Snoring is the noise that air makes when it is passing through relaxed tissue in the nose and throat during sleep. Most people will snore occasionally, especially when they have a cold, take certain medications or drink alcohol, but in some cases, the noise is so loud it can disturb their sleeping partner. In other cases, the snoring is accompanied by choking or gasping for air, known as sleep apnea. Sleep apnea can eventually contribute to health problems including heart and lung disease, stroke and diabetes. Symptoms can include daytime sleepiness, difficulty concentrating, morning headaches and behavioral problems in children.
Diagnosis begins with a physical exam, occasionally endoscopic visualization of the airway anatomy (flexible laryngoscopy) or imaging with a CT or MRI, as well as a sleep study that is done either in a lab overnight or in your home at night time.
There are two main types of sleep apnea: obstructive and central. Obstructive sleep apnea occurs when the throat muscles relax and droop during sleep, blocking the airway and causing breathing difficulty. It is by far the most common form of the disorder. Central sleep apnea is the result of the brain failing to properly control breathing during sleep; this is rare.
Those who are male, overweight and older than the age of 40 are most at risk, though sleep apnea can – and does – affect people of both sexes and all ages. Other factors that can contribute to sleep apnea include natural aging, excessive or bulky throat tissue, large soft palate or uvula, small jaw, large neck and oversized tonsils or adenoids.
Allergies, sinus infections, tobacco use and alcohol all may play a role as well.
Treatment for obstructive sleep apnea can include lifestyle changes including cutting out alcohol before bed and losing weight, as well as a CPAP machine (continuous positive airway pressure), which uses air through a mask to stent the airways open during sleep. Patients that cannot tolerate CPAP may be candidates for in office or surgical procedures depending on their specific anatomy and the severity of the sleep apnea.
What are the most common Sleep Apnea treatments?
Continuous Positive Airway Pressure (CPAP)
The most popular type of treatment for obstructive sleep apnea is the CPAP (continuous positive airway pressure) device. This machine utilizes a face or nasal mask connected to a pump, which provides a positive flow of air powerful enough to keep your airway passage open. The device must be worn every night to be effective.
While some find it inconvenient and uncomfortable, the results are typically instantaneous and worth the discomfort. Both machines and masks are available in a variety of styles and sizes, which can be geared toward your individual needs. Some people benefit from a nasal mask that covers the nose, while others require a full-face mask that covers both the nose and mouth.
Nasal pillows, consisting of soft silicone tubes that are placed directly in the nostrils, are another popular option. An optional humidifier can help prevent nasal irritation and drainage by providing a steady flow of heated and moisturized air.
A number of alternative PAP devices are available. Autofiltrating positive airway pressure (APAP) automatically increases or decreases air pressure throughout the night as needed. Bi-level positive airway pressure (BPAP) devices increase the pressure level when the people breathes in, and decrease it when they breathe out. These machines often help individuals who have trouble with the basic CPAP device.
While continuous positive airway pressure (CPAP) therapy is the preferred method of treatment, not everybody is able to tolerate sleeping with a mask attached to a machine that delivers bursts of air to the throat. Oral appliances are an alternative for these patients. They work by either moving the lower jaw forward to keep the airway passages open or holding the tongue in place to prevent it from falling backward and blocking the airway.
Oral appliances may be either fixed or adjustable and are available in many different styles with as many as 40 different patents in existence. Some are custom designed to fit the individual’s mouth after impressions are made and must be prescribed by a dentist, oral surgeon or ENT physician with sleep medicine experience. Others are considered one-size-fits-all.
There are several advantages to using oral appliances over other sleep apnea treatment methods. They are easy to use, inexpensive and effective for treating a number of sleep disorders including snoring, upper airway resistance syndrome and obstructive sleep apnea. They are easy to insert and remove and tend to have higher compliance rates than CPAP. Younger patients who have to moderate sleep apnea, lower BMI and smaller neck sizes are most likely to see positive results from oral appliances.
Call River ENT at (512) 677-6368 for more information or to schedule an appointment.