Repeated breathing interruptions during sleep–ranging from partial airflow obstruction to complete breathing cessation–can significantly impact health and quality of life. These disruptions, known as sleep apnea, prevent restful sleep and, when untreated, contribute to serious health conditions including high blood pressure, heart disease, stroke, and diabetes. Dr. Michael Cohen provides comprehensive evaluation and treatment for sleep apnea at his Long Island practice, offering effective solutions that restore healthy sleep patterns and improve overall wellbeing.
Same day booking and was assisted by a wonderful medical receptionist, Ross. Dr. Cohen really cares about his patients and takes his time. I will be back.
Specialized Expertise in Sleep-Related Breathing Disorders
Dr. Michael Cohen brings over 25 years of specialized experience in diagnosing and treating conditions affecting the upper airway, including sleep apnea and chronic snoring. As a board-certified otolaryngologist recognized as a Top Doctor by NY Top Docs for 25 consecutive years, he offers advanced diagnostic capabilities and a range of treatment options tailored to each patient’s unique needs.
“Sleep apnea often goes undiagnosed because many patients don’t realize their sleep difficulties and daytime fatigue stem from breathing problems during sleep,” explains Dr. Cohen. “As an otolaryngologist, I focus on identifying and addressing the specific anatomical factors contributing to airway obstruction, allowing for targeted treatment that addresses the root cause of the disorder.” This approach leads to more effective management and improved treatment outcomes.
Types of Sleep Apnea We Treat
Understanding Sleep Apnea
Sleep apnea is characterized by repeated interruptions in breathing during sleep, resulting in oxygen level drops and sleep fragmentation. The condition affects approximately 25 million Americans, with many cases remaining undiagnosed. When treated properly, patients experience significant improvements in sleep quality, daytime functioning, and long-term health outcomes.
Different Types of Sleep Apnea
There are several forms of sleep apnea, each with distinct causes and treatment approaches:
Obstructive Sleep Apnea (OSA)
The most common form, occurring when throat muscles relax during sleep and block the airway.
Central Sleep Apnea (CSA)
Less common, resulting from the brain failing to send proper signals to the muscles that control breathing.
Complex/Mixed Sleep Apnea
A combination of both obstructive and central components, often discovered during treatment for OSA.
Upper Airway Resistance Syndrome (UARS)
A milder form of partial airway obstruction and sleep fragmentation without complete breathing cessation.
Most patients seeking treatment have obstructive sleep apnea, which is directly related to the physical structure and function of the upper airway–areas specifically within Dr. Cohen’s expertise as an otolaryngologist.
Risk Factors and Common Causes
Several factors increase the likelihood of developing sleep apnea:
Anatomical Factors
Physical characteristics that narrow the upper airway, including enlarged tonsils and adenoids, deviated septum, nasal polyps, large tongue base, or small jaw structure.
Obesity
Excess weight, particularly around the neck, contributes to airway narrowing during sleep. Even modest weight gain can increase sleep apnea risk significantly.
Age
Sleep apnea risk increases with age, with prevalence rising notably after 40 years.
Gender
Men have a higher risk than women, though women’s risk increases after menopause.
Family History
Genetic factors influence both facial structure and muscle control of the upper airway.
Smoking and Alcohol
Tobacco use increases inflammation and fluid retention in the airway, while alcohol relaxes throat muscles.
Medical Conditions
Certain conditions including hypothyroidism, acromegaly, and chronic nasal congestion increase risk.
Understanding individual risk factors helps guide both diagnosis and treatment planning, allowing for personalized approaches to managing sleep apnea.
