Treatment for Sleep Apnoea

In this post, let us understand about Treatment for sleep apnoea. Before you read about treatment procedures, do read Know About Central Sleep Apnoea   and Obstructive Sleep Apnoea

Treatment for Sleep Apnoea basically include three aspects:

• Behavioural changes

• Medical treatment

• Surgical treatment

Behavioural change:

• Lose weight if you are overweight. But remember that sleep apnoea occurs in thin people as well; the airway can close during sleep for a number of reasons, not just excess weight.

• Sleep on your side and not your back.

• Change sleep positions to promote regular breathing.

• Avoid alcohol and medicines such as sedatives before bed.

• Stop smoking. Smoking can increase the swelling in the upper airway which may worsen both snoring and apnoea.

If you have moderate to severe sleep apnea, you may be able to use a machine that helps you breathe while you sleep. Treatment is called continuous positive airway pressure. (CPAP).

Medical treatment:

CPAP:

• Continuous positive airway pressure (CPAP) is nearly always the first medical treatment for sleep apnea.

• CPAP works by gently blowing pressurized room air through the airway at a pressure high enough to keep the throat open. This pressurized air acts as a "splint." The pressure is set according to the patient's needs at a level that eliminates the apnoeas and hypopnoeas that cause awakenings and sleep fragmentation. Pressure that is too low will not be as effective in eliminating the apneas and hypopnoeas.

Oral appliances:

• Oral appliances, also called dental appliances, are intended to treat apnea by keeping the airway open in one of three ways:

• By pushing the lower jaw forward (a mandibular advancement device or MAD),

• By preventing the tongue from falling back over the airway (a tongue-retaining device)

• By combining both mechanisms.

Oral appliances are more effective in mild sleep apnea and for non-obese people but can, for some, be effective for moderate and severe sleep apnea.

The most common type of oral appliance, a MAD is often adjustable so that the dentist can move the jaw further or reduce the advancement as necessary. The goal is to find the most comfortable and effective position for the patient. On occasion oral appliances may worsen the apnea. Not all dentists have the necessary knowledge of sleep apnea, so if you wish to pursue this therapy, ask your sleep doctor to refer you to a dentist who is familiar with apnoea and who works with oral appliances.

Surgical Treatment:

Uvulopalatopharyngoplasty, by this surgery excess tissue in the throat is removed to make the airway wider. It is the most common surgery to treat sleep apnoea in adults.

Tonsillectomy and/or adenoidectomy, which removes the tonsils and/or the adenoids. It may be used if person has enlarged tonsils and/ or adenoids that are blocking the airway during sleep. This is often the first treatment option for children because enlarged tonsils and adenoids are usually the cause of their sleep apnoea.

Other surgical procedures, which are used to repair bone and tissue problems in the mouth and throat.

Tracheostomy, which creates a hole in the windpipe (trachea). A tube is then put in the hole to bring air in. this surgery is rarely used because of complications. But when other techniques have failed to cure sleep apnoea, almost all people who are treated with tracheostomy will be cured of their sleep apnoea.

Bariatric surgery is useful for extremely overweight patient and in whom the excess weight is making sleep apnea worse. Bariatric surgery can promote weight loss that improves sleep apnoea. This surgery is done only for people who cannot lose weight with diet and exercise.

Laser-assisted uvulopalatoplasty may be used to treat snoring. It is sometimes used to treat mild to moderate sleep apnea, though it does not benefit all people.

Newer Pillar Palatal Implant can reduce snoring and improve sleep for people suffering from snoring and sleep apnea. 

The implants work by reducing the movement or vibration of the soft palate with implants designed to stiffen it. 

Using a special needle, three pieces of polyester mesh are inserted into the soft palate near where it meets the hard palate. It is a out patient procedure and takes only about 10 minutes and is done under local anesthesia.

Somnoplasty is an unique surgical method for reducing habitual snoring by removing tissues of the uvula and soft palate. 

Unlike other approaches (such as the laser), somnoplasty uses very low levels of radiofrequency heat energy to create finely controlled localized burn-areas beneath the lining (mucosa) of the soft tissues of the throat. 

These burn- areas are eventually resorbed by the body, shrinking the tissue volume, opening the passage way for air, and thereby reducing symptoms of snoring.

Somnoplasty is performed under local anesthesia in an outpatient setting and takes approximately 30 minutes. 

