Obstructive Sleep Apnea Treatment

Frequently Asked Questions

1. QUESTION:
   SLEEP APNEA TREATMENT?
   PILLAR PROCEDURE. MAY I HAVE YOUR COMMENTS ON YOUR EXPERIENCE? I HAVE BEEN DIAGNOSED WITH OBSTRUCTIVE SLEEP APNEA AND I'M NOW ON THE CPAP TREATMENT WITH THE AUTOSET BY RESMED. A LIVE IN MEXICO CITY AND I AM PLANNING TO HAVE A CONSULTATION IN DALLAS. THANKS

   • ANSWER:
     Continuous Positive Airway Pressure (CPAP) is the most common treatment for sleep apnea which may help to stop snoring. But one need to use it properly, also till it is recommended. CPAP may eliminate snoring and prevent sleep apnea. It has some side effects like dry or stuffy nose, sore eyes, bloating of stomach, skin irritation etc.
     Some treatment includes- surgery, dental appliances, Tracheostomy, Maxillomandibular advancement, etc. All these are possible treatments which may be used according to the severity of the disorder.
     For more information regarding sleep apnea syndrome
     know more, click here

2. QUESTION:
   Can somebody explain to me what is central end-peripheral sleep apnea? treatments included?
   (sorry for the grammer and spelling)
   So far i found out that tissues at the back of your throat are collapsing and that's normal but the thing that prevents it from collapsing is the problem.

   Well, my cousin's son (infant) is having a problem breathing and some doctors said that there is something wrong with the brain (the neurons go to something, i don't know; i'm sorry). The probable diagnosis was central end-peripheral sleep apnea or obstructive sleep apnea.

   • ANSWER:
     Obstructive sleep apnea (OSA) is the most common category of sleep-disordered breathing. Since the muscle tone of the body ordinarily relaxes during sleep, and since, at the level of the throat, the human airway is composed of walls of soft tissue, which can collapse, it is easy to understand why breathing can be obstructed during sleep. Mild, occasional sleep apnea, such as many people experience during an upper respiratory infection, may not be important, but chronic, severe obstructive sleep apnea requires treatment to prevent sleep deprivation and other complications. The most serious complication is a severe form of congestive heart failure called cor pulmonale.

     Individuals with decreased muscle tone, increased soft tissue around the airway (e.g., due to obesity), and structural features that give rise to a narrowed airway are at high risk for obstructive sleep apnea. Older people are more likely to have OSA than younger people. Men are more typical sleep apnea sufferers, although the condition is not unusual in women or children.

     Common symptoms include loud snoring, restless sleep, and sleepiness during the daytime. Diagnostic tests include home oximetry or polysomnography in a sleep clinic.

     Some treatments involve lifestyle changes, such as avoiding alcohol or muscle relaxants, losing weight, and quitting smoking. Many people benefit from sleeping at a 30 degree angle or higher, as if in a recliner. Doing so helps prevent gravity from collapsing the airway. Lateral positions (sleeping on your side), as opposed to supine positions (sleeping on your back), are also recommended as a treatment for sleep apnea, largely because the airway-collapsing effect of gravity is not as strong to collapse the airway in the lateral position. Some people benefit from various kinds of oral appliances to keep the airway open during sleep. "Breathing machines" like the continuous positive airway pressure (CPAP) may help. There are also surgical procedures that can be used to remove and tighten tissue and widen the airway.

     The most common treatment for sleep apnea is the use of a positive airway pressure (PAP) device[13] (PAP), which 'splints' the patient's airway open during sleep by means of a flow of pressurized air into the throat.

     In addition to PAP, a dentist specializing in sleep disorders can prescribe Oral Appliance Therapy (OAT). The oral appliance is a custom made mouthpiece that shifts the lower jaw forward which opens up the airway. OAT is usually successful in patients with mild to moderate obstructive sleep apnea. OAT is a relatively new treatment option for sleep apnea in the United States, but it is much more common in Canada and Europe.

3. QUESTION:
   What causes obstructive sleep apnea in children that already have their adenoids & tonsils out?
   If adenoids and tonsils are out, what is the treatment? CPAP only?

