Good Blog and informative too
Andrea Pisani Babich
Andrea is a writer and Mattress Advisor sleep expert, spending large portions of her day ruminating about the ever elusive good night's sleep.
Andrea is a writer and Mattress Advisor sleep expert, spending large portions of her day ruminating about the ever elusive good night's sleep.
Expert Insights from Dr. Luis Javier Peña-Hernández, MD, FCCP, a lung health specialist at PCSI, the largest integrated pulmonary and chest specialty group in Palm Beach County.
Snoring. It’s a funny word that conjures up a comic image: a drooling sleeper with mouth agape making otherworldly sounds that could wake the dead, all the while oblivious to the racket they’re creating. But ask anyone who sleeps with a snorer (that’s a funny one, too), and they’ll tell you snoring is no laughing matter. Of course, they’re right. And not just because they lose sleep every night. Snoring can be a sign of obstructive sleep apnea (OSA), a serious health problem that affects nearly 18 million Americans.
“Some of the most common signs of a case of obstructive sleep apnea are excessive nighttime snoring and daytime sleepiness,” explains Dr. Luis Javier Peña-Hernández.
Not all snoring indicates OSA, but OSA is almost always heralded by loud, frequent snoring. Snoring occurs when the soft tissues in your throat collapse and close off your airway. As you struggle to inhale through the obstructed airway, the tissues vibrate, causing the characteristic rattle and roar of snoring.
When the obstruction is severe, snorers may suffer from sleep apnea, a chronic condition characterized by pauses in breathing. People with OSA may stop breathing as many as 30 times each hour they are trying to sleep. As you might imagine, such breathing disruptions also disrupt the snorer’s sleep and prevent them from achieving the deep sleep stages, leaving them exhausted the next day.
Daytime sleepiness is just the beginning of the problems associated with lack of sleep. Left untreated sleep apnea can lead to:
Ask any new parents how they feel (or just look at them) and most will tell you “exhausted.” At least when sleep disruptions are caused by a newborn baby, there’s hope for relief as the baby learns to sleep through the night. But sleep apnea? It’s here to stay without some kind of intervention. The good news is there are several different types of therapies that can alleviate obstructive sleep apnea and let you and your partner get the rest you both need.
“A sleep specialist can diagnose a case of obstructive sleep apnea and prescribe treatment,” says Dr. Peña-Hernández. “Your doctor will likely recommend you partake in an overnight sleep study to determine the best treatment plan for you.”
You will likely need to participate in a polysomnogram, which is an overnight sleep study. This painless test requires you simply to sleep for at least seven hours while electrodes attached to your head and body monitor your:
The results will tell your doctor how much your snoring and/or apnea impairs your sleep and what type of therapy is appropriate for you. “In some cases, it’s possible to circumvent treatment with a few simple lifestyle changes,” says Dr. Peña-Hernández. “By losing weight and avoiding alcohol and smoking, you may be able to minimize or eliminate your sleep apnea. However, if the cause of your sleep apnea is related to anatomical abnormalities or a more serious underlying condition, treatment is likely needed.”
Here are some of the options available to you.
Read More: Types of Products to Treat Sleep Apnea
There are three kinds of Positive Airway Pressure therapies. All are designed to prevent your airways from collapsing while you are relaxed and trying to sleep.
According to the National Sleep Foundation, the most effective and most frequently prescribed treatment option for obstructive sleep apnea is a Continuous Positive Airway Pressure device, or CPAP machine. CPAP provides a constant stream of air at a prescribed pressure to keep your airways open while you sleep.
Unfortunately, many patients who would benefit from CPAP cannot tolerate sleeping with the device. In fact, while more than 5 million patients own CPAP machines in North America, more than 46% do not comply with their CPAP prescription. The most common complaint from patients is the difficulty they experience exhaling while the airflow blows into their nasal passages. This is especially problematic for patients with moderate to severe sleep apnea who require significant pressure to keep their airways unobstructed. Patients also complain about the discomfort and inconvenience in wearing a mask every night, all night long.
But just because CPAP therapy is not the right fit for you doesn’t mean you have to struggle to sleep with OSA or bothersome snoring. Alternative therapies can help you and your sleep partner sleep better.
Bilevel Positive Airway Pressure or BiPAP therapy is designed to address the most common complaint from CPAP users: trying to exhale through the resistance created by the airflow that props your airway open during inhaling. The solution? Two airflow pressure settings. A BiPAP device delivers one pressure for inhalation (that is prescribed based on the results of your sleep study) and a lower pressure that facilitates exhaling. For patients who require high pressure for inhaling, a BiPAP machine provides a more comfortable breathing therapy and encourages more consistent compliance.
Automatic Positive Airway Pressure or APAP therapy is the most adaptable of the positive airway pressure therapies. Similar to CPAP and BiPAP, APAP delivers air pressure to prop open your airways, but instead of providing constant positive pressure or two alternating pressures, APAP delivers a range of pressure levels to meet a patient’s fluctuating breathing needs throughout the night. This flexibility makes the machine more comfortable than CPAP or BiPAP devices, which may be providing more pressure than is sometimes necessary, making it difficult to breathe naturally.
APAP therapy is a good choice for patients
Your sleep specialist can help you determine which type of positive airway pressure device is the best fit for you.
Even with comfortable air pressure, some people cannot get used to sleeping with a mask on their face or tubes up their nose and tethered to a PAP machine. If you are one of these people, you have alternatives to PAP devices.
Sleep apnea dental appliances are good alternatives for patients whose apnea is mild and who cannot tolerate any type of positive airway pressure machine. A patient with severe sleep apnea can also use a dental device as a supplement to their PAP machine. With the dental appliance helping to keep the airway open, the PAP machine can be set to a lower pressure, making it a more comfortable therapy.
Just like any surgical procedure, surgery to alleviate sleep apnea entails risks and discomfort. These include pain, bleeding and throat swelling, several weeks of a limited diet, and your jaws wired shut for several days. In addition, the benefits may not be permanent, and you may find yourself snoring again at any time after surgery. But if you want the freedom to sleep unencumbered by a PAP device or other appliance, surgery may be the best option for you.
Well, yes; if you suffer from sleep apnea you should take some form of action to eliminate it. But treatment may not be necessary if you can get the sleep you need by making some critical lifestyle modifications. By simply changing some of your daily habits, you may be able to minimize or eliminate your sleep apnea.
So, what can you do?
Dr. Luis Javier Peña-Hernández, MD, FCCP, is a lung health specialist at PCSI, the largest integrated pulmonary and chest specialty group in Palm Beach County. His areas of expertise include asthma and immunotherapy, COPD, lung cancer, and invasive diagnostic techniques in pulmonary medicine including endo-bronchial ultrasound and diagnostic bronchoscopy. He is also one of the few experts in cardiopulmonary exercise testing and exercise physiology in Palm Beach County.
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