Just in case somebody asks . . . . . .
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The definitive definition of Obstructive Sleep Apnea & Hypopnea Syndrome |
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OSAHS is a common chronic disorder of impaired airflow during sleep associated with oxyhemaglobin desaturation, sleep disruption, neurobehavioural consequences, and cardiovascular irregularities |
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American Academy of Sleep Medicine |
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Introduction to Obstructive Sleep Apnea (OSA)
What is snoring and how is it different from OSA?
During normal sleep, the muscles that control the tongue and soft palate hold the airway open.
If these muscles relax, the airway will become narrower, partially blocking the passage.
As you breathe in, the soft or floppy part of the throat vibrates and the noise of snoring results.
If the throat is already narrow, or the muscles relax too much, the airway can become completely blocked, preventing breathing. When this happens repeatedly over the night, it is known as Obstructive Sleep Apnea (OSA) syndrome.
When a blockage happens, it may last anywhere from ten seconds to two minutes.
During this time, if the brain experiences a lack of oxygen, it will alert the body to wake up in order to open the airway and breathe again. Although you are not normally aware of it, this cycle can occur several hundred times during the night, severely disturbing sleep.
There are several factors that can cause or worsen throat narrowing during sleep.
They include being overweight, drinking alcohol, abnormalities of the nose and throat, smoking, and the use of sleeping pills.
How common is OSA?
OSA is a very common type of sleep disorder. It can affect people of any age, from newborns to elderly adults. Some studies have shown that about nine percent of women and twenty four percent of men have OSA.
How can I tell if someone has OSA?
Normally a sleep study will be ordered by your physician to assist in diagnosis of OSA. However, there are many signs and symptoms that you may want to look for. Typical OSA can usually be seen while a person sleeps. An event may be heard as snoring followed by a period of silence that is then broken by a loud snort or gasp. The person will usually breathe more heavily afterward. Symptoms of OSA include daytime sleepiness and irregular or restless sleep.
How is OSA treated?
The most common treatment of OSA is CPAP (continuous positive airway pressure) therapy, pronounced “see-pap”. It is effective in almost all cases. CPAP provides light air pressure to hold the airway open and, as a result, allows uninterrupted sleep throughout the night. Normally the air is delivered through a small mask worn over the nose during sleep. There are many different types of masks, and finding the most comfortable one is very important.
Other methods used to treat OSA include surgery and dental devices. If you wish, you may discuss these other methods with your doctor. In some people lifestyle changes are enough to control snoring and possibly OSA. Recommendations include losing excess weight, quitting smoking, and avoiding alcohol or sedatives in the evening.
Why is OSA treated?
There are two main consequences of OSA. The first is excessive sleepiness during the day, which can lead to decreased attention, affecting the ability to work, socialize, operate machinery, or drive automobiles safely. It is often difficult to do extra activities and some people are perceived as irritable, lazy or unsociable, simply as a result of not sleeping properly.
The second consequence has to do with the physical harm OSA has on the body. When oxygen levels in the blood drop to a certain level, the heart detects this and responds by beating more quickly to try and compensate. This stresses the heart and when it happens over and over again, it can cause long term damage. High blood pressure and heart problems have been strongly associated with OSA. There is also evidence that strokes and heart attacks can be associated with untreated OSA.
NOT TREATING OSA CAN BE VERY HARMFUL, NOT ONLY TO YOU, BUT TO OTHERS AS WELL, BECAUSE DRIVING WHILE EXCESSIVELY SLEEPY CAN BE AS DANGEROUS AS DRIVING DRUNK.
Driving & OSA
Please discuss this issue with your GP.
Treatment
How is OSA Treated?
The most common treatment of OSA is CPAP (continuous positive airway pressure) therapy, pronounced “see-pap”. It is effective in almost all cases. CPAP provides light air pressure to hold the airway open and, as a result, allows uninterrupted sleep throughout the night. Normally the air is delivered through a small mask worn over the nose during sleep. There are many different types of masks, and finding the most comfortable one is very important.
Whilst the CPAP system may look a bit daunting, you will find that using it has minimal effect on anything but your sleeping. Putting on your CPAP will quickly become part of your regular routine. Please look at the equipment available for all the different options.
What is CPAP?
CPAP is an acronym for Continuous Positive Air Pressure. It is a system comprised of a flow generator connected to a mask that forces low level pressure air flow, usually through the nose, and which keeps yourt’s airway from totally collapsing or closing during sleep.
CPAP therapy has been successfully used, since discovery in 1980, to treat patients with sleep apnea. Much of the negativity against CPAP stems from these early days, well before the benefits of ongoing research and manufacturing technology and progress have led to the incredibly effective and comfortable products in use today.
The best evidence of the effectiveness of CPAP therapy is the fact that every competing product feels the necessity of proving that their poroduct is "as good as", or better in some way than CPAP.