   • ANSWER:
     Although adenoids and tonsils are the most common cause, problems with deviated septum, collapseable soft tissue in the neck, and underbite can be causes as well, and may be amendable to treatment surgically.

     CPAP is a good treatment, but if there's any other surgical intervention it should be considered first especially for someone young.

4. QUESTION:
   How does Obstructive Sleep Apnea impact cirrhosis and high blood pressure?
   My 60-yr. old husband has Cirrhosis of the liver, High blood Pressure, Rheumatoid Arthritis and severe Obstructive Sleep Apnea - and depression, as a result. I worry in particular because he refuses to use his sleep mask, so for now the sleep apnea seems to be his biggest hurdle, along with depression. He was diagnosed with Cirrhosis over 2 yrs. ago, Stage 4. He stopped drinking, and his liver got better; he still takes meds for that. His blood pressure is controlled with meds, and his RA has all but crippled his knees. I've tried everything to get him to try the newer, lighter sleep masks, get a new sleep study, or at least consult a dr. for the apnea. (He hasn't seen a dr. for that since diagnoses 15 yrs. ago.) He won't even consider any treatment for the apnea; he's just given up on it. He wakes up countless times during sleep; stops breathing over 100 times per sleep cycle, according to his last sleep study 15 yrs. ago. I'm at a loss here..any suggestions?

   • ANSWER:

5. QUESTION:
   I have sleep obstructive apnea and I'm only in my twenties...?
   What treatment options are there besides cpap cause I really don't want to have to use the face mask every night. Plus I was wondering if sleep apnea could cause anxiety and breathing difficulty during the day. I have been checked out by several doctors and I don't have any other serious conditions but I'm worried about the long term effects and complications of sleep apnea. I want to lose weight I heard that could help significantly(I'm about 50 lbs overweight).

   • ANSWER:

6. QUESTION:
   what is the treatment for central sleep apnea?
   im on cpap. doesnt work. cant get enough pressure to go thru my nose. only my mouth. i sleep using my nose only. sleep study says negative for obstructive sa. do i have central. what can i do. doc is no help.

   • ANSWER:
     This article might help. Its about a person who went through the same stuff you are.

     http://www.parade.com/health/2010/05/16-the-end-of-snoring.html?index=2

     Hope this helps

7. QUESTION:
   treatment of sleep disorders after CABG surgery ?
   I have a patient with mild obstructive sleep apnea, who had Coronary Artery Bypass Graft Surgery recently after a Myocadial Infarction, and now he is recovering well 5 days post-op but his sleep apnea has worsened and he can't get any sleep ever since the surgery.
   do you have any suggestion or any management options to offer?
   thanks a lot !

   • ANSWER:
     Cardiac asthma suspected.

8. QUESTION:
   Why does sleep deprivation make the symptoms of sleep apnea worse?
   I recently did a sleep study and found that I have obstructive sleep apnea and it causes me to wake up during the night - often many times. I go through cycles where the problem gets much worse, one night of poor sleep leads to another worse night of interupted sleep, and so on - sometimes for a month or even more. I have heard that sleep deprivation makes the symptoms of sleep apnea much worse, and as I am searching for the right treatments, I was just interested in finding out why - what is the mechanism that causes this? Very strenuous exercise during the day or early evening can have the same effect. Thank you for any insights.

   • ANSWER:
     Actually, sleep apnea is a condition where you actually stop breathing during sleep. For most people, this causes them to wake up quickly; for others, it's a life-threatening situation (especially for babies and small children). I imagine if you're not getting much rest, when you do finally get to sleep your body is so tired it's hard for your body to wake up when you stop breathing. Also, even though your body eventually trains itself to sleep lightly in order potentially avoid apnea, when YOU finally get some sleep your body falls into a deeper sleep. This makes it harder for your body to avoid apnea. I would advise you to get plenty of rest whenever possible. I believe you should obtain a sleep apnea monitor from your physician. This will sound an alarm to wake you up when you stop breathing, or if your oxygen saturation level drops below a certain percentage. This may alleviate some of your anxiety and help you sleep better at night. Just a thought. Good luck.

