Jun 08

Sleep apnea is a serious medical problem and should never be brushed aside as being nothing more than an annoyance. An estimated twelve to eighteen million individuals in the United States suffer from sleep apnea. This works out to be approximately four percent of men and two percent of women, most of whom are middle aged and overweight. Sleep apnea affects children as well but is less rare than it is in adults. It is believed that sleep apnea is almost as widespread across the nation as is other serious diseases such as asthma, diabetes and heart disease.

OSA comes about as a result of repeated episodes of airway obstruction during sleep. Men and women who are considered to be what is known as the “diagnostic criteria for OSA” means that they have on average ten bouts of sleep apnea occurrences (or what is often called apneic events) in the course of one hour’s time.

You should get in touch with your physician right away if either yourself or your spouse or sleeping partner experiences loud, habitual snoring followed by excessive sleepiness during the day coupled with a lack of concentration and memory. If you make note of the alarming fact that your spouse experiences cessation of breathing during the night or other symptoms such as gasping or choking then it is time to schedule a visit to the doctor’s office. If you have the recurring tendency to fall asleep throughout the day and/or at inappropriate periods of time, for example while you are working, eating or even driving then the condition is serious enough to warrant medical attention. The latter can prove deadly for yourself and others.

Since sleep apnea can occur in children as well it is important to pay attention to your child’s sleeping habits. Does he or she have a problem with breathing throughout the night? Does he snore or sleep less than soundly? Does he wake up many times in the night and feel tired during the day? If yes then your child may very likely be suffering from sleep apnea and medical intervention is necessary.

Sometimes what is known, as “watchful waiting” is needed. What this means is that you play a game of “wait-and-see.” If for whatever reason your symptoms improve on their own then that’s good news and nothing further is needed. However if your symptoms worsen you will need to seek out your doctor and he or she can help map out the best treatment for your condition. If you snore then watchful waiting might be exactly what you need especially if you don’t find yourself extremely tired or drowsy throughout the daytime. Snoring is not always a sign of sleep apnea as snoring sometimes exists on its own. Immediate medical intervention as opposed to watchful waiting is what the doctor ordered if you snore often and heavily, if you experience restless bouts throughout the night, if you stop breathing during intervals throughout the night and if you find yourself feeling unrefreshed when you wake and groggy during the workday.

Jun 08

During waking hours it is the muscles that make up the air passages that provide both rigidity and strength and for the clear passage of air into and out of the body. As a person inhales and exhales without any problem, this exerts necessary pressure on the muscles of the airways and muscles to keep them as rigid as possible and in good working order. This continuous cycle of breath going freely in and out of the lungs is thought of as being an “interdependent relationship”.

Now while a person sleeps it is an all together different story. In this case, not only are you giving your mind and body a rest and plenty of relaxation but the muscles that line your mouth and throat decide to relax also. This causes a narrowing of the air passages. For those without any sleep or breathing problems this doesn’t pose any extra concern whatsoever. However for those who suffer from sleep apnea a dangerous turn of events can be put into play. Sleep apnea often involves snoring and an obstruction of the airways and coupled with the relaxation mode that the mouth and throat have gone into, this causes the normal airflow to be partially and/or totally blacked. Due to this, regular breathing is unable to take place.

If regular breathing is disrupted then there is very little if indeed any air flowing through that can bring about the required pressure on the airway muscles to keep everything running smoothly. When this happens it is dangerous because the air passages can narrow and collapse even further, thereby limiting all of the air that is attempting to pass through. Air then has no route from which to reach the lungs and with this, the level of oxygen in the blood begins to drop.

The brain is now on overdrive trying to let the lungs know that they must get air and return to a normalized breathing pattern. Unfortunately the lungs are unable to do as they are told as the air passages are collapsed and will not allow air to flow through. Finally the brain realizes that its oxygen supply is depleted as well and it then goes about the task of letting the body know by waking the person up in order for them to restore the required amount of muscle tone to their air passages and kick start regular breathing.  Some people who suffer from sleep apnea awake with a choke, a gasp or a snort as they attempt to force breath into their lungs.

Once the cycle of regular breathing commences, the oxygen levels rise again to their normal place and then the person falls back to sleep, and into the rapid eye movement (REM) deeper stage of sleep. However this causes the cycle of the muscles in the airways to collapse and become obstructed again thereby perpetuating the cycle.

Research into this cycle shows that it brings about disrupted sleep over a consistent period as the body requires in particular a sufficient amount of REM sleep per night in order for a person to feel rested and energized the following day. This cycle causes the brain to not get the necessary rest as well as it constantly needs to awaken the sleeping individual to alert him or her to the breathing problem at hand.