How will CPAP treatment affect my life?
CPAP treatment should not interfere with your lifestyle. In fact most patients find the increased energy levels mean that their lifestyle improves considerably. The unit need only be used during sleep, and all other activities are unaffected. CPAP units are quite small, portable and travel easily. Most units offer the advantage of internal voltage converters so that they can be used in virtually any country. Many also have the capability of being run from batteries (with the appropriate adapter), so overnight camping, caravanning and fishing trips need just a little more planning.
CPAP treatment can have a very positive effect on one’s life. Many people report feeling less sleepy during the day, having a greater amount of energy and stamina, and having a much more refreshing sleep when they use their CPAP regularly. The extra energy has given many patients the desire and ability to begin ongoing exercise programs, and led to substantial weight loss for some patients, and the resultant health benefits.
How long will it take to get used to CPAP?
It takes different amounts of time for different people. It is important to reduce any problems, as quickly as possible, in order for you to become used to it faster. It is always better to get as quiet a machine as possible. But most of all, find a comfortable mask.
For most people the use of a humidifier greatly increases the comfort and subsequent usage of CPAP. Consult with your CPAP Australia adviser to maximize your CPAP comfort.
Remember, it is not how the mask looks that’s important, it’s how it feels.
How soon after I start using CPAP before I notice a difference?
You should not be snoring while you are using CPAP. If any of your previous symptoms continue to occur, contact CPAP Australia, or your doctor. Some people feel an immediate improvement after using their CPAP treatment. Others do not feel as dramatic a difference. The most important factor is that your OSA is being treated and you have eliminated the negative effects it has on your body. If not, please contact your medical practitioner.
Life Style Change
In some people lifestyle changes are enough to control snoring and possibly OSA. However except for patients with very mild Sleep Apnoea usually life style changes on their own are not enough. If you are very tired it is very hard to exercise and lose weight. Once treated with CPAP many patients find they can do far more because of the extra energy.
Other Treatments
As the "Sleep Market" becomes more and more visible, many fringe therapies are coming to light. The most recent being opera singing and didgeridoo playing, as ways of improving your muscle tone, and minimising or eliminating the severity of your apnea. We also have the herbalists hovering around, and an interesting device that's essentially a suction cup for your tongue. And if you will just learn to breathe properly . . . . . .
Please read the small print. These therapies do not treat Sleep Apnea, they are geared for the lucrative "Snoring" Market. Most state that you will need to continue using your CPAP machine. As we all know, if it sounds too good to be true, is usually is.
Surgery
An effective, long term surgical treatment option has yet to be found. Effectiveness of implants and other trial devices appears to be limited to an 18 month to 2 year maximum, for the majority of patients.
Current surgical techniques include breaking your jaw and moving it forward, hopefully increasing the size of your airway, or cutting out a portion of the back of your tongue, again to hopefully increase the size of your airway.
The disconcerting part of many surgical interventions is that many patients who have had surgery in the past still need to use CPAP.
Your Sleep Doctor can advise you on new developments in this area.
Dental Devices
Properly fitted Mandibular Advancement Splints have proven effective in the treatment of low levels of Obstructive Sleep Apnea, sometimes in concert with a CPAP machine to lower required pressures (yes, it always comes back to the effectiveness of CPAP therapy, doesn't it?). Replacement is required about every 12 to 18 months, and major jaw pain is the biggest patient issue. Still, at least these devices provide some level of treatment.
Healthy Lifestyle
OSA is linked in many patients to obesity, and Type 2 Diabetes, as well as other health problems. An important part of the ongoing treatment of your OSA is to be as healthy as you are able. Volumes have been written about taking care of yourself, but we felt the need to reinforce this point.
• Enjoy a variety foods especially fresh foods such as vegetables and fruits
• Select lower fat dairy products and leaner cuts of meat
• Drink plenty of water
• Exercise 30 minutes per day (make sure you sweat)
• Make your own lunch and take it to work
• Avoid snacking between meals
• Eat three meals a day
• Avoid eating after 8pm
• Moderate alcohol intake - try to avoid 4 hours before bedtime
Weight loss and general good health have been shown to lessen the severity of Obstructive Sleep Apnea. The only way to find out if it will work for you is to do something about it.
Who are we?
CPAP Australia Pty Ltd is a Brisbane based business with 10 years experience in helping patients with Obstructive Sleep Apnoea. During this time we have helped thousands of patients overcome the devastating effects of not getting quality sleep.
We strongly believe that everyone who starts their CPAP treatment should be set up correctly by experts with experts to assist them should they run into difficulties. Early successes with any new treatment are important. Problems and questions should be addressed as quickly a possible. Should you require further assistance once you are using your CPAP you are encouraged to come back and see us at your earliest opportunity.
