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.

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.

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.

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.

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.

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.

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.

Not everyone who suffers from sleep apnea is aware of it. Sometimes it takes the person you share a bed with to bring it to your attention. The most common symptoms of sleep apnea include loud, habitual snoring, periods throughout the night when your breathing stops for anywhere from a ten second period to a minute or even more, excessive daytime sleepiness, problems concentrating throughout the day and waking up in the morning feeling as if you had not slept at all.

In as basic terms as possible sleep apnea is “the cessation of breathing during sleep.” Those who study sleep apnea break it down into three categories- central, obstructive and mixed sleep apnea. Obstructive sleep apnea (abbreviated to OSA) is the most widespread form while central sleep apnea is not terribly common. Mixed sleep apnea is a combination of the other two types but its treatment is much the same as OSA.

Lower airway surgery is undertaken by doctors to both increase the size of the airway to allow for proper breathing as well as to prevent the worry that the airway might suddenly collapse. It also goes a long way in preventing snoring in sleep apnea patients. As the name implies, lower airway surgery is meant to “narrow the lower part of the airway, located behind the back of the tongue.” Let’s take a look at the various types of lower airway surgery.

There is a muscle known as the genioglossus muscle that connects from the back portion of the tongue to a place on the back of the chin. A lower airway surgery known as genioglossus advancement takes place in order to move the tongue forward in the mouth to make more space behind the tongue allowing for air to circulate easily. This operation must be done in a hospital under general anesthesia and is performed by way of an incision being made inside the lower lip of the patient.

Sitting slightly above the Adam’s apple in the throat is a boned shaped like the letter “C” known as the hyoid bone. This bone connects to muscles at the edges of the lower throat as well as to the back of the tongue. Sometimes an operation known as hyoid advancement is performed on a sleep apnea patient to make the space behind the tongue more accommodating for airflow. With this surgerical procedure an incision is made in the hyoid bone and then it is brought forward and the doctor attaches it to either the jawbone or the Adam’s apple.

Sometimes the cause of air obstruction is a tongue that is too big. Doctors may decide to make the tongue smaller by taking out a small part of the center of it, in a V-shape formation. This surgery is known as midline glossectomy. When even more of the tongue is removed including side parts it is called a lingualplasty. If they are inflamed or enlarged, the lingua tonsils may be gotten rid of by way of a laser. The lingual tonsils are defined as the “tonsil-like tissue on the back part of the tongue.” Very often doctors will also perform a temporary tracheostomy because swelling from any one of these surgeries could cause breathing problems in the patient.

Some doctors choose to move both the lower and upper jawbones forward as well as the teeth of the patient. By pulling the “soft tissue structures” forward this allows more room for the tongue to rest in and can decrease air obstruction concerns. The portions of the jawbone that are brought forward must then be held where they remain by way of titanium screws and metal plates. This surgery is known as bimaxillary advancement (or the more scientific name is lafort 1 maxillary osteotomy with bilateral sagittal split mandibular osteotomy) and is usually performed on patients who have a jaw that is very small or else those who have not found relief from their sleep apnea symptoms from other forms of “soft tissue surgeries.” This surgery must take place in a hospital under general anesthesia. Often a patient will need to go to an orthodontist for realignment of their teeth after the surgery. This surgery will affect a patient’s facial appearance. How much change will be noted depends on how much work needed to be done to move the jawbone forward during surgery.