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Obstructive Sleep Apnea Treatment

A Critical Look at Obstructive Sleep Apnea Treatments

Obstructive sleep apnea (OSA) is a disorder wherein the breathing of a person can start and stop during sleep. Since it is considered to be a serious problem, having knowledge about this condition is of prime importance. This SleepHearty article gives you a brief information about OSA, along with the options used for its treatment.
Shalu Bhatti
Last Updated: Apr 9, 2018
Sleep apnea is considered to be a serious problem, wherein the person sleeping can suddenly stop breathing for a few seconds and start again. This irregular breathing pattern can make one prone to many serious ailments, including heart diseases. Mostly, people who snore loudly have the chances of suffering from sleep apnea, which is of three different types.
The first being Obstructive Sleep Apnea, which occurs mostly due to relaxation of the throat muscle while sleeping; the second being Central Sleep Apnea, which occurs when the brain is unable to send signals to the muscles that are responsible for controlling the breathing patterns while sleeping; and the third (and most rare) type is Complex Sleep Apnea, which is caused by a fault in the brain signals, and muscle relaxation of the throat. However, in this article, we shall focus only on obstructive sleep apnea.
Causes and Symptoms
OSA accounts for almost 84% of all sleep apnea cases. It occurs when there is an obstruction in the airways causing breathing to stop for a few seconds. Usually, the airways are blocked for 10 seconds or more, preventing the person to breathe for that period of time. But what causes this obstruction? Well, this happens because of the tongue and throat muscles. As these muscles relax themselves, they become all the more narrow and prevent adequate passage of air. These muscles include the soft palate, tonsils, uvula, and the adenoids of the tongue.
This blockage leads to drop in the level of oxygen in the body, therefore making the brain realize the need for oxygen. The brain then sends signals to these tissues to remove blockage, which makes one wake up for a brief period of time and breathe properly so that the blockage is removed. However, this happens for a moment, and people don't even realize when they wake up to breathe in between. The time when the muscles block the airways, and the time when one wakes up and breathes, is roughly 10-15 seconds, therefore being difficult to recall.
If one doesn't even realize the blockage and breathing, how would one know that he/she is suffering from OSA? It is best to ask the sleeping partner to notice the signs and symptoms, just to be sure. If that is not possible, then it is advisable to install a voice recorder or a camera to notice the symptoms. Just have a look at the symptoms mentioned below to know what to look for.
  • Loud snoring
  • Long pauses in breathing
  • Abrupt awakenings in between due to shortness of breath
  • Morning headache
  • Feeling drowsy all throughout the day
  • Irritation
  • Unable to function in a proper way, mentally or emotionally
  • Heaviness in the head
  • Fatigue
  • Waking up with an extremely dry mouth
Unlike some health conditions that occur only in people within certain age group, sleep apnea can occur in anyone, from kids to the elderly, however, men are considered to have this condition more than women. Even other factors, such as family history, weight, alcoholism, smoking, and medical conditions including diabetes, gastroesophageal reflux disease (GERD), and obesity can also put people at a higher risk. Therefore, even if you have the slightest suspicion of falling under the risk zone, or having sleep apnea already, you must get in touch with your healthcare specialist as soon as possible. Your doctor will ask you about the symptoms that you are experiencing.
A sleep specialist will closely monitor your medical history, your weight, structure (neck circumference as larger than 17 inches can cause sleep apnea), your sleeping patterns, etc. Various tests are conducted in order to check the activities of your heart, brain, and muscles which affect the breathing pattern, creating obstruction. These tests are: Nocturnal Polysomnography and the Portable Monitoring Devices.
Here, the doctor attaches an equipment which helps in monitoring the various activities that take place in the body while asleep. The activities of the brain, heart, lungs, arms, legs, and the breathing patterns along with the rise and drop in the oxygen levels are monitored. Based on these observations, the doctor diagnoses the kind of sleep apnea and its possible causes. Once diagnosed, the treatment option includes various medications, devices, and surgeries. These are discussed as follows.
Treatment Devices: There are many devices and machines which can be used to help open the airways of the person while he/she is asleep. The most popular device is the CPAP mask. CPAP (SEE-pap) is the abbreviation for Continuous Positive Airway Pressure and is worn by the patient while asleep. This mask is worn over the nose and helps in providing a larger air pressure in the nostrils to prevent them from relaxing and obstructing the airways. This helps in preventing sleep apnea and other symptoms including snoring, sleep disturbances, etc.
Apart from CPAP, there are other devices that are designed to effectively adjust the air pressure while a person is sleeping. There are some people who might find it uncomfortable to wear these, or even CPAP, for that matter. In this case, there are certain oral appliances which are specifically designed in order to open up the throat and prevent obstructive sleep apnea. You might have to try a number of different devices to decide which one suits you the best.
Medications: Although medications don't prove to be all that helpful, your doctor may still advice you certain drugs to treat disorders that accompany this condition. However, these medications are always suggested in combination with other treatment measures. For example, in 2004, Provigil was approved by the FDA to be used in combination with CPAP in order to treat sleepiness, which is an accompanied condition with OSA. However, some of the drugs can have serious side effects, including Provigil. Therefore, consult a trusted doctor to know your options.
Surgical Treatment: Remember, I had mentioned earlier that the tissue and muscles in the throat may lead to blockage and obstruction in the airways. Well, if it is necessary, then a surgery may be done to remove the excessive tissues that vibrate and obstruct the airways. The surgical options include - Uvulopalatopharyngoplasty (UPPP), wherein tissues from the rear of the mouth as well as the top surface of the throat are removed to prevent vibration that causes snoring. A surgical procedure called Tracheostomy is usually performed in severe cases.
Here, a metal or plastic tube is inserted in the neck after creating an opening to help the passage of air. The opening is usually kept covered during the day, however, during the night the opening is uncovered, enabling the patient to breathe smoothly. Another procedure known as Maxillomandibular Advancement is used, wherein the jaw of the patient is moved forward in order to create some extra space behind the soft palate and the tongue, so that there is minimal or no obstruction in the airways. Doctors may also take help of nasal surgery to remove the polyps to help one breathe better.
There are certain home remedies which can also prove to be of help, especially as preventive measures. Losing weight, avoiding smoking and drinking alcohol, etc., is essential. Also, it is advisable to keep the nasal passages clear and open at night before sleeping, which could be done by steam inhalation. Sleeping on one's back and sides may prevent the soft palate and tongue from resting at the back of the throat. Therefore, avoid sleeping on the back.
Sleep apnea may become life-threatening if ignored. Therefore, it is advisable to get in touch with your doctor as soon as possible to prevent further complications. Take care.
Disclaimer: This SleepHearty article is meant for informative purposes only and should not be considered as a substitute for expert medical advice.