Jun 08

Continuous positive airway pressure (CPAP) is believed to be one of the most effective treatments for those suffering from sleep apnea. Many people have witnessed an improved quality to their life and found they were able to return to a more restful night’s sleep. However others find their experience with CPAP to be less than a desirable one. Many patients describe it as being uncomfortable and develop such problems as dryness in their nose and nasal congestion that mimics having a head cold. There are ways to help minimize the level of discomfort. Let’s take a look.

First of all it may seem obvious but it is important to sit down and read the manual for the CPAP from cover to cover and make sure you understand everything. Familiarize yourself with the mask and the headgear and experiment with the buckles, straps and Velcro seams to see if you can get a comfortable fit. The leakage of air is often a common problem with CPAP but it has more to do with positioning than it does pressure. Pressure is important to seal it in place but take the time to guarantee that you have the mask properly in position before you begin tightening the straps. And remember tighter straps don’t necessarily allow the mask to fit better.

Some people find the use of a heated humidifier helps decrease the chance of CPAP being uncomfortable. If you find that your sinuses are drying out at a quick rate and the air in general is too dry then invest in a heated humidifier. Sometimes these can be costly but some manufacturers offer them at reasonable rates to work with specific CPAP models. Basically put a heated humidifier is, “a piece of plastic which you fill with water and place in between the machine and your mask.” How it works is the air makes it way over the water and as it does so it picks up a significant amount of moisture. In this way it works very much the same as an ordinary humidifier used around the home. Many patients strongly advise the use of a heated humidifier for comfort.

Continuous positive airway pressure is usually fairly quiet but some people find the sound of it which is comparable to “white noise” to be calming while others find it annoying. If you are one of the latter there are only two things that you can do to resolve the problem. First you can somehow find a way to block the noise (such as covering it with something or wearing ear plugs at night) or you can move the machine as far away from your bed as possible.

Some patients need help from a qualified health care provider or a family member or friend in order to decide on a mask that fits as well as possible. Some people try a few before they find one that is just right for them. Most of the side effects that patients experience when they first begin the treatment of CPAP are temporary and generally mild, such as headaches, sore, itchy eyes, bloating in their abdominal area and nasal congestion. The average patient becomes accustomed to CPAP treatment anywhere from two to twelve weeks after commencing the treatment and research into the use of CPAP has found that approximately less than half of patients who start it choose to not continue with it.

Jun 08

Sleep apnea is a problem that affects many people. There are two types of sleep apnea: obstructive sleep apnea and central sleep apnea, and in this article, we will attempt to explain the differences between the two conditions.

Obstructive sleep apnea occurs when there is some sort of blockage in a person’s airway, causing them to be unable to get the air that they need while they are asleep. This can be due to many reasons, with obesity being a common cause. Overweight people have deposits of fatty tissue in the neck area, which can weigh on the esophagus and cause a lack of sufficient room for air to get through. Other causes of obstructive sleep apnea include allergies, nasal deformation, large adenoids, large tonsils, and sleeping in an awkward position. Snoring is often present in those who have obstructive sleep apnea, since the sound of snoring represents your body trying as hard as it can to get the oxygen that it needs.

Central sleep apnea is a similar disease but with different causes. Cases of central sleep apnea are rare, occurring much less often than diagnoses of obstructive sleep apnea. In central sleep apnea, the afflicted person has a problem with their brain’s timing. The brain subconsciously tells the body when it should perform its regular functions, and sometimes the timing can be off when it comes to telling the body when to breathe. So, like obstructive sleep apnea, central sleep apnea sufferers do not get enough oxygen while they sleep.

Both disorders cause the sufferer to wake up numerous times throughout the night, gasping for air and even choking. The afflicted often wake with headaches and sore throats due to the lack of oxygen and their body’s struggles with trying to get some. This lack of sleep can lead to many other problems, both physical and mental. Since sleep apnea causes the sufferer to wake up so much throughout the night, the person rarely gets enough REM sleep to fully refresh their body.

This can leave them in a permanent state of grogginess, leading to a lack of concentration, increased irritability, and a much higher risk of being involved in an automobile accident. These problems with alertness can cause an apnea patient to lose productivity in the workplace and in the home, causing a host of problems in the sufferer’s life. Also, the lack of sufficient oxygen taken in by apnea sufferers while they sleep can lead to some very serious physical problems.

