Your patient and empathic bed partner, with velvet hammer high overhead, notices that you suddenly cease not only your snoring, but your breathing as well. You actually stop breathing, for 10, then 20, then 30 seconds. Then, to his or her surprise and dismay, you begin to gasp for air, as if it were your last breath. This cycle repeats itself over and over, all night long. For your part, you may be totally unaware of all of that, as the alarm clock rings. You may wake with a dry mouth, a headache, and feeling hungover. You may also be sleepy during the day, have significant memory loss, concentration, attention, mood and other related problems. This rather horrifying scenario is typical for a disorder called sleep apnea.
There are two types of sleep apnea, obstructive (OSA) and central (CSA). In OSA the throat collapses during sleep, preventing the flow of air to your lungs. As your oxygen levels decrease, your brain gets an alert message to "wake up and breath." These apnea episodes may occur 20 to 60 to 100 or more times per hour.
Present in about 7% of the population, the prevalence of sleep apnea is on par with diabetes and asthma. It is also a primary risk factor for high blood pressure. Fortunately, with the proper diagnosis, it can be treated quite effectively.
There are three categories of treatment for obstructive sleep apnea:
- Physical or mechanical therapy
- Non-specific therapy
Which therapy is used depends on your specific medical, lab, and physical exams and other findings.
Physical or mechanical therapies only work at the time they are properly used. Apnea episodes return when they are not utilized.
- Continuous positive airway pressure (CPAP) is the most common treatment. With the use of a snugly fitted face mask or nasal plug, air is blown into the nasal passages, forcing the airway open and allowing air to flow freely. The pressure is continuous and constant and is adjusted so that it is just enough to open the airway.
- Dental or oral appliances reposition the lower jaw and tongue, moving them outward, creating something akin to a pronounced "underbite." Used in mild to moderate sleep apnea, this physically opens the airway, allowing the free flow of air. They are custom-made devices usually fitted by a dentist or orthodontist.