January 24, 2007

How Do We Treat Sleep Apnea?

 

My 8-year-old has sleep apnea and is currently on CPAP. Watching him sleep with a bulky mask on his face is really killing me. Is sleep apnea treatable? Aside from CPAP, how do we cure sleep apnea episodes.

Sleep apnea is a condition wherein breathing cessation occurs during sleep causing a drop in the levels of oxygen saturation in the bloodstream. This could be due to airway blockage (obstructive sleep apnea) or respiratory muscle weakness (central sleep apnea) and often detected through polysomnography or sleep study.
 
Signs and symptoms of sleep apnea disease often include snoring, excessive daytime sleepiness, restlessness, choking spells, headaches or migraines, nocturia, heartburn, and cessation of breathing especially when asleep. Other behavioral symptoms include personality changes, lack of concentration, memory loss, and increased irritability. These can be managed through CPAP and other sleep apnea treatments.
 
The definitive diagnostic test for sleep apnea is polysomnography wherein sleep apnea medical devices are attached to the patient to record electrical brain activity, muscle movements, airflow, oxygen saturation, and EKG.
 
Common sleep apnea treatments include:
 
·          1.) Lifestyle changes. In this option you are advised to minimize, if not eradicate, tobacco and alcohol use. You are also encouraged to avoid the use of medications such as sedatives, muscle relaxants, and other similar drugs that can affect the respiratory muscles and increase the incidence of apnea. Weight loss is also a big help in reducing sleep apnea episodes since obesity is one of the main causes of airway obstruction.
 
·          2.) Continuous positive airway pressure (CPAP). This is a therapy where you are made to wear a sleep apnea mask over the nose. This mask is connected to a CPAP machine that delivers a predetermined air pressure to prevent the airway from collapsing therefore getting you enough air that you need and will maintblood oxygen levels. This method is recommended by doctors because it is highly effective, but it also has its undesirable effects. A newer procedure is now becoming more popular: the BiPAP or bilevel positive airway pressure. Its function is similar to CPAP, but it delivers two levels of pressures. The higher pressure is provided when you are breathing in, and a lower pressure is delivered when you are breathing out. That way, you wouldn’t have any difficulty letting the air out when exhaling.
 
·         3.) Surgery. This is commonly done in cases where obstruction is the main cause of the sleep apnea. Examples would be uvulopalatopharyngoplasty, which is the removal of the tonsils, uvula, and part of the soft palate, or the laser-assisted uvulopalatoplasty, which is the removal of the uvula and part of the soft palate using a laser device to prevent sleep apnea episodes. They are basically done to remove the obstruction from the airway. This often works among younger patients with apnea. Other surgeries include reconstruction of structural deformities commonly involving the jaw or the nose and surgery to treat obesity for obvious reasons.
 
·         4.) Conservative measures. First, you can try not sleeping your back. The supine position is one of the most common causes of apnea and snoring because this is when the tongue muscles relax and tend to fall back into the throat, thereby blocking the airway. It's better to lie on your side. Some people prevent lying on their backs by putting a pillow behind them; some pillows are specially designed to help you lie on your side or elevate your neck a little to keep airways open.
 
      5.) Dental Devices. Some cases you might require a visit to the dentist to see if you might need to have oral appliances put in to help you breathe more easily while asleep. You can choose a tongue-retaining device, which prevents your tongue from falling back, a MAD, or mandibular advancement device, which pushes your lower jaw forward, or you can have a combination of the two, depending on your dentist's advice. This is recommended more for mild sufferers, but it can also work for moderate cases. It is important to note that not all dentists are familiar with sleep apnea, so visit only a specialist on this matter.
 
      6.) Pillar Procedure. The newest treatment option for sleep apnea, the pillar procedure is not as popular as the others.  Tiny implants are attached in the soft palate to make the tissue stiff and prevent them from collapsing and blocking your airway passage.  This is very appealing since it's less invasive than surgery and you don't have to wear a bulky mask, the only thing is this procedure only works well with mild sleep apnea sufferers.
 
 

Overall, sleep apnea is a condition that you need not really worry about because it is treatable.

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