MedCentral Obstructive Sleep Apnea User Manual

MedCentral Obstructive Sleep Apnea User Manual

Patient: I often wake up at night, but I don’t think I have sleep apnea. How can I tell?

Clinician: There are questionnaires that ask about snoring and whether you feel tired during the day, but these are not particularly accurate. The best way to know for sure whether you have obstructive sleep apnea is to do a sleep test that measures your breathing over the course of a night.

There are two main types of sleep apnea, obstructive and central. In obstructive sleep apnea or OSA, your throat closes off or obstructs during sleep. So even though you may be trying to breathe, no air is getting into the lungs. In central sleep apnea disorders, the problem is not the throat closing but just that the person has a pause in trying to breathe while asleep – so they may go 10 or 15 seconds without any attempt to breathe and then restart breathing.

OSA is much more common, accounting for more than 90% of cases of sleep apnea.

Patient: What is involved in a sleep test? Do I have to stay overnight in a clinic?

Clinician: There are two kinds of sleep tests: an overnight test at a sleep center and a home test.
The sleep center test does involve going to the center in the evening and staying overnight. A technician puts monitors all over your body. Then, you sleep in a bedroom while a technician sits in the next room and watches the signals from the monitors.

For OSA, most people can get equivalent results by doing a home sleep test. A home test involves fewer sensors, which focus on breathing. For some home tests, a sleep lab mails you the test with instructions. You put the device on before you go to bed in your own home, press a button, and then take it off the next morning. You’ll send it back to the sleep lab, where they download the data, have a physician look at it, and determine whether you have OSA.

A home sleep test might not work, however, if the person has other sleep- related disorders because it cannot distinguish between different types of sleep apnea. This can also include people who are taking opioid pain medicines or have severe lung or heart disease, in which case it might be better to test at a sleep center.

But for people who are otherwise healthy, home testing is as good as in-center testing and can often be done quicker, cheaper, and more conveniently.

Patient: If I do have obstructive sleep apnea, what is the treatment?

Clinician: We may recommend conservative lifestyle changes that generally will improve your sleep apnea and overall health, such as getting more physically active, losing some weight (if appropriate), avoiding alcohol (especially close to bedtime), treating any nasal congestion, and sleeping on your side rather than your back.

If you have more bothersome OSA symptoms, the most common treatment is a device called CPAP, which stands for “continuous positive airway pressure.” This machine uses a fan to blow air under pressure into your throat through a mask that covers either your nose or your nose and mouth. The CPAP machine keeps your throat from closing off in your sleep.

For people who have trouble getting used to sleeping with a CPAP mask, another option is a dental appliance. This is a mouthpiece you wear over your teeth at night that pulls your lower jaw forward, which pulls your tongue forward, and opens up your throat. The main issue with this type of device is that, in the long run, it can move your teeth. So, we would want to minimize that risk by getting one made by a dentist who specializes in treating sleep apnea.

If those treatments don’t work, there are some surgical options. For children and young adults, removing enlarged tonsils may be a good option. For adults, there is a procedure called hypoglossal nerve stimulation. A surgeon puts a pacemaker on the nerve that controls the tongue, with a battery pack that sits in the chest like a heart pacemaker. You turn the device on before you go to sleep, and it stimulates the muscle in the tongue to move forward and out of the way as you breathe

Patient: Will losing weight make the sleep apnea go away?

Clinician: Being overweight is the most important risk factor for sleep apnea, especially for younger people. There are a lot of studies that have shown that, in general, every 1% decrease in your weight reduces the number of breathing stoppages during sleep by 3%. In these cases, the apnea is likely to become less severe.

But there are a lot of people with sleep apnea who have a fairly normal weight, so there’s no guarantee that losing weight will make the sleep apnea go away.

Patient: You said there are some risks associated with OSA. What are they?

Clinician: Yes, in terms of day-to-day risks, sleep apnea can cause people to be drowsy or sleepy during the day, so a major concern is falling asleep behind the wheel.

Sleep apnea is also associated with several long-term heart health problems, such as atrial fibrillation, which is an abnormal heart rhythm, and heart failure, where the heart doesn’t pump enough blood to the body. Sleep apnea is also associated with a higher risk of having a stroke or mini-stroke.

And there’s some recent evidence suggesting that having sleep apnea increases the risk of developing Alzheimer’s disease.

One of the complicating factors with these longer-term conditions is that the risks can overlap with those of being overweight or less physically active. So, it’s not always clear if the reason a person with sleep apnea has a higher risk of these complications is because the sleep apnea causes those problems or if it’s a result of the common risk factors.

We do know that most people with sleep apnea have symptoms for many years before finally getting a diagnosis and starting treatment. When sleep quality and daytime fatigue worsen, some people attribute this to getting older, but falling asleep while sitting quietly is not normal and not part of aging. So it’s important to get screened.

Disclosures: Dr. Patel is an employee of the University of Pittsburgh Medical Center. He has an active research program and has received grant funding from NIH as well as industry sponsors including Bayer Pharmaceuticals, Philips Respironics, Respicardia, the ResMed Foundation, and Sommetrics. He currently serves as a consultant for Apnimed.

© 2024 HealthCentral Corporation. All rights reserved.

Read User Manual Online (PDF format)

Read User Manual Online (PDF format)  >>

Download This Manual (PDF format)

Download this manual  >>