Sleep Apnea Treatment

Sleep apnea is a sleep disorder, in which breathing stops repeatedly. Apnea denotes the timespan for which the breathing stops. Generally, a 10 second interval between two breaths is considered as an apnea. Sleep apnea is classified into three types - central, obstructive and complex. In central sleep apnea, breathing is disrupted when the brain fails to send proper signals to the muscles that control breathing. Obstructive sleep apnea is caused due to some physical blockage, which hinder the air flow to the lungs. Throat muscles, in a relaxed state can also cause this blockage. Complex sleep apnea is a combination of both obstructive and central sleep apnea. Studies show that obstructive apnea accounts for around 84.5% of the reported cases of sleep apnea; followed by 15% of complex apnea and 0.5% of central apnea.

The common symptoms of sleep apnea are loud snoring, daytime sleepiness, fatigue and choking or gasping for breath during sleep. The treatment for this disorder varies with the type of apnea. If the sleep apnea is very mild, the doctor may recommend some lifestyle changes like controlling obesity and not smoking, but moderate to severe cases need treatment, which may include some instruments to open the airway or surgery.

Obstructive Sleep Apnea

Obstructive sleep apnea is the most common form of sleep apnea and is formed by the blockage of the airways. Usually, aged people, primarily men, are affected by obstructive sleep apnea. Mild or occasional apnea is not fatal, but moderate to severe conditions can result in further complications, including death due to congestive heart failure.

The most common instrument used by people suffering from this disorder is the continuous positive airway pressure (CPAP) device. This device ensures flow of pressurized air into the patient's airways and the air pressure keeps the upper airway passages open, thereby preventing apnea. In severe cases, bilevel positive airway pressure (BiPAP) device is preferred to CPAP, as the latter takes care of inhalation only. BiPAP regulates both inhalation and exhalation and can adjust the pressure automatically, during your sleep. A comparatively recent development in this area is the Oral Appliance Therapy (OAT), which denotes the usage of an oral appliance, i.e. a custom made mouthpiece that moves the lower jaw forward which results in the opening of the airway. This is used by those affected by mild to moderate obstructive sleep apnea. In some mild cases, usage of specially designed pillows and shirts, which induces the users to sleep on the side, instead of on the back, helped in reducing apnea.

In some people, these devices fail to produce any results, or cause discomfort. In such cases, surgery can be done to open up the airways. This is achieved through the removal of excess tissue from the nose or throat, which is responsible for the snoring and blockage of the airways. The most common surgeries are uvulopalatopharyngoplasty (UPPP), maxillomandibular advancement and tracheostomy. Uvulopalatopharyngoplasty refers to the removal of tissues from the posterior end of the mouth and the top portion of the throat, along with the adenoids and tonsils. Sometimes, this surgery may not be fruitful, as the remaining tissue in the throat can obstruct the passage.

In maxillomandibular advancement, the upper and lower jaws are moved forward to facilitate unobstructed air flow. This surgery results in the enlargement of the space behind the tongue and the soft palate. Tracheostomy is done in the most severe cases. A metal or plastic tube is inserted through an opening made in the neck. This tube helps in breathing, even if your throat is blocking the airflow. This tube can be covered during the day and opened in the night. There are many other individualized surgeries, which are planned as per the area of obstruction.

Central and Complex Sleep Apnea

Central sleep apnea can be prevented to some extent by treating associated medical conditions like heart diseases or neuromuscular disorders. Usage of supplemental oxygen can also provide relief to patients suffering from this disorder. Another airflow device called adaptive servo-ventilation (ASV) is noted to be more effective in curbing central and complex sleep apnea. This device is connected to a computer, which stores information regarding the sleeping pattern of the patient and prevents disruptions in breathing. The device exerts pressure to normalize the breathing pattern. BiPAP is also found to be effective in controlling central and complex sleep apnea.

Sleep apnea can be prevented to some extent by adopting a healthy lifestyle at a young age. If you feel sleepy during the daytime or if you feel lethargic, then ask somebody to check your sleep pattern. If there are recurrent episodes of breathing disruptions, then consult your doctor at the earliest.