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Obstructive Sleep Apnea

It’s true: A woman’s work is never done. But don’t let that keep you from seeing your obstetrics and gynecology (OB-GYN) specialist regularly. Your OB-GYN provides vital routine screenings and exams to keep tabs on your health. They also treat conditions that are specific to women’s health, and offer expert guidance and care through every stage of life: from teenage years to family planning, pregnancy, menopause and beyond.

Want to learn more about which birth control option is best for you? Or how to be your healthiest before pregnancy? Maybe you just want to run, laugh and sneeze without embarrassing bladder leaks. Orlando Health OB-GYNs are here to help.

Prevention and Wellness

Your OB-GYN provider is an essential partner in your health. They can tell you which
well-woman preventive services are right for you, when to begin certain screenings, and how often you should have them based on your personal and family health history. Think of your OB-GYN as your personal women’s health and wellness coach.

Annual Exams and Screenings

You may be wondering why you need to see an OB-GYN specialist annually if you aren’t planning to get pregnant or if you already see your family doctor for an annual exam. But, if you have questions or concerns about your menstrual cycle, your reproductive health, urinary incontinence or menopause, your OB-GYN is the best person to talk to.

An annual gynecological exam (or well-woman exam) is also your opportunity to be screened for common cancers that affect women and sexually transmitted diseases (STDs).

Every well-woman exam includes a general health screening for high blood pressure, body mass index, and a review of personal and family health history. From there, you and your OB-GYN provider will work together to customize your care. Your preventive care is based on your age, health and family history, and other risk factors.

Depending on your needs, your annual well-woman exam may include:

  • A pelvic exam is a routine checkup to assess your gynecologic health. During the exam, the doctor will check your vulva, vagina, cervix, ovaries, uterus and pelvis for any abnormalities

  • A pap smear to check for cervical cancer or HPV (the virus that causes most cases of cervical cancer)

  • A breast exam to check for breast abnormalities

  • A discussion to help you choose the right birth control for you

  • A discussion about lifestyle choices that could hurt your reproductive and general health

  • Immunizations for HPV, the flu, Tdap and more

  • Pre-pregnancy counseling

  • Screening for STDs

  • Skilled counseling and treatment for female health problems such as:

    • Irregular or painful periods

    • Painful intercourse

    • Menopause symptoms

    • Bladder control

    • Trouble getting pregnant

    • Prenatal and postpartum depression

    • Domestic abuse

    • Other concerns you may have

Pregnancy Care and Screenings

If you’re pregnant, make an appointment with your OB-GYN now to begin prenatal care and screenings. Special care and screenings help you have the healthiest pregnancy possible. Part of your pregnancy care will include advice on nutrition, exercise and any vitamins you might need. Screenings help spot risks or conditions early on, before they cause complications for you and your baby.

You’ll have screenings throughout your pregnancy, which include:

  • A complete blood count test to check for anemia (too few red blood cells) and other health problems

  • Tests to check for hepatitis B and C, rubella, syphilis, chlamydia, and HIV

  • Urine tests to diagnose urinary tract infections and preeclampsia (high blood pressure that’s new with pregnancy)

  • A blood test to see if you have Rh-negative blood type and will need an Rho(D) immune globulin shot (prevents problems if your baby has Rh-positive blood)

  • A glucose tolerance test to help diagnose gestational diabetes (high blood sugar during pregnancy, which can affect your baby’s health)

  • A test to check for group B strep infection (which can affect your pregnancy and your baby’s health)

  • Ultrasound imaging to check for birth defects or problems with the placenta

Setting Long-Term Health Goals

Whether or not you want to have children, it’s good to have a plan for how you’ll reach your short-term and long-term fertility goals.

Often called a “reproductive life plan,” this set of goals is your strategy for becoming a parent or preventing pregnancy. Your OB-GYN will help you make that plan and put it into practice. With a reproductive life plan in place, you’ll know exactly what kind of care you’ll need to reach your goals. This may include contraceptive, pre-pregnancy or infertility counseling.

Your OB-GYN can also help you set long term goals related to your overall health. If you have questions about diet, exercise or overall wellness, your doctor is here to help you make a plan for achieving your goals.

Ask your Orlando Health OB-GYN provider for more information about reproductive life planning and achieving any other health goals at your next appointment.

Questions for Your OBGYN

Your Orlando Health OBGYN is here to answer your questions. Make the most of your time during your next checkup by bringing a list of questions with you so you don’t forget to ask anything important. Some frequently asked questions are:

  • Is my menstrual cycle normal?

  • What tests and exams do I need, and how often do I need to have them done?

  • What are all the types of birth control?

  • What do I need to do to have a healthy pregnancy?

  • What immunizations do I need?

  • Am I going through perimenopause?

Vaccinations

Because of vaccines, many serious diseases that used to be common or deadly are now obsolete or less severe. Vaccines protect you and those around you from disease by using dead or weakened forms of bacteria or viruses to strengthen your immune system against the real thing. And if you’re pregnant, the benefits of immunizations are passed on to your baby.

