SLEEP APNEA

SLEEP APNEA

What is Sleep Apnea?
The Greek word "apnea" literally means "without breath." There are three types of sleep apnea: obstructive, central, and mixed; of the three, Obstructive Sleep Apnea (OSA) is the most common. Despite the difference in the root cause of each type, in all three, people with untreated sleep apnea stop breathing repeatedly during their sleep, sometimes hundreds of times during the night and often for a minute or longer.
Obstructive sleep apnea is caused by a blockage of the airway, usually when the soft tissue in the rear of the throat collapses and closes during sleep. In central sleep apnea, the airway is not blocked but the brain fails to signal the muscles to breathe. Mixed sleep apnea is a combination of the two. With each apnea event, the brain briefly awakes sleep apnea victims from sleep in order for them to resume breathing, therefore sleep is extremely fragmented and of poor quality.
Sleep apnea is very common and affects more than twelve million Americans. Risk factors include being male, overweight, and over the age of forty, but sleep apnea can strike anyone at any age, even children. Yet still because of the lack of awareness by the public and healthcare professionals, the vast majority remain undiagnosed and therefore untreated, despite the fact that this serious disorder can have significant consequences.
Untreated, sleep apnea can cause high blood pressure and other cardiovascular diseases, memory problems, weight gain, impotency, and headaches. Moreover, untreated sleep apnea may be responsible for job impairment and motor vehicle crashes. Fortunately, sleep apnea can be diagnosed and treated. Several treatment options exist, and research into additional options continues.

How is Sleep Apnea treated?
There is currently no proven drug therapy for sleep apnea. However, there are 4 basic approaches to treatment, which are not mutually exclusive:
1. Modification of circumstances which may be causing sleep apnea or making it worse. This would include weight loss, avoidance of alcohol and sedative drugs, trying to sleep only on your side and stopping smoking. It would also help to improve nasal breathing if this problem exists; sometimes this can be done with some simple medication and occasionally it requires an operation. Finally it is important to avoid sleep deprivation.
2. Use Continuous Positive Airway Pressure (CPAP) in the upper airway to support and hold the airway open. This involves wearing a close fitting mask over the nose, which is attached to a supply of continuously flowing air via a flexible plastic hose from a medical air pump that sits on the floor or bedside table. The flow of air into the mask creates a dilating pressure that is transmitted from the mask through the nose into the upper airway. This positive pressure dilates the upper airway so the breathing is not interrupted. When a sleep apnea patient no longer has obstructed breaths they are able to sleep continuously and hence their quality of sleep improves dramatically. An added benefit is that when the upper airway is dilated sufficiently there shouldn\'t be any further snoring. The amount of airflow and hence the amount of pressure is determined by your doctor. To date this has been the most successful and well-studied treatment for sleep apnea. This type of treatment almost always works regardless of the underlying cause of the sleep apnea. It is usually well tolerated and does not have any serious side effects. The treatment is not covered by the provincial health care plan, but is covered by some third party insurance companies
3. One of the reasons for the upper airway to become narrowed at night is because the tongue falls posteriorly, especially in the supine position. Since the tongue is attached to mandible this can be a significant problem in people with retrognathia and/or a very large tongue. It is possible to use a dental splint at night that effectively prevents the jaw and tongue from moving back when someone lies down and goes to sleep. There has been less experience with this type of treatment compared to CPAP. Since the upper airway can be narrowed for different reasons, this approach may not work for all patients. The splint may put some strain on the temporal mandibular joint, causing some discomfort. There are now many types of