Recognizing Symptoms and Health Impact
Sleep apnea often manifests through various symptoms, both during sleep and while awake:
Nighttime Symptoms Observable signs during sleep include:
- Loud, chronic snoring, often with gasping or choking sounds
- Witnessed breathing pauses during sleep
- Restless sleep with frequent position changes
- Awakening with gasping or choking sensations
- Frequent nighttime urination
- Night sweats
- Insomnia or difficulty maintaining sleep
Daytime Symptoms Effects that appear during waking hours include:
- Excessive daytime sleepiness despite adequate time in bed
- Morning headaches and dry mouth
- Difficulty concentrating and memory problems
- Irritability, mood changes, or depression
- Decreased libido or sexual dysfunction
- Falling asleep during routine activities
The health consequences of untreated sleep apnea extend beyond these immediate symptoms, affecting multiple body systems and increasing the risk of serious medical conditions including hypertension, heart disease, stroke, type 2 diabetes, and metabolic syndrome. Studies indicate that severe, untreated sleep apnea can increase mortality risk by up to three times compared to those without sleep apnea.
Comprehensive Diagnostic Approach
Dr. Cohen employs a thorough evaluation process to accurately diagnose sleep apnea and identify its specific causes:
Initial Assessment
Dr. Cohen begins with a comprehensive medical history and focused examination:
- Detailed sleep history including snoring patterns, observed breathing interruptions, and sleep quality
- Evaluation of daytime symptoms and their impact on quality of life
- Review of medical conditions that may contribute to or result from sleep apnea
- Examination of the nasal passages, throat, and oral structures that influence airway patency
- Assessment of body mass index and neck circumference
This initial evaluation helps determine the likelihood of sleep apnea and guides further diagnostic testing.
Sleep Testing
Definitive diagnosis typically requires overnight sleep testing:
- Home sleep apnea testing using portable monitoring devices that measure breathing patterns, oxygen levels, and body position
- In-lab polysomnography for complex cases, providing detailed data on sleep stages, brain activity, muscle movements, and respiratory events
- Split-night studies that include both diagnostic testing and treatment trial in the same night when appropriate
These studies determine whether sleep apnea is present, its severity (mild, moderate, or severe), and its specific characteristics–essential information for developing an effective treatment plan.
Upper Airway Evaluation
For patients diagnosed with sleep apnea, Dr. Cohen may perform additional assessments:
- Nasal endoscopy to evaluate the nasal passages and nasopharynx
- Laryngoscopy to examine the base of tongue and throat structures
- Imaging studies when needed to assess facial structure and airway dimensions
This targeted evaluation identifies the specific anatomical factors contributing to airway obstruction, allowing for individualized treatment recommendations.
Personalized Treatment Options
Dr. Cohen develops individualized treatment plans based on sleep apnea severity, contributing factors, patient preferences, and overall health considerations:
Conservative Approaches
Initial recommendations often include lifestyle modif ications:
- Weight management through nutrition and exercise programs
- Positional therapy to avoid sleeping on the back
- Alcohol reduction and smoking cessation
- Improved sleep hygiene practices
- Management of nasal congestion and allergies
These approaches may be sufficient for mild cases or serve as adjuncts to other treatments.
CPAP Therapy
Continuous Positive Airway Pressure (CPAP) remains the gold standard treatment for moderate to severe OSA:
- Delivers pressurized air through a mask to keep the airway open during sleep
- Highly effective when used consistently
- Various mask styles and machine features to improve comfort and compliance
- Regular adjustments to optimize pressure settings and mask fit
Dr. Cohen works closely with sleep medicine specialists to ensure optimal CPAP therapy when this treatment is recommended.
Oral Appliance Therapy
Custom-fitted dental devices offer an alternative for mild to moderate sleep apnea:
- Repositions the lower jaw and tongue to maintain airway patency
- Generally more comfortable and portable than CPAP for many patients
- Developed in coordination with dental professionals specializing in sleep medicine
- Regular follow-up to ensure proper fit and effectiveness
These devices provide an effective option for patients who cannot tolerate CPAP or prefer a less intrusive approach.
