a signal to resume breathing. The patient experiences an arousal from sleep in response to the brain signal, and the muscles of the tongue and pharynx open the airway and breathing resumes. Often this occurs with a loud snort or gasp.

The arousal from sleep is necessary to restart breathing, but prevents the patient from getting good quality sleep; and repeated episodes over the course of a night result in such symptoms as excessive daytime sleepiness, compromised immune system, poor concentration, memory problems, a slow reaction time and the medical problems mentioned previously.

Figures 1-4 are actual PSG recordings.  The time period for examination can be selected by the doctor or technician between 10 and 360 seconds.

The PSG used for these figures is the BRAEBON MediByte®, an ambulatory home testing device shown to be highly accurate.
Figure 1
Figure 1

Figure 1 is a 30 second epoch showing very loud snoring at between 104 and 105 decibels and an apnea episode (green) of 22 seconds.  Chest and abdominal effort can be noted.  The patient is sleeping on the right side.  The histograms of the whole night on the lower part of Figure 1 clearly shows many apneic episodes, many and frequent desaturations (blue) and very loud snoring  the whole night but incredibly loud snoring during the last hour of sleep.  The thirty second epoch shown #2423 out of 2470 is identified on the histograms by the bolder vertical line near the end of the histogram.

Note:  Snoring can be seen to occur during apneic episodes.  Apneas are 80-100% reduction in air flow.  The greatly reduced airflow can still cause snoring.  The snores are approximately 2 seconds in duration and incredibly loud, ranging from 104 to 105 decibels.
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