An estimated 22 million Americans have sleep apnea, with 80 percent of moderate and severe cases of obstructive sleep apnea undiagnosed. Left untreated, obstructive sleep apnea (OSA) can lead to chronic heart failure, atrial fibrillation, stroke, high blood pressure and other cardiovascular problems. OSA is associated with type 2 diabetes and depression and may lead to accidents caused by daytime drowsiness.
Three Types of Sleep Apnea
The three types of sleep apnea are obstructive sleep apnea, central sleep apnea and complex sleep apnea.
Obstructive sleep apnea is a condition in which the throat is closed off to the point that it inhibits breathing for a few seconds. In central sleep apnea, the brain fails to signal the muscles to breathe. Complex sleep apnea is a combination of the two conditions.
During each apnea event, the brain partially wakes the individual to signal breathing to resume. Individuals with severe sleep apnea may wake up hundreds of times per night and not realize it. This reduces the quality of sleep and lowers the oxygenation of blood.
Sleep Apnea Treatment: CPAP Masks and Other Devices
Individuals with moderate to severe sleep apnea may need to wear a continuous positive airway pressure (CPAP) mask to deliver air pressure and ensure the airways stay open while they sleep. The CPAP mask increases air pressure and forces the upper airway passages to remain open.
Patients may need to try on different masks to find one that feels comfortable. The tension of the straps may need to be adjusted to obtain a secure and comfortable fit.
An auto-CPAP device may be a more suitable option for patients having difficulty with the CPAP machine. An auto-CPAP device automatically adjusts the pressure while the individual is sleeping. A bilevel positive airway pressure (BPAP) device provides more pressure when inhaling and less when exhaling.
An oral appliance is designed to open the throat by bringing the jaw forward. Patients should speak to their dentist to find one that feels comfortable.
Sleep Apnea Treatment: Surgery
If these devices fail to alleviate symptoms of sleep apnea, patients may need to undergo surgery. Surgery may involve tissue removal, tissue shrinkage, implants, nerve stimulation, jaw repositioning or a tracheostomy. Some patients may need to undergo weight loss surgery or surgery to remove enlarged tonsils or adenoids.
Tissue removal, also called a uvulopalatopharyngoplasty, involves removing tissue from the rear of the mouth and top of the throat. The physician may also remove the tonsils and adenoids.
Tissue shrinkage is performed using radiofrequency ablation. Patients with mild to moderate sleep apnea may benefit from this procedure.
Implants are plastic rods that are surgically implanted into the soft palate.
Nerve stimulation involves inserting a stimulator for the nerve that controls tongue movement. This procedure helps keep the tongue in a position that promotes breathing.
Jaw repositioning is a procedure that involves enlarging the space behind the tongue and soft palate.
A tracheostomy is a last resort for patients with severe, life-threatening sleep apnea. During this procedure, the surgeon makes an opening in the neck and inserts a metal or plastic tube that is used to breathe. The opening is covered during the day but uncovered at night to allow air to flow to the lungs.