Innovative Solutions
Dr. Cohen offers advanced treatment options for appropriate candidates:
- Inspire Upper Airway Stimulation–an implantable device that stimulates key airway muscles during sleep
- Nasal valve support devices for patients with nasal valve collapse
- Emerging technologies as they become available and demonstrate clinical effectiveness
These innovative approaches provide additional options for patients who haven’t achieved success with traditional treatments.
Surgical Interventions
When anatomical factors significantly contribute to sleep apnea, surgical options may include:
- Nasal surgery to address deviated septum, enlarged turbinates, or nasal valve collapse
- Tonsillectomy and adenoidectomy, particularly beneficial in children with sleep apnea
- Palate and throat procedures to reduce tissue obstruction
- Tongue base reduction or advancement procedures
- Maxillomandibular advancement for appropriate candidates
Dr. Cohen carefully evaluates the potential benefits and risks of surgical intervention, recommending these approaches when they offer the best prospect for long-term improvement.
What to Expect During Treatment
The treatment journey for sleep apnea typically follows a structured path:
Initial Treatment Phase
After diagnosis and treatment selection:
- Education about the condition and treatment approach
- Implementation of the primary treatment plan
- Adjustment period to optimize comfort and effectiveness
- Close follow-up to address any challenges or concerns
Most patients require several weeks to fully adapt to treatment, with support from Dr. Cohen and his team throughout this period.
Monitoring and Optimization
Ongoing management ensures continued effectiveness:
- Follow-up sleep testing to confirm treatment adequacy
- Periodic reassessment of symptoms and treatment adherence
- Adjustments to treatment approach as needed based on results and patient feedback
- Coordination with other specialists when appropriate
This continuous monitoring helps maintain optimal results and addresses any changes in the condition over time.
Frequently Asked Questions About Sleep Apnea
While not all snorers have sleep apnea, certain characteristics suggest increased risk: loud, disruptive snoring with gasping or choking sounds, observed breathing pauses, excessive daytime sleepiness, and morning headaches. Professional evaluation is the only way to definitively determine whether sleep apnea is present.
Yes, even without noticeable daytime symptoms, untreated sleep apnea increases the risk of serious health conditions including hypertension, heart disease, stroke, and diabetes. The repeated drops in oxygen levels and sleep fragmentation can damage multiple body systems over time.
Yes, pediatric sleep apnea affects approximately 1-5% of children. In children, symptoms may include snoring, restless sleep, bedwetting, morning headaches, daytime behavioral problems, and poor academic performance. Enlarged tonsils and adenoids are often the primary cause in children.
Not necessarily. While CPAP is often a long-term treatment, some patients may transition to other options as new treatments become available or if contributing factors change. Weight loss, for example, can sometimes reduce sleep apnea severity enough to allow for alternative treatments.
Most insurance plans cover sleep apnea diagnosis and treatment when medically necessary. Coverage specifics vary by plan for different treatment options. Our office staff can help verify your coverage and explain any out-of-pocket costs.
While mild sleep apnea may improve with weight loss or positional changes, most cases require specific treatment to resolve. The condition typically does not improve spontaneously and may worsen over time if left untreated.
Why Choose Dr. Michael Cohen for Sleep Apnea Treatment
- Board-certified otolaryngologist with specialized training in upper airway anatomy and function
- Comprehensive evaluation of the specific anatomical factors contributing to airway obstruction
- Personalized treatment recommendations based on individual needs and preferences
- Access to advanced treatment options including Inspire therapy
- Surgical expertise when anatomical corrections offer the best solution
- Recognition as a Top Doctor by NY Top Docs for 25 consecutive years
Restore Restful Sleep and Improve Your Health
Don’t continue to struggle with the health risks and daytime consequences of untreated sleep apnea. With proper diagnosis and individualized treatment by Dr. Cohen, you can experience significant improvements in sleep quality, daytime energy, and overall health.
Expert sleep apnea care is available at our convenient offices in both Syosset and Port Jefferson Station, making specialized treatment accessible throughout Nassau and Suffolk counties.
Contact our office today to schedule your consultation and take the first step toward restful sleep and better health.