Higher blood pressure is often present in those with both types of sleep apnea, and those who have an untreated case of sleep apnea have a significantly higher risk of suffering from a stroke or heart disease than those who have their condition treated. For that reason, if you or someone you love has any of the symptoms described above, it’s important to consult a health care professional to ensure that sleep apnea is not present. The test for apnea is painless, and involves an overnight sleep study. The test is also usually covered by insurance, so there is no need to worry about costs assuming you have an insurance provider.

Jun 08

Traditionally the tonsils were taken out as a way to improve such problems as serious throat infections and sleep apnea (especially in youngsters). However this ushered in a host of other problems such as pain post surgery as well as a slow recovery period, in particular in regards to returning to a normal diet and day-to-day activities. Although this is a relatively safe and effective form of surgery, it has been hypothesized that completely removing all of the sensitive tissues of the tonsils leaves a patient highly susceptible to the three “I’s”- infection, inflammation and injury.

For that very reason doctors have discovered that a partial or “near-complete” removal of the tissues of the tonsils (in the area of ninety to ninety-percent) can prove every bit as effective as the complete removal, while eliminating some of the postoperative complications. With this idea in mind the PITA Technique (Powered Intracapsular Tonsillectomy and Adenoidectomy).

On a traditional basis what is known as a T&A or a combined tonsillectomy and an adenoidectomy is done. What this means is that a Bovie tonsillectomy and a curette adenoidectomy are undertaken surgically. While the procedures are generally both successful and safe to perform they are also less than precise than the PITA Technique and tend to involve a great deal of pain for the patient afterwards. The pain that follows a T&A procedure can make for an unusually long healing period, which can cause great distress to patients. As well dehydration can often result. Lacking in precision can also cause negative results in the form of a voice with a very strong nasal quality to it.

The PITA Technique is a revolutionary medical procedure that makes use of a powered instrument known as a microdebrider. The microdebrider allows for more precision as well as control on the part of the surgeon due to its small rotating tip. In other words the surgeon is able to take out the maximum amount of adenoid tissue that is obstructing the airway or causing disease while also leaving enough tissue from the tonsils as they are. Leaving a small percentage of tonsil tissue intact “protects the delicate throat muscles, decreases postoperative pain, and shortens the convalescent period.”

By leaving five to ten percent of the tonsil tissue as it naturally is and by leaving a thin section of adenoid tissue in place nearby tissues help to speed up the recuperation period and cause less pain to occur. With the PITA Technique patients can return to school or work sooner and they can also resume their normal day-to-day activities at a faster rate. As well the area that was operated on is less susceptible to thermal injury, inflammation, oozing of fluid and bacteria which can lead to infections. With traditional tonsil and adenoid surgical procedures patients often experienced a great deal of swelling as well as pain. The pain sometimes could become so bad that patients stopped eating and drinking fluids which led to cases of dehydration. As well a conventional curette adenoidectomy can sometimes by accident bring about damage to the underlying tissue of the muscle which can then lead to chronic neck pain.

Jun 08

Continuous positive airway pressure (CPAP) is a form of therapy for sleep apnea that allows for a steady stream of air to flow back and forth from the lungs in order to make it possible for “uninterrupted breathing and unobstructed airways during sleep.” This is done by way of a CPAP machine and a mask worn over the face. The CPAP blows steady constant pressure all through the night. Let’s look at some common questions that CPAP users have regarding the equipment.

Now that I have been diagnosed with sleep apnea, what next?
The first thing you must do is invest in the best CPAP equipment that you can. In particular this means finds a mask that fits comfortably and then wearing it faithfully every night for optimum results. The next thing you should do is reassure yourself that you are not alone with your sleep apnea problems by getting in touch with either an online or a real time community of likeminded individuals. One option if you wish to communicate via the Internet is www.cpaptalk.com. It is essential to replace the disposable parts of the CPAP equipment as applicable. For example filters should be changed every two to three months and masks approximately every six months. Often the consequence of not replacing equipment as required is sinus problems and nasal congestion.

What maintenance is necessary in regard to CPAP machines?
There is not a great deal of maintenance involved. You need to keep the machine as clean as possible and as discussed in the above question, replace the filter on average every two to three months.

What comes with the CPAP machine when it is delivered?
Besides the actual CPAP machine you will receive a special hose to attach it to the mask (which on average is anywhere from four to six feet long), an instruction manual and a case for transporting it. The CPAP mask is a separate item that must be purchased on its own.

Can I mix and match brands in regards to the CPAP machine and masks?
If you want to use different brands you might want to check with the manufacturers of both but for the most part most brands of machines and masks are compatible. However sometimes APAP machines cannot be used in conjunction with all CPAP masks. When in doubt, take the time to fond out!

