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Sleep Apnea

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by Hollenstein J

(Obstructive Apnea; Central Apnea; Mixed Apnea)

 

Diagnosis

An overnight sleep study is used to help diagnose sleep apnea.

Overnight Sleep Study (Polysomnography)

This test helps detect the presence and severity of sleep apnea. During sleep, it measures your:
  • Eye and muscle movements
  • Brain activity using an electroencephalogram
  • Heart rate
  • Breathing pattern and depth
  • The percent of your red blood cells that are saturated with oxygen

Other Studies

In addition to sleep studies, your doctor may order:
 

Treatment

There are a number of treatment options for sleep apnea, including:

Behavioral Therapy

  • Lose weight if you are overweight.
  • Avoid using sedatives, sleeping pills, alcohol, and nicotine, which can make the condition worse.
  • Try sleeping on your side instead of your back.
  • Use pillows to increase your level of comfort when sleeping.
  • For daytime sleepiness, practice safety measures, such as avoiding driving or operating potentially hazardous equipment.

Mechanical Therapy

Continuous positive airway pressure (CPAP) entails wearing a mask over your nose and/or mouth during sleep. An air blower forces enough constant and continuous air through your air passages to prevent the tissues from collapsing and blocking the airway. In some cases, dental appliances that help keep the tongue or jaw in a more forward position may help.

Surgery

In some cases, surgery may be recommended. It is most often beneficial in pediatric patients.
Types of surgery that may be done to treat severe cases of sleep apnea include:
  • Adenotonsillectomy—The adenoids and tonsils are removed.
  • Uvulopalatopharyngoplasty—Excess soft tissue is removed from the nose and/or throat.
  • Maxillomandibular advancement—The jawbone is repositioned forward.
  • Tracheotomy —For life-threatening cases of sleep apnea, an opening is made in the windpipe to allow for normal breathing.
Bariatric surgery may help with weight loss in some people who are obese . This surgery may reduce many of the complications that are related to obesity, including sleep apnea.

Medications

Only used in central apnea, acetazolamide may help improve the ability to regulate breathing. Overall, there is not a lot of evidence to support the use of medicines to treat sleep apnea.
Supplemental oxygen may be given if blood levels of oxygen fall too low during sleep, even after opening the airway.
 

Prevention

You may be able to prevent sleep apnea by maintaining a healthy weight . Avoid alcohol, nicotine, and sedatives, which may contribute to airway obstruction.
 

RESOURCES

American Sleep Apnea Association
http://www.sleepapnea.org

National Sleep Foundation
http://www.sleepfoundation.org

 

CANADIAN RESOURCES

Canadian Lung Association
http://www.lung.ca

Canadian Sleep Society
http://www.canadiansleepsociety.ca

 

References


American Academy of Sleep Medicine. The International Classification of Sleep Disorders. 2nd ed. Westchester, IL; American Academy of Sleep Medicine; 2005.


Kushida CA, Littner MR, Hirshkowitz M, et al. Practice parameters for the use of continuous and bilevel positive airway pressure devices to treat adults with sleep-related breathing disorders. Sleep. 2006;29:375-380.


Littner MR, Kushida C, Wise M, et al. Practice parameters for clinical use of the multiple sleep latency test and the maintenance of wakefulness test. Sleep. 2005;28:113-121.


Morgenthaler TI, Kapen S, Lee-Chiong T, et al. Practice parameters for the medical therapy of obstructive sleep apnea. Sleep. 2006;29:1031-1035.


Obstructive sleep apnea (OSA). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated May 23, 2013. Accessed June 3, 2013.


Pack AI, Maislin G. Who should get treated for sleep apnea? Ann Intern Med . 2001;134:1065-1067.


Sleep apnea. American Sleep Apnea Association website. Available at: http://www.sleepapnea.org/learn/sleep-apnea.html . Accessed June 3, 2013.


Smith I, Lasserson TJ, Wright J. Drug therapy for obstructive sleep apnea. Cochrane Database Syst Rev . 2006;19:CD003002.

 

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