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Sleep Apnea – Types and Treatments

People suffering from Sleep Apnea find it difficult to breathe during the night. Their breathing is often blocked due to throat and mouth muscle collapse which cuts off the oxygen through the airway passage. These cessations occur from a few times up to hundreds of times in a single night, depending upon the severity of the condition.

There are numerous factors responsible for the condition: excessive weight gain, aging, enlarged tonsils, smoking, and high alcohol consumption, etc. We will look into these factors as we read about the various types of Sleep Apnea, their symptoms, and treatments like CPAP & Bipap Ventilation.

Sleep Apneas can be further classified into – Obstructive Sleep Apnea, Central Sleep Apnea, and Mixed Sleep Apnea

Obstructive Sleep Apnea (OSA)

Individuals who suffer from OSA normally aren’t aware of the difficulty in breathing, even upon awakening. The condition is noticed by others who observe the individual during this phase of his/her sleep. It is thus far, the most common of the three apneas and often goes unnoticed in the early stages.

In OSA, the soft tissues of the mouth and throat block the airway when an individual is asleep. This causes difficulty for air air to get into the lungs. The brain is notices the deficiency of oxygen and signals the tissues to vibrate as an attempt to take in air. The continuous vibration is the sound that we call “snoring.”

Gradual to consistent snoring in periods of sleep is a one-off symptom to assess if one is on a path of developing OSA. Most individuals sleeping alone are often unaware of the condition for weeks to years. This later results in daytime sleepiness and fatigue.

Signs and Symptoms of OSA

● Snoring

● Unexplained daytime sleepiness

● Restless periods of sleep at night

Minor accompanying symptoms include: morning headaches, lack of concentration, forgetfulness, frequent mood swings, and an increase in heart rate or blood pressure.

Understanding the link between Sleep Apnea and Depression

Precautions

a. Check Weight Gain / Obesity

Physical inactivity, over-eating, consuming junk food, an uncontrolled eating schedule, and psychological factors are the primary reasons for putting on weight. Controlling them is a head-start in curbing OSA

b. Regular Exercise

Hectic jobs, fatigue, stress, and lack of sleep keep you away from a healthy exercise. Try allotting a small window daily for keeping fit, which can help you with overcoming stress and enjoying a sound sleep.

c. Quit Smoking

Excessive smoking has a negative impact on the breathing muscles. They have to work harder to help you breathe and tire out pretty easily. This leaves you gasping for breath while sleeping. Quitting the habit will definitely help!

d. Sleeping on your Side

Many people generally tend to sleep on their backs. It may cause your tongue and soft palate to rest against the back of the throat and block the airway. Side sleeping prevents this!

Treating OSA - CPAP Therapy/ CPAP Ventilation

CPAP – Continuous Positive Airway Pressure is a therapy that delivers air at a constant pressure value to the patient’s airway using a face mask worn by the patient during sleep. The CPAP consists of a small motor fitted within the machine. This motor draws air from the room very quietly and gently pressurizes it. With a preset pressure, the air is delivered to the mask for breathing.

A CPAP machines force air under a constant pressure from the mask into the nose/mouth. This pressure prevents the soft tissues from blocking the airway and allows continuous air-flow to the lungs. CPAP machines are most commonly used by patients suffering from OSA. They have a single pressure setting for Inhalation (I-PAP) and Exhalation (E-PAP)

Some CPAP machines come with an additional component – The Humidifier. It warms water to humidify the pressurized air before it is delivered.

Central Sleep Apnea (CSA)

CSA is a less common condition and is diagnosed in comparatively fewer individuals than OSA. Though the individual experiences breath cessations during his/her sleep, it is because of the brain’s inability to send signals to the muscles that control respiration. During an episode of someone with Central Sleep Apnea, breathing stops for at least 10-30 seconds.

CSA is more common in older adults.

Signs and Symptoms of CSA 

● Abnormal breathing patterns during sleep

● Disrupted period of sleep with frequent awakenings

● Shortness of breath while sleeping

● Hypersomnia – Excessive daytime sleepiness

There are minor symptoms that are a sufficient signal of progressing towards CSA. These include: difficulty in concentrating, mood swings, and morning headaches. Individuals with CSA tend to feel tired even after taking a nap. They wake up from sleep, unaware of when they stopped breathing. This can happen over a hundred times in a single night and leave them tired the next day. 

