SLEEP DISORDERS

What is sleep apnea? | What causes sleep apnea? | What are the different types of sleep apnea? | Who suffers from sleep apnea?
What are the symptoms of sleep apnea? | What sleep apnea treatments are available?

What sleep apnea treatments are available?

There are a very wide range of treatment options available from mild to severe sleep apnea treatment and from the established to the latest treatment for sleep apnea including:

• Behavioral changes. Behavioral changes form an extremely important part of any treatment plan and, in mild cases, may be all that is required. The subject of behavioral therapy for the treatment of sleep disorders (including sleep apnea and its associated insomnia) is too complex to cover here and so mention is made of only three changes that are particularly aimed at sleep apnea sufferers.
• Lose weight. Being only slightly overweight can have a marked impact on the effects of sleep apnea and even a small weight loss of 5 to 10 percent can make a significant difference.
• Avoid alcohol, tobacco and sleeping pills. Alcohol, tobacco and sleeping pills all make it more likely that your airways will collapse during sleep. In addition, alcohol and sleeping pills can increase both the frequency and duration of pauses in your breathing.
• Adjust your sleeping position. Many sufferers sleep on their back and this is the one position in which it is easy for the soft tissue at the back of your throat, or for your tongue, to block your airway. You should try using pillows or cushions therefore to prop yourself up so that you sleep on your side.
  
  If using pillows or cushions doesn't work, then try sewing something like a tennis ball into the back of your pajama jacket. The discomfort of rolling onto the tennis ball will prompt your brain to react by turning you back onto your side.
  
  
• Continuous Positive Airway Pressure. A very popular form of treatment is the use of continuous positive airway pressure (CPAP). The principle here is to force air into your mouth while you are sleeping and, by so doing, 'push open' your airway. This is achieved by wearing a mask during sleep which is connected to a special CPAP machine. There are, however, a number of problems with this method that mean that it is not always a suitable treatment.
  
  Apart from the obvious difficulty of getting used to sleeping with a mask on your face, the treatment can cause nasal irritation, facial skin irritation, abdominal bloating, sore eyes and headaches.
  
  More importantly, however, is the fact that this is not a cure for sleep apnea. While you may derive benefit from CPAP treatment, you'll be right back to square one the moment you discontinue using the machine.
  
  
• Dental Appliances. A variety of dental appliances can be worn in the mouth during sleep to reposition your lower jaw and tongue and keep your airway open. These of course need to be individually manufactured and fitted by a medical specialist.
  
  Once again these devices only provide relief while they are being used and you may find it difficult to get used to wearing them. There are also a range of problems associated with their use including damage to your teeth, the soft tissue of your mouth and your jaw joint.
• Surgery. In a significant number of cases, sufferers turn to surgery to cure their problem and, in very severe cases, this is often the only real solution. Surgery is not however without risk and the currently available surgical options are rarely completely successful. Indeed, many patients find that they have to try a series of different procedures before they see any real results.
  
  There are four main types of surgery used in cases of sleep apnea:
• Nasal surgery. Procedures include:
• Septoplasty. The removal of bone and cartilage from the septum (which divides the two nasal passages) to enlarge the airway and prevent its collapse.
• Turbinate Reduction. Each nostril contains three structures (turbinates), composed of bone covered with soft tissue, that are designed to warm and moisturize the air you breathe in before it is passed to your lungs. Reducing the size of these structures enlarges the airway.
• Removal of Polyps. Polyps are small and normally harmless lumps that can appear throughout your body and which are particularly common in the nose. Their removal enlarges the airway.
• Sinus Surgery. Infection of the sinuses can often result in a restriction of the nasal airway and requires surgery to remove the infected sinus tissue.
  
• Upper Airway Surgery. Upper airway surgery includes:
• Tonsillectomy and Adenoidectomy. The removal of the tonsils or adenoids is often a preferred treatment in the case of children.
• Uvulopalatopharyngoplasty. An enlarged or elongated uvula (tissue that hangs from the roof of the mouth just above the throat) can be the cause of sleep apnea and uvulopalatopharyngoplasty (UPPP), carried out using standard surgical instruments or laser surgery, and is used to remove this tissue. Commonly areas of the soft palate and the tonsils are also removed during this procedure.
• Somnoplasty. Areas of the soft palate can be reduced by placing needle electrodes under the surface of the soft palate and using low-power, low-temperature radio frequency energy. This is a progressive process and often requires multiple treatments.
  
• Lower Airway Surgery. Lower airway surgery includes:
• Genioglossus Advancement. The genioglossus muscle joins the back of the tongue to the chin and the aim here is to pull the tongue forward to prevent it from falling back and obstructing the airway during sleep.
• Hyoid Advancement. The hyoid bone is a C-shaped bone that sits in the upper neck, just above your Adam’s apple, and is attached to the back of your tongue and the sides of your lower throat. This procedure is designed to enlarge the airspace behind your tongue.
• Midline Glossectomy, Lingualplasty and Lingual Tonsillectomy. These procedures are performed in cases where the tongue is enlarged and are designed to reduce the size of the tongue and enlarge the airspace behind it.
• Bimaxillary Advancement. Both the upper and lower jaws, together with the teeth, are moved forward to, in turn, advance the soft structures at the rear of the mouth and create greater space behind the tongue.
• Tongue Suspension Suturing. To prevent the tongue falling backwards during sleep a titanium screw is placed in the back of the chin and a permanent stitch is inserted from this screw to the back of the tongue, pulling the tongue forward.
  
  
• Bypass Surgery. If all else fails bypass surgery can be performed.
• Tracheostomy. If other forms of nasal, upper and lower airway surgery prove ineffective, or are not possible, then one solution is to simply bypass the problem altogether.
  
  Instead of attempting to enlarge the airway, a tracheostomy (also sometimes referred to as a tracheotomy) creates an opening in the front of the neck directly into the windpipe into which a tube is inserted. During the day this tube is closed and breathing is carried out normally through the nose and mouth. At night, however, this tube is left open and breathing is effected through the tube.
  
  Many medical practitioners will only perform this form of surgery in severe (often life-threatening) cases of sleep apnea.

Much of this page has been devoted to sleep apnea symptoms, treatment and, in particular, the surgical option for treating sleep apnea however, in the vast majority of cases, this is not recommended. Apart from the risks involved in any form of surgery, and the often unpleasant and lengthy recovery period following surgery, the plain fact is that surgery is rarely effective.

The information contained here should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider.

The information provided here is for educational and informational purposes only and in no way should be considered as an offering of medical advice.