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Do you
feel tired or have a headache when you wake up in the morning? Something
might be going wrong while you sleep that you don’t know about: obstructive
sleep apnea (pronounced app-nee-uh).
What is
Obstructive Sleep Apnea?
The Greek
word "apnea" means "without breath." An apnea is
defined as a pause in breathing for at least 10 seconds. Obstructive sleep
apnea, also called OSA, causes you to stop breathing in your sleep for several
seconds, up to many times an hour.
People
diagnosed with OSA have at least five breathing pauses an hour and can have
many more. During these breathing pauses, your brain, heart, kidneys, and other
essential organs do not get enough oxygen, and carbon dioxide can build up in
your body. When your brain notices there is not enough oxygen and too much
carbon dioxide in your body, it sends out a signal to take a breath. You wake
up enough to take a few breaths, but not enough to remember it the next
morning. This cycle repeats itself many times each night, making you feel tired
or exhausted in the morning.
When you
have OSA the apnea is caused by an obstruction or blockage. Usually the
blockage is tongue muscles, soft palate or parts of your throat that relax too
much during sleep and block your airway. A less common form of sleep apnea,
called central sleep apnea, happens if the area of your brain that controls
breathing doesn't send the correct signals to the muscles that help you
breathe.
If you
have OSA, a person sleeping with you may notice you snore loudly, snort or make
a choking sound when you start breathing again after a breathing pause. These
symptoms may happen less often or go unnoticed in women with OSA. Other
symptoms include:
· More than
usual daytime sleepiness
· Waking up
with a dry throat or headache
· Waking up
often during the night
· Difficulty
concentrating or mood changes during the day
Talk to
your doctor if you experience symptoms of sleep apnea. The diagnosis of a sleep
disorder such as OSA requires a sleep study done in a sleep lab or at home. A
diagnosis will determine if your OSA is mild, moderate, or severe based on the
average number of times you stop breathing each hour during sleep.
Getting
Treatment
There are
treatments for OSA that work well. Eric Mann, M.D., Ph.D. at the FDA's Center
for Devices and Radiological Health says, “Many FDA-approved and
FDA-cleared treatments can help people with OSA wake up in the mornings feeling
rested and refreshed, improving their overall health.”
Getting
treatment for OSA is key because OSA not only affects your sleep but increases
your risk of serious health problems and even death. OSA may increase your risk
of heart attack, stroke, type 2 diabetes, glaucoma, and some types of cancer
along with other serious health conditions. Lifestyle behavior changes such as
losing weight, drinking less alcohol, stopping smoking, and using devices
that help you sleep in a certain position may help improve OSA, but may not
make it go away entirely. Taking certain medicines, such as sedatives or sleep
aids, that slow or lessen breathing can also contribute to OSA. Talk to your
doctor before stopping or starting any medicine.
OSA
treatments can work well to manage OSA, but not every treatment is right for
everyone. Some treatments work best for people with mild OSA while others are
best for people with more severe OSA. Sometimes you must try a specific
treatment before you can move on to a different treatment. Some
treatments involve surgery to correct a narrow airway or a specific part of the
airway that may collapse during sleep. Any type of surgery has risks, so talk
with your doctor about all of your options before you decide.
The U.S.
Food and Drug Administration evaluates the safety and effectiveness of certain
medical devices before they can be marketed to the public, including the device
most often used for OSA. Depending on your health status and the type of
OSA you may have, your doctor may prescribe one of these OSA treatments.
The most
common OSA treatment is using a continuous positive airway pressure machine,
commonly known as a CPAP machine, every night during sleep. CPAPs use mild air
pressure to keep your airways open during sleep. The air is delivered through a
mask that fits over your nose and mouth, or only your nose. CPAPs are considered
the standard treatment for OSA, but you may need to work with a doctor or
technician for a few weeks to find the best combination of settings and CPAP
accessories for you.
Nasal
Expiratory Positive Airway Pressure (EPAP)
This
alternative treatment uses disposable or reusable valves inserted into or over
the nostrils during sleep. The valves limit your exhalations or breaths out,
which helps maintain pressure to keep your airway open during sleep. Unlike a
CPAP machine, EPAP valves do not need power from an electrical outlet or
batteries.
Oral
Appliance
A
prescription-only oral appliance is worn during sleep and fits like a sports
mouth guard or an orthodontic retainer but is for both the top and bottom
teeth. It keeps your jaw positioned forward so that your airway stays open
while you sleep. A dentist takes impressions of your teeth so a custom device
can be made and fitted for you.
Tongue
Retaining Device
This type
of oral appliance is worn in the mouth during sleep and includes a part that
prevents your tongue from falling back into the airway during sleep.
Neuromuscular
Tongue Muscle Stimulator
A
neuromuscular tongue muscle stimulator is a prescription-only device you put in
your mouth for 20 minutes a day while you are awake. The device delivers mild
electrical currents to your tongue muscle, strengthening it so that it does not
relax and block your airway as much during sleep.
Implantable
Nerve Stimulator
The FDA
approved a medical device for OSA that can be surgically implanted during an
outpatient procedure. A surgeon implants the device, which is similar to a
pacemaker, on the upper chest below the collarbone. During surgery the doctor
places wires from the implant near the nerves that control your tongue and
nearby muscles. The implant sends mild electrical impulses through the wires to
nerves in your tongue muscles during sleep. The nerve stimulation
prevents your tongue and the muscles around it from collapsing and blocking
your airway during sleep.
Most
implants have a remote control you use to turn the device on before going to
sleep and off after waking up.
Position
Therapy Device (a pillow or similar device)
A special
pillow or other bed device may help mild to moderate positional OSA. Positional
obstructive sleep apnea is caused by lying on your back (face-up) during sleep.
A special pillow or similar bed device can help you stay sleeping on your side
where gravity does not cause your tongue or throat to block your airway.
Before
purchasing a device, some people try homemade positional methods such as
a special pillow or bumpers for the bed.
Position
Monitoring Device/Stimulation
A
positional monitoring device can treat mild to moderate OSA caused by sleeping
on your back. It is worn on the body (usually around the neck or chest) and
monitors your sleeping position with a position accelerometer. When you are
lying on your back, or face-up, during sleep the device vibrates in increasing
intensity until you turn over to sleep on your side.
Medicines
May Not Mix With OSA
There are
no FDA-approved drugs to treat sleep apnea. Elisabeth Boulos, M.D., at the
FDA's Center for Drug Evaluation and Research, says that doctors sometimes
prescribe medicines that help keep you awake if you have OSA and persistent
daytime sleepiness despite treatment with a CPAP machine. These medicines may
help manage some symptoms but do not fix the nighttime breathing problem.
Moreover,
Dr. Boulos recommends that if you've been diagnosed with sleep apnea and are
taking other medicines, you should let your doctor know what those medicines
are. "A number of prescription drugs—in addition to alcohol and tobacco
products—can actually make sleep apnea worse, including many for insomnia,
anxiety or severe pain," she says.
Contact :
TriMedicare
Sleep Care Unit
1st Floor, 68/113A Jessore Road, Amarpally, Dum Dum, Kolkata – 700074
Email : trimedicare@aol.com
Call : (+91) 7003945473
(+91) 8777052658
(+91) 9883235935
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