9. QUESTION:
   Anybody have Obstructive Sleep Apnea, or know someone who has it?
   Today I found out from my respirologist's office that I have severe Sleep Apnea. I had a polysomnogram done a couple of weeks ago at the hospital, which is how my diagnosis was confirmed. I have been WAAAY more tired than usual for the past few weeks......sometimes even falling asleep just while sitting on the toilet going pee (sorry if that's T.M.I.) Anyway now I am scared to go to sleep because I'm worried that I might have a bad episode and not even wake up. I know that having Sleep Apnea can cause death in the most severe cases. My specialist's office has moved up my appointment from next week to tomorrow so that he can talk to me about this and also to get things going for me to get onto CPAP treatment. But just for tonight, does anybody have any words of warning, (or words of comfort even) for me? Does anyone know of anyone ever dying from sleep apnea?

   • ANSWER:
     I was recently diagnosed with sleep apnea. When I went to a specialist, he told me what you already know...the possibility of dying from sleep apnea is extremely rare. Your body is just too smart. Basically, the reason you're so tired all the time is because when you stop breathing, your body "wakes up" just enough to force you to change position or do something to start breathing again. This pulls you out of the much-needed deep phase of sleep, and if it happens frequently throughout the night, your quality of sleep is poor and you'll be tired the next day.

     I did two sleep studies, and the second one was with a CPAP machine. I hated that thing...besides making me sound like Darth Vader, it was way too uncomfortable, and the forced airflow gave me a sore throat. As it turned out, my quality of sleep was worse with the CPAP anyway, and so the doctor didn't prescribe it for me. However, one important result of my studies that you might want to consider: When I slept on my back, I stopped breathing almost TEN TIMES as often as when I slept on my side! So you might want to try sleeping on your left side when you go to bed and see if that improves your quality of sleep.

     The other option to a CPAP is a surgical procedure to remove any obstruction(s) that are causing the sleep apnea. I've opted not to do that for now...at 37 I have no desire to have throat surgery! But if my wife gets too fed up with my snoring, I'll probably bite the bullet and do it for her.

10. QUESTION:
    Is surgery to cure sleep apnea safe?
    I recently have been diagnosed with severe obstructive sleep apnea and have started treatment with a CPAP. It makes me feel better but I just feel uncomfortable no matter how hard I try to get used to it. I am not obese(185 lbs, 5'11") so that is not the cause of my sleep apnea. I am meeting with my doctor soon to discuss other treatments outside of the CPAP, but I wanted to see if anyone could give me information or personal experiences on the surgery before I meet with him.

    • ANSWER:
      I had the surgery for sleep apnea....they did the laser removal of my uvula. They also fixed a deviated septum......It was the worst thing I ever did....not only did it hurt like H*** but it never really got rid of my sleep apnea....the pain after surgery was so intense I lost 15 pounds in one week.....couldn't eat or drink anything...it just caused it to hurt that much more...the only thing I looked forward to was my liquid Tylenol every 4 hours.....good luck with your decision!!

11. QUESTION:
    Is sleep apnea a real problem, or is the doctor trying to scam me?
    My doctor, who's new because I moved, referred me to a "sleep specialist" because I told him I snored heavily, am often tired during the day, and am overweight. The sleep specialist, after having me sleep with a bunch of wires strapped to me for a night, diagnosed me with "obstructive sleep apnea", and is telling me I need a breathing machine for when I sleep at night as treatment. Also, he's told me all sorts of stuff about health risks from the apnea: I'll get to being fatigued to the point of narcolepsy, I'm at even more risk for an early heart attack, even though I've started going to the gym I won't be able to lose weight, etc.

    Now, what I want to know is, are there really health risks from sleep apnea, and is it a real problem, or is it just some sort of medical fad or scam?