Depending on your age and health history, your OBGYN provider may recommend getting the HPV vaccine to protect you from cervical cancer and genital warts. If you’re pregnant, your OB-GYN will recommend receiving the flu vaccine and the Tdap vaccine to protect your baby from the flu and whooping cough, which can be life-threatening for babies.

Orlando Health follows the Centers for Disease Control and Prevention’s recommendations for vaccinations. Learn more about the recommendations for the HPV vaccine and maternal vaccines.

What is Obstructive Sleep Apnea in Adults? Obstructive sleep apnea is a common problem that affects a person’s breathing during sleep. A person with obstructive sleep apnea has times during sleep in which air cannot flow normally into the lungs. This occurs because there is a blockage in the airflow (obstruction) that is usually caused by the collapse of the soft tissue in the back of the throat (upper airway) and tongue during sleep.

Apnea means breathing cessation. In obstructive sleep apnea (OSA) you may stop breathing for short periods of time. Even when you are trying to breathe, there is little or no airflow into the lungs. This causes oxygen saturation to drop in cycles. These pauses in airflow (obstructive apneas) can occur off and on during sleep, and cause you to wake up from a sound sleep. Frequent apneas can cause many problems. With time, if not treated, serious health problems may develop.

OSA is more common in men, women after menopause, and people who are over the age of 65. OSA can also occur in children. People who are at high risk of developing sleep apnea include those with:

  • Enlarged tonsils and/or adenoids

  • Family history of OSA

  • Excessive weight–obesity

  • Jaw problems such as a small jaw (micrognathia) or a pulled back jaw (retrognathia)

Can OSA be dangerous?

Lack of sleep can cause you to fall asleep while driving and result in car accidents. OSA can, with time, cause high blood pressure (hypertension), heart disease, stroke, diabetes mellitus or early death.

How do I know if I have OSA?

If you have symptoms of OSA, you need to talk with your healthcare provider. Your healthcare provider can help you decide if you need a sleep study and whether you should be evaluated further at a sleep center.

OSA is diagnosed by a sleep study (Polysomnogram). A sleep study is often done at a sleep center where you will be scheduled to sleep overnight. Alternatively, an at home sleep apnea test may also be used to diagnose OSA. During a sleep study, your breathing, heart rate and oxygen levels will be monitored.

How is sleep apnea treated?

Sleep apnea can be effectively treated, and there are a number of ways to do so. The choice of treatment will depend on the reason for and severity of the sleep apnea. If your OSA is from being overweight, weight loss may cause that apnea to go away completely.

Continuous positive airway pressure (CPAP) is a device, commonly ordered to treat OSA. CPAP is a machine that works like a compressor to blow air into a mask that is worn snugly over the nose and/or mouth or in the nostrils (nasal pillows) during sleep. The flow of air acts like a splint to keep the upper airway from collapsing. This helps prevent obstruction and the apnea from occurring. The air pressure is adjusted to a setting that works best to control the apnea. Often a person will also notice much less snoring when wearing a CPAP.

As alcohol can suppress breathing it should be avoided. Sleep apnea is often worse when a person sleeps on his or her back. If you sleep on your back, you can use a pillow or some other strategy to force yourself to sleep on your side.

There are other devices that can work for some people. For some, surgery can be done to treat OSA. The type of device or surgery will depend on what has caused the apnea. Some oral appliances or devices that are worn in the mouth during sleep may keep your airway open. Most oral devices work by either bringing the jaw forward or keeping the tongue from blocking the throat. Oral appliances are most likely used to help a person who has mild sleep apnea and who is not overweight. The devices are usually custom made and fitted under the supervision of a specialized dentist or oral surgeon who has worked with these problems.

When the tonsils or the adenoids are causing the throat to be blocked, surgery can be done to take out the tonsils (tonsillectomy) and/or adenoids (adenoidectomy). Surgery can also be helpful for people with jaw problems. Other surgeries for OSA either clear out the tissue from the back of the throat, repositioning the tongue forward, or implant a nerve stimulator to cause the tongue to move forward during sleep. These surgeries are not, however as effective as CPAP to control OSA and are usually reserved for people who have failed CPAP therapy.

What are the symptoms of obstructive sleep apnea?

You may not be aware that you have OSA, but the symptoms may be more obvious to a spouse, other family members or a close friend.

Common symptoms you may have during sleep include:

  • Snoring that is usually loud and bothers other people trying to sleep nearby you. Snoring can come and go through the night.

  • Gasping or choking sounds.

  • Breathing pause observed by someone watching you sleep.

  • Sudden or jerky movements.

  • Restless tossing and turning.

  • Frequent awakenings from sleep.

Common symptoms that you may have while awake:

  • Waking up feeling like you have not had enough sleep, even after sleeping many hours.

  • Morning headaches.

  • Dry or sore throat in the morning from breathing through your mouth during sleep.

  • Fatigue or tiredness through the day.

  • Personality changes, such as mood swings and difficulty getting along with others.

  • Problems with poor memory or inability to concentrate.