Treating Obstructive Sleep Apnea

By Kanu Patel, MD

ENT & Sleep Specialists

. http://entsleepspecialists.com/ent/

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Treating Obstructive Sleep Apnea

If you snore regularly and experience constant daytime sleepiness, you may have a condition called obstructive sleep apnea (OSA), which limits the amount of sleep and oxygen you get each night. OSA is a serious condition in which you have one or more pauses in breathing or shallow breaths while you sleep. Breathing pauses can last from a few seconds to minutes and can occur hundreds of times during the night. They often occur 5-30 times or more an hour.

Typically normal breathing then starts again, sometimes with a loud snort or choking sound. This results in poor oxygen to the brain and the rest of the body.

Do You Have OSA?

If you are concerned you may be suffering from sleep apnea, you should consider visiting an integrated sleep model. In an integrated sleep model, patients come to one place to get evaluated, treated, and follow-up care.

An integrated sleep model begins with a patient visit to the sleep specialist who will determine the most appropriate test (home or in-lab) for that individual. Following the test, and depending on the results, the sleep specialist then decides, along with the patient, the best form of treatment, whether that be CPAP, a dental appliance, surgery, or some other more conservative treatment.

CPAP Mask Alternatives

Wearing a CPAP mask every night is not the only treatment option. With an intergrated sleep model, the physicans can evalute the patient to identify the best treatment option tailored to you. Surgical procedures, including laser surgery, may be used to treat OSA. An in-depth evaluation will identify possible surgical options that best fit your needs. Sometimes more than one procedure may be required along with other treatments in addition to surgery. Your doctor can discuss these treatment options with you.

Not all OSA sufferers will be good candidates for surgical treatment of their condition. About 70% of people with obstructive sleep apnea are overweight or obese. Their health care professionals usually encourage them to lose weight. The vast majority of OSA cases can be improved, if not eliminated, with significant weight loss.

Positional therapy can be used to treat patients whose OSA is related to body positioning during sleep. Most people with sleep apnea have worse symptoms if they lie flat on their back during sleep. Most bed partners can attest to this from experience and often try to make their partner move onto their side during the night to stop their snoring.

If you have mild to moderate OSA, your condition may improve with a custom-made dental device that is worn in the mouth during sleep. These devices are designed to adjust the tongue or lower jaw position to keep the airway open. Their effectiveness in treating OSA varies and their cost may not be covered by all health insurance plans.

Continuous Positive Airway Pressure (CPAP) is the most common, most effective form of OSA treatment. Thousands of people use it every time they sleep. CPAP is a continuous stream of air directed into the airway during sleep that holds the airway open and prevents apnea. Oxygen levels, blood pressure, heart function and sleep patterns are stabilized, resulting in a more restful sleep. About half of all patients who use CPAP do so on a nightly basis for more than four hours.

Moving Forward

Sleep centers with established relationships and direct access to durable medical equipment helps close the treatment loop, creating a more seamless management process that keeps the sleep specialist at the center with the patient. Patients are followed for two years and outcomes evaluated. During this time, their treatment would be monitored to ensure not only compliance but better health.

Tracking the patient is important, not only tracking how much they use their CPAP, but whether they're actually getting better, whether it's preventing them from having a stroke or a heart attack, or developing diabetes.