    • ANSWER:
      My story mirrors your's. I got the CPAP and started using it last year. I was underwhelmed when I did not see a perceivable change. After a few months I went on vacation and forgot the machine. Wow i felt it then I did not get any rest from sleeping and felt run down. After I got home and used the machine again I felt rested. Now occasionally I will take it off during the night or just forget to put it on. When I do that I feel as though I get no rest. I think overall it is a great benefit to my as well as to my wife that I don't wake up with my snoring.
      I think there are real health risks and the "bother" of wearing the machine is worth not having or decreasing the risk of some of the apnea health risks.
      I have had chronic sinusitis for years and since using the CPAP I have found I am far less sensitive to sinus problems. I am not sure if it is the air pressure in my sinuses or not snoring. I have always wondered if the vibration from snoring caused some of my sinus problems. Overall I am healthier today than I was without the machine.

      The medical scam I see is not about the benefits of the machine, it is in the leasing of the machine to the health insurance company. I priced the machine on eBay at about 0 all in. The company that owns my machine leases it to the insurance company for 9/mo. for the last year = 68. I am not sure what to do about this issue, and I don't want to deter you from getting the machine and using it.

      Be Healthy!

12. QUESTION:
    Is there any treatment for the esophageal varices?
    I am 460 lbs. I have Type II non-insulin dependant Diabetes, hypertension, obstructive sleep apnea, and hypersplenia.

    I was scheduled for Gastric Bypass surgery on April 5th, 2007 but they aborted the operation due to the esophageal varices. The GI specialist that my bariatric surgeon sent me to says there in NO TREATMENT. Yet my surgeon will not allow a second opinion. Please leave any advice you have.

    • ANSWER:
      The treatment for esophageal varices is directed immediately to control the bleeding, and then long-term medical therapy. Immediate control of bleeding is usually performed by endoscopic means. In fact, bleeding can be initially controlled in approximately 90 percent of cases. However, the failure rate for endoscopic therapy is between 10 and 30 percent. Thus, longer term therapy is required in order to prevent a patient from bleeding.

      Variceal hemorrhage stops spontaneously in approximately 62 to 70 percent cases. However, recurrent bleeding occurs in 40 percent of patients within the next 72 hours. In fact, 60 percent of patients will rebleed within seven days of their initial bleeding. Although this type of bleeding will stop, it is the high rebleeding rate and the complications from acute hemorrhage which make control of bleeding mandatory in both the initial period of the variceal bleed and the chronic state after the patient has been stabilized.

      Variants of esophageal varices are gastric varices. Gastric varices are dilated blood vessels that are found predominantly in the stomach. The true incidence of gastric varices is unknown. However, investigators have reported a wide incidence ranging between 20 and 70 percent in patients with esophageal varices. When gastric varices are identified without coexisting esophageal varices, a splenic vein thrombosis may be present.

      Another variant of portal hypertension is portal hypertensive gastropathy. It is present in 50 percent of patients with portal hypertension. These patients have dilated arterioles and venules (small veins). This abnormality is seen usually in the fundus and cardia of the stomach (approximately 2/3 of the stomach). It is rarely seen in the antrum (last 1/3) of the stomach. It appears to have a "snake skin " or "reticulated" appearance.

      Long-term treatment of portal gastropathy and gastric varices is with beta-blockers. They usually take the form of propranolol, a nonselective beta-blocker. These medications allow the pressure within the veins to be decreased, thus reducing the chance that bleeding will occur. Increased incidence of portal hypertensive gastropathy is noted in patients who undergo sclerotherapy for esophageal varices in the past.

      Other treatments for upper GI bleeding associated with esophageal varices include vasopressin, vasopressin with nitroglycerin, somatostatin, balloon tamponade, TPSS (transhepatic portosystemic shunt), transhepatic catheter embolization, shunt surgery, gastric stapling and sclerotherapy with or without any.

      =]

13. QUESTION:
    Military Service Connected Sleep Apnea?
    I was diagnosed with Obstructive Sleep Apnea (OSA) a few weeks ago. I have been off of active duty for roughly 1.5years. Currently I have a disability claim for this condition, but while i was on active duty, i didn't have any treatment or diagnosis of symptoms (I was a young marine who had no clue that snoring could be serious). Anyway, since I didn't complain about any symptoms I was having on active duty, and the OSA diagnosis was just made 1.5yrs after discharge, what would my likelihood of receiving a service connection be? THE VA HAS ISSUED ME A CPAP SINCE THE DIAGNOSIS.

