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What Are My Treatment Options? Diagnosed with sleep apnea? Now What?

July 28, 2012

If you have been following our blog you should have some knowledge of obstructive sleep apnea (OSA) and the physical strain it puts on your organs. (http://bit.ly/N5EYGD) People with OSA can experience decreased productivity, daytime sleepiness, slow reflexes, poor concentration, weight gain, relationship issues, sexual dysfunction, weaker immune system, and an increased risk of accidents. This is in addition to the increased risk of Type II diabetes, heart attack, high blood pressure, stroke, and increased threat of dying from cancer.

For those of you who are new to our blog you may be wondering what causes obstructed sleep apnea. OSA is caused by a physical obstruction in one’s airway which inhibits a person’s ability to take in oxygen while sleeping. People with sleep apnea experience repeated pauses in breathing during sleep, causing multiple awakenings. These sleep awakenings cause acute surges in blood pressure and heart rate, which increases stress on the heart. They also disrupt sleep cycles, interfere with hormone regulation, and limit oxygen flow to the organs. 

 If you’re thinking about getting tested for sleep apnea, but an overnight hospital stay makes you extremely anxious, there’s an alternative option. Relay your anxiety to your doctor and ask about an in-home sleep test that can help screen for sleep apnea.

Now for the good news on sleep apnea – you have treatment options with this as well! Since no two people are exactly alike, one choice for sleep apnea treatment doesn’t fit all. Below are a few options people have for sleep apnea treatment.

Weight loss

An individual who is overweight can have extra tissue and fat present around the airway. The extra mass on the soft palate narrows the airway, which becomes more prone to collapsing. Losing weight helps shrink one’s neck size and therefore eliminates the narrowing of an airway due to excess tissue.

What many do not realize is that having OSA causes extreme daytime fatigue and irregular weight-related hormone levels, severely jeopardizing weight loss efforts. As individuals gain additional weight, it is important for loved ones to alert them of the snoring that may also occur. This snoring could be an alarm to a much larger problem (OSA).

CPAP

CPAP is an abbreviation that stands for Continuous Positive Airway Pressure. The CPAP is a breathing device that works by continuously forcing air down one’s airway. The pressure of the air pushes the soft palate and key muscles (what collapses and obstructs the airway) aside and eliminates the obstruction.

The CPAP is the ‘gold standard’ of treatment in treating OSA. When worn correctly, it is 100% effective in all severity levels of OSA.

Unfortunately the CPAP can have a low compliance rate. Some of the complaints of the CPAP which result in intolerance are; dryness, noise, vanity, mask irritation, and claustrophobia.

Surgery

There are several surgical options available and they are always evolving. Some of the current options are:

  • Uvulopalatopharyngoplasty      (UPPP)
    • Removes Uvula & tissue       from soft palate.
    • Most common surgery for OSA
  • Tongue Reduction
    • Remove a section of the tongue
  • Tongue Retention (Repose)
    • Screw is anchored into the mandible and tongue is tied forward and attached to it
  • Somnoplasty
    • Radio frequency heats and electrode and causes tissues to shrink slightly.

All surgeries have been documented to be less than 50% effective. 

Oral Appliance Therapy

 An oral sleep appliance is a custom-fabricated mouthpiece similar to an orthodontic retainer or sports mouth-guard worn over the teeth.  The appliance works by comfortably repositioning the lower jaw and tongue forward or by restraining the tongue to keep the airway from collapsing during sleep.  Snoring and sleep apnea are then effectively managed and good quality sleep can be achieved without interruption.

The American Academy of Sleep Medicine recommends oral sleep appliances as a first line treatment option for individuals with mild or moderate sleep apnea or for those who are unable to use THE CPAP successfully.  Oral appliances are also considered for those who are not candidates or prefer not to pursue airway surgery.

A dentist specially trained in the field of dental sleep medicine can expertly fabricate a dental sleep appliance.  The dentist will work closely with sleep physicians and sleep lab technicians for sleep test diagnosis and to ensure appliance efficacy and long term health of the individual.

When seeking help for sleep apnea, the most important things to remember is that you are not alone and you have options. Do your homework. Many doctors are not inclined to offer all of the treatment options because they may be biased to one option or another.

Please remember that sleep apnea is a national epidemic estimated to affect over 22 million people. This shows that you are not alone. Do your research and ask your physician and/or dentist questions about all available treatment options. In the meantime, you can take a quick 5 minute preliminary online questionnaire to see if you may be at risk for sleep apnea.  This questionnaire can be found at www.SLEEPTEST.COM or by calling 1-800-SleepTest.

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