WHAT IS SLEEP APNEA?
Sleep apnea is a syndrome that is defined by repetitive episodes of 10 seconds or greater in length where there is no airflow at the nose or mouth, or decrease in airflow with a drop in oxygen level. When there is no airflow and no breathing effort this is defined as Central Sleep Apnea. If there is breathing effort and no airflow this is defined as Obstructive Sleep Apnea; this occurs when tissue collapses in the patient’s upper airway preventing air movement. These episodes are followed by brief arousals, resulting in fragmented sleep. By convention 5-15 episodes per hour is considered to represent mild sleep apnea, 15.1-30 per hour moderate, and greater than 30 episodes per hour as severe sleep apnea.
WHAT ARE THE SYMPTOMS OF SLEEP APNEA?
Symptoms can vary in intensity and these symptoms could have other causes. Additionally, a lack of these symptoms does not exclude a diagnosis of sleep apnea. Complaints of sleepiness, fatigue, morning headaches, frequent urination during sleep time, loud snoring and waking up gasping are some of the most common symptoms.
Other complaints can include disturbing dreams, restless sleep, decrease libido, trouble focusing, poor school or job performance, fear of sleeping, and needing to sleep with the head elevated.
HOW CAN SLEEP APNEA EFFECT HEALTH?
Sleep apnea has been associated with contributing to hypertension, poor glucose control in diabetics, increase risk for stroke, heart attacks, heart failure, and an increase in motor vehicle accidents.
HOW IS SLEEP APNEA TREATED?
Individuals who are overweight can see improvement with weight reduction, and possibly eliminate sleep apnea.
The most common treatment is to use a breathing device that keeps the individual’s airway open, and/or assists in the individual’s breathing. All these devices connect to the individual by various different types of masks and headgear. There are a number of different devices that are used the most with four types being the most common.
CPAP, which stands for continuous positive airway pressure, is the simplest machine. It establishes constant positive airway pressure with stable airflow that keeps the upper airway open.
AutoPAP is essentially an auto-adjusting CPAP machine that can vary the pressure being delivered depending on the individual’s needs.
BIPAP, which stands for bilevel positive airway pressure, will have a continuous positive airway pressure as CPAP. However, it will also have a second higher pressure that increases the amount of air into the lungs. For some individuals who find CPAP uncomfortable BIPAP can be used. In addition, some patients require the added help in breathing in air to take in an adequate breath.
BIPAP autoSV Advanced is an auto-adjusting BIPAP machine that can also deliver full breaths to the patient.
The individual’s Sleep Specialist will decide and order the proper settings to best treat the individual’s sleep apnea.
Oral Appliance Therapy (OAT) devices can be used to treat sleep apnea. These devices are made by experienced dentists. An individual wears the device while sleeping which can help move an individual’s jaw forward which can open the upper airway.
Surgical therapy is directed at removing upper airway obstructions. This would include tonsillectomy, UPPP (Uvulopalatopharyngoplasty), nasal surgery and tracheostomy.
Implantable hypoglossal nerve stimulators are the newest form of therapy and may benefit specific patients who fail using breathing devices.