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Demystifying Sleep Apnea, Part 2

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Continuing to demystify Sleep Apnea, let us take a look at what the different types of prevalent Apneas are. Clinical diagnoses have found 3 basic types, namely Central Sleep Apnea, Obstructive Sleep Apnea and Mixed Sleep Apnea.

Central Sleep Apnea is caused when the brain misfires on it’s cues and fails to trigger the respiratory control centres in time. In such cases the neurological feedback mechanism fails to maintain the respiratory rate despite the increase in the amount of carbon dioxide in the blood. This means that with the respiratory centre failing to signal ‘inhale’ the person may miss some cycles of breathing, which is potentially dangerous as it can trigger seizures, angina, arrhythmias etc. Usually the respiration is re-established on its own with frequent exhalation to flush out the CO2 build-up and inhalation to replace gas impurities with oxygen.

In the more common case of Obstructive Sleep Apnea (OAP), there are one or more obstructions in the upper airway. The obstruction could occur due to excess fat/tissue build-up in the wind pipe or due to large tonsil structure or even a misaligned lower jaw, structure of your head and neck, a blocked nasal airway or a large tongue. This too results in drop in blood O2 levels and dangerous increase in CO2 levels. The resumption of breathing is almost always with gasping or chortling/coughing etc.

Mixed or Complex Sleep Apnea is a combination of the above 2 types of apneas. It usually happens that a chronic and acute case of Obstructive Sleep Apnea festers into a Central Sleep Apnea condition. This is an even more dangerous situation.
So, what are the options available to one suffering from this breathing disorder? Fortunately, there are many lines of treatment depending on the type and cause of your Apnea. Your doctor will run a conclusive test on you with the help of a computerised device called the polysomnograph, which will read your brain signals, eye movement, respiration rate, oxygen levels, muscle tension etc through an overnight sleep test at the hospital or home assisted by a sleep technologist. The results of this test will determine the course of treatment you will follow. Let us take a brief look at each of options:
1. CPAP- The Continuous Positive Air Pressure is a customized device generally recommended for moderate to severe cases of OAP. It is a strap-on mask-like device to be worn at bedtime that provides rhythmic pressurised air with a built-in humidifier to prevent the air passage from collapsing.
2. OAT-The Oral appliance Therapy is a dental device which pushes the lower jaw (mandible) forward, elevates the palette and lowers the tongue to open the airway. It is also used on OAT patients only.
3. Bi-PAP – The Bi-Level PAP is used in severe cases. The device switches between higher (while inhaling) and lower pressures (as prescribed by the doctor for you) during exhalation to make for easier breathing.
4. Mandibular Myotopy –This involves the cutting out of a portion of the bone of the lower jaw to which the muscles of the tongue are brought forward to and re-attached to undo the obstruction caused by the tongue-jaw-chin area. This type of surgery is still being researched and refined.
5. UPPP – the Uvulo-Palato-PharyngoPlasty is a surgical procedure doe on the pharynx (join between the food and the wind pipe) to remove excess tissue build-up. It is prescribed only for those patients who cannot adjust well to the CPAP and other such devices. Laser procedures of the UPPP known as the LAUP are also being done with very successful results nowadays.
6. Tracheotomy – This is the last resort for the very severe cases where a hole is made at the trachea located in the neck and fitted with a valve which is opened at bedtime to avoid obstruction and closed at daytime to enable speaking.
7. Somnoplasty –This is the latest in the arsenal of sleep specialists and approved by the FDA. It involves the volumetric reduction in the tissue of the air passage through the administration of radio frequencies.

Whatever be the line of treatment your doctor has prescribed for you, you are expected to make certain lifestyle changes at your end that will help you manage your condition more effectively. Some of these are:
a. Reducing Weight and thereby your Body Mass Index
b. Reducing on Drinking
c. Quitting smoking
d. Inclining the head of your bed
e. Sleeping on your side
f. Using nasal dilating drops
g. Joining a Sleep Apnea support group
h. Getting your families help and emotional support.
As a last word, make sure you do your own homework and gather as much data about your condition so that you ask the right questions to your doctor. Some procedures are not covered by insurance, so you will do good to check them before you consult your doctor.

Mamta Singh is a published author (Migraines for the Informed Woman – Tips from a Sufferer. Publisher: Rupa & Co.), seasoned business, creative and academic writer.
She is a certified fitness instructor, personal trainer & sports nutritionist through IFA, Florida USA. She is the lead writer and holds Expert Author status in many well-received health, fitness and nutrition sites. Mamta runs her own popular blogs on migraines in women and holistic health. Mamta holds a double Master's Degree in Commerce and Business, and is presently training as a Holistic Healing Therapist from the U.K. She is a registered practitioner with the UN recognised Art of Living Foundation.
Link: http://www.migrainingjenny.wordpress.com and http://www.footstrike.wordpress.com

Add a Comment2 Comments

EmpowHER Guest

can you wear the mask in the day?

December 7, 2009 - 2:57pm
(reply to Anonymous)

Hi Anonymous,
Yes, most people do wear the mask during the day as well right from the start of their treatment. You may have a look at this site for additional info: http://www.sleepapneacenter.com/brochure_cpapmask.html
However, you must consult a doctor before taking any decision.
Best Regards,

December 9, 2009 - 9:35am
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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.


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