Thanks a lot for reading, hope you have understood about Apnoea (Sleep Apnea) disesase, symptoms and its treatments.

Please share your comments /suggestions below, as always stay fit and healthy

Know About Central Sleep Apnoea

In todays post, let us learn about Central Sleep Apnoea

Central sleep apnoea About 10% of patients with sleep disordered breathing have central sleep apnea (CSA). 

Apnoea is a breathing pause of at least 10 second. Causes of Central Sleep Apnea The brain may be slow to recognise or not respond to changes in oxygen and carbon dioxide levels when breathing decreases. 

This can occur in patients with longstanding obstructive sleep apnea due to dulling of the breathing reflexes. Heart failure may also cause central sleep apnea by causing a pattern of over-breathing followed by under-breathing or apnea due to slow circulation disturbing the normal reflex pathways. 

Other causes in this pattern of CSA include some medications (particularly narcotics) or strokes affecting the breathing centres in the midbrain. In addition to the symptoms of disturbed sleep, there may be symptoms of carbon dioxide retention such as morning headache or confusion. 

Assessment of Central Sleep Apnea Requires a thorough evaluation of all the possible causes including a sleep study. What can be done about Central Sleep Apnea? Medications – medications such as narcotics which may cause CSA may need to be reduced or stopped if possible. 

There are some medications which stimulate breathing which may be trialled. Nasal CPAP may be effective. Home ventilation is sometimes very successful, particularly in the neuro muscular weakness/chest wall conditions which cause hypoventilation. If heart failure is present, this should be treated with medications, sometimes with the addition of oxygen therapy at night. 

Do Read: Treatment for Sleep Apnoea

There is also a new type of auto/ventilator which has been specifically designed for the treatment of CSA due to heart failure which may also need to be trialled if other treatments have not worked.

A diaphragm pacemaker is occasionally recommended (has been used in spinal cord injury patients or in congenital hypoventilation syndrome).

Thanks a lot for reading, hope you have understood about Apnoea (Sleep Apnea) disesase, symptoms and its treatments.

Please share your comments /suggestions below, as always stay fit and healthy

Know How Obstructive Sleep Apnoea can affect you

 

Obstructive Sleep Apnoea (OSA) is a serious condition where the muscles in the throat relax during sleep causing the sufferer to temporarily stop breathing. If untreated it can occur hundreds of times in a night leading to daytime fatigue and other serious health problems. Once diagnosed it can be easily treated.

Basically, Obstructive sleep apnoea is caused by the blockage of the upper respiratory tract during sleep. This condition is caused by obstruction. Mostly, this is caused with a sudden cessation of breathing in the middle of deep sleep, which makes us wakeup suddenly.

Sometimes, these episodes last only for 5 to 10 seconds, but they can also be more than a minute long. Usually, obstructive sleep apnoea occurs only once or twice per night, but if it happens more than 5 times an hour in children and more than 30 times in adults it means that you have a severe form of Obstructive Sleep Apnoea (OSA).

What exactly is sleep apnoea ?

Apnoea is a breathing pause of at least 10 second.

Hypoapnoea is a 10 second event where there is continuous breathing but ventilation is reduced by at least 50 % from the previous baseline during sleep.

Sleep apnoea is the most common cause of excessive day time sleepiness. Sleep apnoea or apnea is a disorder characterized by a reduction or cessation (pause of breathing, airflow) during sleep. It is common among adults but rare among children. 

There are two types of sleep apnea, obstructive sleep apnoea and the central sleep apnoea. Most Common of the two is obstructive sleep apnoea also called Obstructive Sleep Apnoea/ Hypoapnoea syndrome (OSAHS).

When there is no airflow but there is effort to breathe, the apnea is called “Obstructive”. When there is no airflow but no respiratory effort the apnoea is called “Central”. Mixed apnoeas start with no effort but effort develops during the course of the apnoea.

Signs and symptoms of OSA:

* Excessive drowsiness during the day

* Snoring loudly

* Frequent shortness of breath during sleep

* Stopping breathing and waking up suddenly

* Dry throat or mouth during waking hours

 Severe headache in the morning

* Lack of concentration during the day

Important Posts to read:

Treatment for Sleep Apnoea

Know About Central Sleep Apnoea

Thanks a lot for reading, hope you have understood about Apnoea (Sleep Apnea) disesase, symptoms and its treatments.

Please share your comments /suggestions below, as always stay fit and healthy