Center for Sleep Disorders

Causes of Sleep Disorders

Obstructive sleep apnea (OSA) and loud snoring without OSA are caused by obstructions of the airway from the entrance to the nose to the back of the tongue and structures below. With the relaxation of sleep, the muscles in and supporting the structures of the airway relax. In patients who have excessive tissue or certain types of anatomy, the soft tissues of the airway collapse upon breathing in (inspiration), blocking the airway or producing loud snoring.

These obstructions may include:

  • Nasal obstructions, due to the shape of nasal cartilage or bones along the wall of the nasal cavity, that force the patient to breathe through the mouth
  • Soft-palate blockages at the back of the mouth and throat
  • A blockage at the larynx (voice box) due to the location of a related bone

Specialists at the Center have invented surgical solutions to all of these problems and are able, with modern diagnostic methods, to find out and correct the causes of loud snoring or OSA.

Sleep Apnea

Obstructive Sleep Apnea (OSA) is a common disorder that can be very serious. It is the cessation of breathing that occurs during sleep. Usually, it is due to physical airway obstruction by the tissues surrounding and in the airway at some point between the nostrils and the larynx (voice box). The places where airway obstruction happens may be one or a combination of several.

Occasionally, apnea during sleep may be due to the inability of the brain to signal the body to begin breathing (respiration). This is not obstructive sleep apnea, but non-obstructive apnea or simply sleep apnea. It is most often treated with medications.

Snoring with OSA

Often, OSA is accompanied by snoring. Snoring is produced by the vibration of the uvula, the free edge of the soft palate and the tonsil folds called pillars (the arches and little "punching bag" that may be seen at the back of the mouth) against the back wall of the throat. When someone snorts, they are breathing in rapidly while relaxing the soft palate, which is exactly what is happening during loud snoring and also with OSA.

When the person with OSA stops breathing during sleep due to physical obstruction of the airway by their throat tissues, the oxygen carried in the blood is reduced. This is made worse in people who are overweight, as obesity itself prevents the lungs from delivering the normal levels of oxygen to the blood. When an overweight person or any person with OSA stops breathing, the drop in the oxygen level in the blood becomes more severe. As the oxygen level falls in the blood, the person will awaken. Since this awakening is often very brief, the individual is not aware of this cycle. In cases of severe OSA it may be happening hundreds of times during the night.

These sleep disruptions cause increased sleepiness and an increased drive for sleep, which contributes to the loss of muscle activity in the upper airway. This makes an upper airway much more prone to collapse and becoming obstructed, which leads to a cycle of recurring apneic (no breathing) events.

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Meet An Expert

Yosef Krespi, MD, FACS

Yosef Krespi, MD, FACS

Yosef Krespi, MD, FACS is the Director, Center for Sleep Disorders, NYHNI, Associate Director, Head & Neck Surgery Service Line, North Shore-LIJ.

Harly Greenberg, MD, FAASM, FCCP

Harly Greenberg, MD, FAASM, FCCP

Harly Greenberg, MD, FAASM, FCCP is Medical Director, North Shore-LIJ Sleep Disorders Center; Program Director, Hofstra-North Shore LIJ Sleep Medicine Fellowship Program; and Professor of Medicine, Hofstra-North Shore-LIJ School of Medicine.