Sleep Apnea is a sleeping disorder in which a person’s breathing repeatedly ceases while sleeping. These patients may complain of loud snoring, restlessness, dry mouth on waking up, gasping for air while sleeping, night sweats among many other symptoms. To confirm a patient has sleep apnea, a Nocturnal Polysomnography has to be done or a home sleep test can be performed.
What approach should be applied to a patient complaining of Sleep Apnea?
- Mild cases are usually resolved with lifestyle changes like quitting alcohol and/or smoking, and taking care of allergies.
- In moderate to severe cases, devices which can keep the blocked airway open are used.
-Positive airway pressure therapy (PAP) is the most preferred and recommended therapy for obstructive sleep apnea. The patient has to wear a mask over their nose and mouth. Air is blown into the airway in a way that it keeps it sturdy and prevents it from collapsing and closing. PAP is done using machines.
PAP Therapy could involve:
1. Continuous Positive Airway Pressure (CPAP) which controls only a single pressure. It delivers pressure to the back of the throat to keep the airway open. This is the most commonly used therapy, its user friendly and the pressure is adjustable.
2. Bi-Level PAP which delivers inhalation pressure and exhalation pressure both. When a person stops breathing for a certain period of time, BiPAP delivers a breath. It is designed in a way that the patient breathes at a set frequency or breaths per minute. Both BiPAP are CPAP are similar in size, small and compact and silent so as to not interrupt the sleeper.
3. Adaptive Servo Ventilation (ASV) which is another non invasive ventilation technique which normalizes breathing using pressure can be used to manage it very well.
4. Oral Appliances like mandibular advancement device is used to help prevent the jaw from blocking the throat and the airway. This is only used for mild to moderate cases.
5. Lastly, Hyper Glossal Nerve Stimulator can be used that is implanted under the skin on the right side of the chest which interacts with the Hyper glossal nerve in every breath and moves the tongue and hence prevents the blocking of airway from it.