|
|
Sleep Apnea Treatments & Solutions
CPAP (Continuous positive airway pressure) therapy
for Obstructive Sleep Apnoea (OSA)
Continuous positive airway pressure therapy
(CPAP) uses a machine to help a person who has obstructive
sleep apnea (OSA) breathe more easily during sleep.
A CPAP machine increases air pressure in your throat
so that your airway does not collapse when you breathe
in. When you use CPAP, your bed partner may sleep
better, too.
You use CPAP at home every night while you sleep.
The CPAP machine will have one of the following:
• A fullface mask that covers your nose and mouth.
• A nasal mask that covers your nose only-called
nasal continuous positive airway pressure, or NCPAP
(this type of mask is most common).
• A pillow mask that fits into your nose. |
| |
You may want
to try similar machines that have automatically
adjustable air pressure or air pressures that are
different when you breathe in than when you breathe
out.
What To Expect After Treatment
It may take time for you to become comfortable with
using CPAP. If you cannot get used to it, talk to
your doctor. You might be able to try another type
of mask or make other adjustments.
Why It Is Done
CPAP is the most effective nonsurgical treatment
for obstructive sleep apnea. It is the first treatment
choice and the most widely used.
|
|
 |
| |
|
|
• Doctors use CPAP to
treat people who have moderate to severe sleep apnea.
• CPAP is the treatment of choice for people
who have sleep apnea and coronary artery disease
(CAD) or heart failure.
How Well It Works
Overall, CPAP is the most effective treatment for moderate and severe
obstructive sleep apnea:
• Research shows that continuous positive
airway pressure (CPAP) decreases daytime sleepiness,
especially in those with moderate to severe sleep
apnea..
• Studies show that in people who have moderate
to severe sleep apnea, nasal continuous positive
airway pressure (NCPAP) lowers blood pressure during
both the day and the night.
• CPAP is often more effective than other non-surgical methods
for treating systemic obstructive sleep apnea.
• People with coronary artery disease who
use CPAP for sleep apnea are less likely to have
heart problems such as heart failure.
Risks
Problems that may occur with CPAP include:
• Nightmares and excessive dreaming during
early use.
• Dry nose and sore throat.
• Nasal congestion, runny nose, and sneezing.
• Irritation of the eyes and the skin on the
face.
• Abdominal bloating.
• Leaks around the mask because it does not
fit properly.
Nosebleeds are a rare complication of CPAP.
You can expect mild discomfort in the morning when
you first start using CPAP. Talk with your doctor
if you do not feel comfortable after a few days.
Relieving side effects
You may be able to limit or stop some of the side
effects:
• Your doctor may be able to adjust your CPAP
to reduce or eliminate problems.
• Be sure the mask or nasal prongs fit you
properly. Air should not leak around the mask.
• Use a humidifier or a corticosteroid nasal
spray medicine to reduce nasal irritation and drainage.
• You may want to talk to your doctor about
trying a CPAP machine that will start with a low
air pressure and slowly increase the air pressure
as you fall asleep. This kind of machine can help
reduce discomfort caused by too much constant pressure
in your nose. If this does not improve your discomfort,
ask your doctor about trying a bilevel positive
airway pressure machine (BiPAP), which uses a different
air pressure when you breathe in than when you breathe
out. BiPAP may work better than standard CPAP for
treating obstructive sleep apnea in people who have
heart failure. BiPAP machines are more expensive
than CPAP machines.
• If your nose is runny or congested, talk
with your doctor about using decongestants or corticosteroid
nasal spray medicines or fullface masks.
What To Think About
When you are using CPAP, you need to see your doctor
or sleep specialist regularly. You may also need
more sleep studies to adjust the CPAP machine and
check whether the treatment is working.
The machines are expensive. You may be able to rent
a CPAP machine before you buy it. In some cases,
you may be able to rent-to-own a CPAP machine.
The most common problem with CPAP is that people
do not use the machine every night. Or they take
off the mask during the night because it becomes
uncomfortable. Even one night of not using the machine
can make you sleepy the next day.
You might not use the machine daily, or you might
even stop using it because:
• You don't like wearing a mask because of
nasal discomfort.
• The machine is noisy.
• It may discourage intimacy with your sleeping
partner, even though you use the machine only while
you are sleeping.
CPAP Machines
--> |
| |
Mouth Devices for Sleep Apnea
If you have been diagnosed with obstructive sleep
apnea -- a condition in which relaxation of the
muscles around the tongue and throat causes the
tissues to block airflow to the lungs while you
sleep -- there are a number of treatment options
to discuss with your doctor. Two of the most widely
used and most effective are continuous positive
airway pressure (CPAP) and dental appliances, or
mouth guards.
Benefits of CPAP include keeping your airways open
while you sleep, easing snoring, improving sleep
quality, relieving daytime sleepiness, and lowering
blood pressure.