If I need to change the pressure setting on the CPAP machine how do I go about it?
It is a patient’s doctor who usually makes this decision and once he or she has ordered a pressure change it can be done in one of two ways. First of all the majority of sleep clinics or sleep laboratories will send a technician out to change it for little if any cost to the patient. Secondly, a patient can purchase what is known as a manometer which is a very small and accurate device that will allow you to make the pressure setting change as is necessary.

What is a nasal mask?
A nasal mask is an excellent mask for those who are just beginning CPAP therapy. It fits comfortably around the nose and is held there by way of special headgear or straps.

What is a full-face mask?
As the name implies, the full-face mask covers more of the face then the nasal mask, as it takes in the mouth as well. This type also makes use of straps or headgear and is the best choice for those who prefer to breathe through their mouths instead of their noses.

Jun 08

Dental appliances or devices can be helpful when it comes to some patients of sleep apnea but not others. In the past doctors were wary of prescribing this treatment option to their patients due to lack of sufficient testing and research to determine their effectiveness. Dental device research is making inroads as a group of researchers hailing from the University of New South Wales in Australia have tested the devices on subjects to determine their overall effectiveness. The results concluded from these studies were that two thirds of the individuals tested showed a vast improvement in symptoms and their sleep apnea episodes dropped from an average of twenty-five per night to four or five and even in some people, less.

Although continuous positive airway pressure (CPAP) is one of the most widespread forms of treatment for sleep apnea, many patients find the machines uncomfortable and unsettling. Many people use them for a short time and then give up using them or only use them for an hour or two a night without noticing an improvement in their symptoms. Still others find the claustrophobic aspect of the mask to be more than they can bear. For these reasons many sleep apnea patients choose to opt for another form of treatment and that is where the dental appliances come in.

Originally these dental devices were meant to decrease the incidence of snoring of which they did an excellent job however with time and improvement in their design they have come to be used as a type of treatment for those who suffer from mild to moderate forms of sleep apnea. Less rarely are they used by those who suffer from severe sleep apnea, as they tend to be less effective for this group of people.

There are a variety of dental devices available for the patient to choose from. Two of the most popular include the splint and the mandibular advancement device (MAD). The splint keep the tongue in a particular position and by so doing, allows the air passage to remain open and clear. The mandibular advancement device (MAD) looks a lot like the sports mouth guards that athletes wear for protection.  This apparatus forces the lower jaw in a backward direction and this makes it possible for there to be plenty of room for air to flow in and out.

More and more doctors are prescribing dental devices for their sleep apnea patients today than ever before as more is known about how they work to treat the sleep disorder. Most patients report positive results with the use of dental devices although more studies need to be done to determine if they have any significant health benefits for sufferers. MAD in particular has been found to have plenty of benefits. First of all for those who sleep lying on their backs and experience mild to moderate sleep apnea it has been found to decrease the incidence of apnea episodes considerably. Secondly, it may play a role in improving the flow of air into and out of the lungs, although this is less the case with those who suffer from severe sleep apnea. Thirdly, it seems to have a positive effect on getting a good night’s sleep. Finally in one particular study done, eighty-eight percent of the test subjects described their MAD as being extremely effective in decreasing apnea symptoms.

Jun 08

There are only a few treatments to date that are believed to be helpful in alleviating the symptoms of sleep apnea. These are broken down into four groups- life style modifications (such as losing weight and quitting smoking), dental appliances, surgery (more than one type is available) and breathing assistance devices (such as continuous positive airway pressure (CPAP), bi-level positive airway pressure, as well as “smart” and responsive airway pressure). Your doctor will help you in deciding which route for treatment is best for your individual situation.

Jun 08

Yes obstructive sleep apnea can be dangerous to your present and future health and in some rare cases, has proven to be life threatening. OSA has a strong connection to other serious health problems such as high blood pressure, a higher incidence of heart disease, stroke as well as arrhythmia (or irregular heartbeat). As well it is very debilitating to physical and mental health in regards to the constant loss of sleep night after night. Those who suffer from OSA often experience irritability, depression, a lack of concentration and memory, a depleted sex drive and less energy. As well those who suffer from Sleep apnea have a greater risk of being involved in car accidents, workplace accidents and having family/marital problems.

Jun 08

The best thing to do in this case is to schedule an appointment with your doctor ASAP. Sleep disorders are still relatively new in the medical world and not always easy to diagnose. If your doctor suspects that you have sleep apnea he or she will likely send you for a sleep study test known as a polysomnogram. This test can either be undertaken at a sleep clinic / laboratory or at home.

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