    • ANSWER:
      zero hope. sleep apnea is not known to be caused by military service in any way shape or form.

14. QUESTION:
    Orthogonathic surgery: How do I get my Health insurance to pay for it?
    My orthodontist and dentist feel that I need to get Othorgonathic surgery to fix my underbite. They want me to to get surgery to my upper and lower jaws. To be honest I agree with them. I cant close my mouth comfortably along with the fact that I grind my teeth at night and I am already developing minor TMJ issues. However it says this in the exlusions & limitations section of my benefits information
    Upper and Lower jaw bone surgery except as required for the direct treatment of accute traumatic injury or cancer Orthogonathic surgery, jaw alignment and treatment for the tempromandibular joint except atreatment of obstructive sleep apnea
    Services for the evaluation and treatment of tempromandibular joint syndrome (TMJ) whether the services are considered to be medical or dental in nature.
    Has anyone else run into this problem? Were you able to successfully appeal? if so how? By the way I'm over 19.

    Thanks I would like to be able to smile in pics. for a change!
    Traveling outside the country is not an option for me. For the surgery. Travel outside the US is ver cost prohibitive for me.

    • ANSWER:
      Call a very experienced oral maxillofacial surgeon. They are usually located in educational medical schools or consult a trauma hospitals....the folks that operate on gun shot wounds to the face....that is the surgeon you want doing this type of surgery....it is complicated. Call this type of surgeons private practice and ask who is in charge of billing...they usually know how different insurance cos work and how to go about getting coverage. I'd also make sure the doctor is not only a DDS (doctor of denistry), but also an MD (medical doc). Most really qualified oral maxillofacial doctors are...these guys are like artists or even more qualified than plastic surgeons.

15. QUESTION:
    Sleep Apnea... how soon can I expect to feel better, and just what will 'feel better' feel like?
    I've recently been diagnosed with sleep apnea; the full diagnosis was "obstructive, central, and mixed " I've been prescribed a CPAP, w/ full mask (CFlex). Guess my question is.. how soon can I expect to feel better, and just what will 'feel better' feel like? evidently i've had this for quite some time, and would appreciate hearing from someone with personal experience of treatment for same.
    Thanx~

    • ANSWER:
      It takes time. Your body is used to running on empty so to speak and it has to readjust to being normal. Use the CPAP nightly as prescribed and hopefully you'll see effects soon. If after a month you see no change in how you feel (less tired, etc) call your home care company for a follow up (which they should be calling you regularly anyway, be honest when you talk to them) Sometimes the pressure isn't right the mask isnt right for the person and alot of patients hate c-flex from my experience. Sometimes turning that off helps.

16. QUESTION:
    So many headaches, I know the causes, don't know the treatment?
    Okay, I've been plagued with near constant headaches for a while now, and I'm confident I've pegged the causes, and there are 4 separate that are contributing to near constant pain.

    I have obstructive sleep apnea caused by enlarged tonsils. This causes me to wake up EVERY morning with a headache. What should I do?

    I have three wisdom teeth coming in, and two are possibly impacted. How do I make the pain go away?

    I have moderate/severe eye strain, I work in front of the computer all day. How can I minimize this or possibly reverse the damage?

    I'm almost certain I'm anemic also, I have mood swings, dark circles under my eyes, very little energy, I have incredibly strange bowel schedules and I seem to be depressed even though I really have no reason to be. What should I do?
    I also forgot to add: I have asthma.