Although you will likely feel better rested and
alert once you start CPAP, getting used to the device
can take some time. Some people have difficulty
sleeping the first few nights of treatment.
|
|
 |
| |
|
|
Side effects of CPAP use are
minor and may include:
• Feelings of confinement from the face mask
• Sore or dry mouth
• Nasal congestion, runny nose, sinusitis,
or nosebleeds
• Irritation and sores over the bridge of
the nose
• Stomach bloating and discomfort
• Discomfort in chest muscles, which usually
gets better after a while
Mouth Devices
If you have mild to moderate obstructive sleep apnea
and can't tolerate or haven't been helped by CPAP,
oral appliances may be an effective treatment option.
These devices are worn in the mouth at night:
Mandibular advancement device (MAD):
The most widely used mouth device for sleep apnea,
MADs look much like a mouth guard used in sports.
The devices snap over the upper and lower dental
arches and have metal hinges that make it possible
for the lower jaw to be eased forward. Some, such
as the Thornton Adjustable Positioner (TAP), allow
you to control the degree of advancement.
Tongue retaining device: Used less
commonly than MAD, this device is a splint that
holds the tongue in place to keep the airway open.
For people with mild to moderate sleep apnea, particularly
those who sleep on their backs or stomachs, dental
devices may improve sleep and reduce the frequency
and loudness of snoring. Also, people are more likely
to use their dental appliances regularly than CPAP.
Dental devices have also been shown to control sleep
apnea long term compared to uvulopalatopharyngoplasty
(UPPP), the standard surgical procedure for apnea,
in which the surgeon removes soft tissue from the
back of the throat. However, dental devices do have
some potential drawbacks, including altered bite,
movement of teeth, pain, dry lips, and excessive
salivation.
If you are fitted with a dental device you should
have a checkup early on to see if it is working
and periodic checkups for possible adjustment or
replacement. If you experience pain or changes in
your bite, your dentist or orthodontist who fitted
your device may be able to make modifications to
correct the problem.
The best treatment for obstructive sleep apnea depends
on a number of factors, including the severity of
your problem, the physical structure of your upper
airway, other medical problems you may have, as
well as your personal preference. You should work
with your doctor or sleep specialist to select the
best treatment option for you.
CPAP
Machines --> |
| |
Snoring Treatments & Solutions
If you occasionally snore, you
can try the following conservative behaviour changes to help treat
the problem:
• Lose weight and improve your eating habits.
• Avoid tranquilizers, sleeping pills, and
antihistamines before you go to bed.
• Avoid alcohol, heavy meals, or snacks at
least four hours before you sleep.
• Establish regular sleeping patterns. For
example, try to go to bed at the same time every
night.
• Sleep on your side rather than on your back.
• Prop the head of your bed -- not just your
pillows -- up four inches.
If none of the above mentioned behavioural changes
help snoring, talk to your doctor. Otolaryngologists
(ear, nose, and throat doctors) offer a variety
of treatment options that may reduce or eliminate
snoring or sleep apnea.
There are more than 300 devices on the market to
help prevent snoring; however, none of these devices
address all of the underlying anatomical problems
that cause snoring (such as nasal obstruction and
being overweight). Surgery may be one option needed to correct
physical problems.
Snoring and sleep apnea surgeries
Uvulopalatopharyngoplasty (UPPP or UP3): A surgical treatment that tightens and restructures
the flabby tissues in the throat and palate. This
is often prescribed for people who have moderate
or severe obstructive sleep apnea.
Laser-assisted uvula palatoplasty (LAUP): A laser procedure removes the airway obstruction.
This treatment is performed under local anaesthesia
in a doctor's office and is intended for snorers
and for people with mild obstructive sleep apnea.
Somnoplasty: This is a minimally
invasive procedure that uses radio frequency energy
to shrink excessive tissue in the palate, uvula,
and tongue tissue. This treatment can also be used
to relieve nasal obstruction.
Genioglossus and hyoid advancement: This is a surgical treatment for sleep apnea which
prevents the collapse of the lower throat by pulling
the tongue forward.
Septoplasty and turbinate surgery: This is a surgery to fix blockages in the nose and
help air through the nose smoothly and quietly.
Tonsillectomy: Removing the tonsils
and adenoids may be needed to prevent snoring, particularly
in children.
Other Treatments for Snoring
Continuous Positive Airway Pressure (CPAP): A patient may be fitted with a nasal mask which
forces air through the upper airway. The air pressure
is adjusted so that it is just enough to prevent
the upper airway tissues from collapsing during
sleep. The pressure is constant and continuous.
This should help the person breathe better and sleep
through the night.
CPAP Machines
-->
Mouth Guard: A mouth guard is a
intraoral device designed to reduce or eliminate
snoring by holding your lower jaw slightly forward
of its normal position while you sleep. This tends
to widen the upper airway so air is not forced through
such a narrow opening. Mouth guards work because
it opens your upper airway and eliminates the vibrations
we all know as snoring.
Chin Straps: Snoring research has
shown that a chin strap worn during sleep, can keep
the lower jaw in an upward position increasing the
space in the airway tube which reduces air speed
and soft tissue vibration. By increasing the capacity
of the airway and preventing soft tissue vibrations,
snoring can be eliminated or substantially reduced.
|
|
|
