Sleep Apnea Treatment Improves Quality of Life | by Jennifer L.W. Fink

Sleep Apnea

Posted on Sun, Nov 11, 2012

Do you snore at night? Struggle to stay awake during the day? You could have sleep apnea, a serious sleep disorder that increases the risk of high blood pressure, stroke, congested heart failure and other heart conditions. It can also destroy your work performance, impair your relationships and eliminate your social life.

Diagnosis

Approximately 15 percent of men and 5 to 10 percent of women between the ages of 50 and 70 have some form of sleep apnea, says Dr. Rick O’Brien, a sleep medicine specialist with Colorado Internal Medicine in Denver. Most – but not all – snore at night. All suffer sleep interruptions that are caused by frequent pauses in breath.

That’s because obstructive sleep apnea (the most common form of sleep apnea) occurs when the physical structures of the airway temporarily block airflow. “The airway is like a floppy, collapsible hallway,” O’Brien says. “When you sleep, the muscles relax and the hallway can collapse.”

Snoring, snorting and choking sounds occur when the brain senses the temporary oxygen deprivation and sends a signal to rouse the body. People with sleep apnea may experience dozens of brief awakenings an hour, which affects the quantity and quality of their sleep.

Most people who suffer from sleep apnea, though, have no idea that they awaken briefly throughout the night. They might complain, instead, of daytime sleepiness and find it easy to fall asleep in church or in business meetings. Sometimes their bed partners report bouts of loud snoring or startling episodes where the partner stops breathing.

If you experience any of these symptoms – snoring, pauses in breath, daytime sleepiness – talk to your physician. He or she will perform a thorough physical exam, conduct a brief survey of your sleep habits and refer you to a sleep medicine specialist. If the sleep medicine specialist believes sleep apnea is likely, he’ll schedule you for an overnight sleep study – the only way to definitively diagnose sleep apnea.

Sleep studies typically take place at a hospital or specialized sleep lab. Trained technicians attach a variety of leads and wires to patients to monitor breathing, heart rate, snoring, movement and sleep. The data gathered is then sent to a specialist for interpretation.

Treatment

If the sleep study indicates sleep apnea – defined as pauses of breath significant enough to affect the body’s physiologic functioning – treatment will help the patient feel better and decrease the risk of cardiovascular disease.

Treatment options include:

• CPAP (continuous positive airway pressure) – CPAP uses positive air pressure to keep the airway from collapsing. Patients wear a specialized mask at night which blows air into the airway to keep it open. CPAP is generally highly effective and covered by insurance. It can take two to eight weeks to get used to the equipment, though.

• Surgery – Sometimes, removing the tonsils, adenoids and a portion of the uvula can decrease sleep apnea by increasing the size of the airway. This technique is most effective in younger people, though. “Among boomers, surgery is only successful about 30 percent of the time,” O’Brien says.

• Oral appliances – Moving the lower jaw forward during sleep can keep the tongue from falling against the back of the throat. So some specialty dentists craft specially made oral appliances to temporarily move the jaw. Good oral appliances cost about $2000 and are typically not well-covered by insurance.

• Pillar procedure – Tiny polyester rods can be implanted in a patient’s soft palate, essentially providing scaffolding to help prop up the patient’s “floppy hallway.” The procedure is best for mild sleep apnea, costs about $2500 and is often not covered by insurance.

• ProVent ®– A new therapy, Provent® nasal devices are specially-made valves that fit over a patient’s nostrils and use the patient’s own air pressure to prop the airway open. The system costs about $60 per month and may help about 30 percent of sleep apnea patients.

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