    • ANSWER:

17. QUESTION:
    US Navy Administrative Discharge?
    I am an enlisted navy personnel, an E-3, AD for 1.5 yr now. I was on LIMDU and medical board for 4 months before I was returned to duty by my military psychiatrist. After RTD, I undergone a sea duty screening and was found to be "assignment limited." In addition to that, my psychiatrist also recommended an administrative discharge. I was diagnosed to have been suffering from Depression, Anxiety, Psyhcoses and Somatization disorder. Right now, my command admin is waiting to receive the PERS 40BB direction about my separation for them to start the discharge process. Before my military psychiatrist made the recommendation, he referred me to a Sleep Study Doctor for my insomnia, and the result came out lately; I have an obstructive sleep apnea. With this result, I don't know how will my treatment program with the sleep medicine will continue. I still have 3 more sessions with my sleep medicine doctor to complete, but it might not happen anymore as the discharge order may come out anytime in the next few days. Right now I am using a CPAP machine as part of the treatment. Also my military neurologist referred me to a civilian clinic to undergo physical therapy and rehab for my chronic dizziness and unresolve vertigo. I also have on going consults with hearing loss and tinitus with a civilian doctor as per referral by my neurologust. I know all of this will be stopped once the admin discharge comes to the fore. I am thinking of consulting my military PCM about the latest findings and my current treatment programs. I don't know if he could make it to put me in LIMDU or Medboard due to the new medical findings. And if he would do so, would it prevent the decision of the PERS 40BB to administratively discharged me? Are there other ways to have my treatment and consult completed using tricare insurance after the discharge? I shall greatly appreciate any information you will share. Thank you!

    • ANSWER:
      you would not be eligible for TRICARE at all. all your treatment will be through the VA..and only those ailments that the Navy determines were caused by or worsened by your service.

      the MINUTE you get discharged you trot on down tot he VA and submit a claim.

18. QUESTION:
    I have central apnea. It isn't just when I am asleap either. Is there a treatment or cure?
    I can't use a C PAP.I tried for a month and gave up due to sleep deprivation. it doesn't help anyway.
    this is not obstructive. my air ways are open. it is more a neurological problem I think.

    • ANSWER:
      even though taking a sleeping pill will depress your respiratory system, you might try doing that before using a cpap...
      if it is neurological, they can give you meds for that too...

19. QUESTION:
    What can I do if my insurance company is rescinding my past health insurance coverage?
    When I sent in my application for my health insurance, I forgot to note that I have obstructive sleep apnea. Stupid mistake, but I hadn't had insurance since I was 20 years old and paid of my OSA treatments out of pocket nearly two years ago. I had an expensive hospital bill in September for a completely unrelated illness. When my insurer pulled my medical history, they saw the OSA and sent a letter with reimbursement for premiums and said that my coverage was null and void. I feel that they should cover the bill since the illness was unrelated.
    Also, I've began working for a company that offers group insurance through the same insurer that rescinded my policy! I didn't even have a lapse of coverage. I didn't purposefully omit the OSA.

    • ANSWER:
      Well, that's a pretty big disorder to forget about. "Oops, I forgot I'm a type 1 diabetic", kinda thing.

      Sorry. It's YOUR mistake, not theirs.

      Get on that group policy, and wait out your 18 month exclusionary period.

      Meanwhile, you can always file a complaint with your state insurance commissioner - but the company is going to cite "material misrepresentation" which is true. They NEVER would have given you ANY coverage if you had disclosed the OSA. So the commish is likely going to uphold their denial and cancellation.

20. QUESTION:
    Military Service Connected Sleep Apnea?
    I was diagnosed with Obstructive Sleep Apnea (OSA) a few weeks ago. I have been off of active duty for roughly 1.5years. Currently I have a disability claim for this condition, but while i was on active duty, i didn't have any treatment or diagnosis of symptoms (I was a young marine who had no clue that snoring could be serious). Anyway, since I didn't complain about any symptoms I was having on active duty, and the OSA diagnosis was just made 1.5yrs after discharge, what would my likelihood of receiving a service connection be? THE VA HAS ISSUED ME A CPAP SINCE THE DIAGNOSIS.

    • ANSWER:
      Hi Anthony,

      I have to tell you that I had pretty good experiences with the VA and disability rating... and I waited three years after discharge to file. If you don't have a Veteran's Service Officer I'd suggest you get one (I used the DAV, but VFW has good ones too, and the American Legion) so that they can help you navigate the process.

      I don't have any experience with VA disability and sleep apnea, sorry. But if you go to the discussion forums at http://www.military.com there are people who can answer your question for you (and some of them are VSO's too!)

      Good luck!