CPAP BiPAP Titration

Titration is a sleep analysis study conducted by sleep technologists. The process involves a comprehensive data accumulation of breathing patterns, blood pressure stability, etc. while the patient sleeps. The reports are used to determine the individual’s requirement for CPAP Therapy or BiPAP Therapy. CPAP/BiPAP Titration should be carried out every year to update air pressure settings or a change in therapy.

Treating CSA - BiPAP Therapy/ BiPAP Ventilation

BiPAP therapy involves the same mechanism as CPAP. The device has a motorized fan that draws air from the surrounding area and gently pressurizes it before delivering it to the mask of the user. BiPAP has two different pressure settings – One for Inhalation (Higher) and another for Exhalation (Lower).

Individuals needing a high-pressure setting and/or low oxygen levels are suggested to try BiPAP Ventilation therapy. Also, it can be used to treat patients suffering from Congestive Heart Failure (CHF) and Neuromuscular disorders.

Have you been prescribed CPAP Therapy? – Here is an interesting read!

Mixed Sleep Apnea

Mayo Clinic researchers in 2006 conducted CPAP therapy on a group of patients suffering from Obstructive Sleep Apnea. During the course of the treatment, they found that a fraction of patients were not able to breathe normally despite their airway being free from any obstructions. A later diagnosis revealed that their brain was not signaling for the respiratory system to breathe, a common symptom of Central Sleep Apnea patients.

Treating Mixed Sleep Apnea

There is no optimal treatment devised for the Mixed/Complex sleep apnea. Some of the ways to overcome the condition are

- Using CPAP machines but at a lower pressure range. It offers dual benefits – A. Helps supply continuous air and prevent muscle collapse/obstruction & B. Prevents CSA symptoms from developing.

- BiPAP machines too are a great way to control MSA. They are able to deliver pressurized air that can resolve the obstructive component, as well as stabilize ventilation by forcing breathing during Central apneas.

- The one treatment approved by the FDA is ASV (Adaptive Serv-Ventilation). It involves a process where the breathing pattern is tracked to create a pressure that is equal and opposite to the user’s own breathing. It is not recommended for patients suffering from CHF or other cardiovascular problems.

The Benefits of a Sleep Therapy

Controlling Heart Diseases

Sleep Apnea cause you to stop breathing momentarily during sleep, which may lead to a number of heart problems. The breathing cessation changes blood pressure levels and has an adverse effect on blood oxygen levels. This puts enormous strain on your heart. People with Congestive Heart Failure (CHF) are advised to undergo the BiPAP therapy which helps the respiratory system with dual pressure ranges.

Also, people with untreated sleep apnea are more prone to succumb to heart diseases as compared to those undergoing sleep therapy.

Preventing Stroke

Stroke is a leading cause of death and long term disability. Stroke is a sudden loss in brain function and occurs when one of the blood vessels leading to the brain is blocked or ruptured. People with untreated sleep apnea have a strong chance of getting a stroke as opposed to those undergoing treatment

Reduced Fatigue

Getting sleep therapy during the night has a positive impact on the next day! A complete and uninterrupted sleep removes all the fatigue of the previous day and leaves you refreshed and confident in the morning. It helps give you enough energy to kick-start your day!

Increased Focus/ Concentration

Sleep therapies provide your lungs with much-needed air, and your brain with much-needed oxygen! Untreated sleep apnea can damage your brain tissue and decrease your ability to think, concentrate and focus on important things.

Curb Mood Swings

Lack of sleep is one of the primary reasons for mood swings. The inability to sleep due to breathing can leave you with headaches and dizziness during the day, ultimately resulting in frequent mood swings. Getting sleep therapy helps you awaken to refreshed mornings with enough energy for the day.

Philips Respironics DreamStation Auto CPAP DSX500T11

Philips Respironics offers a compact and sleek design in their CPAP machine, the DreamStation DSX500T11. It comes with many advanced features and takes sleep therapy to an altogether new level. It gives the user the finest comfort and best experience in making the sleep therapy a success.

Some of the best features of the CPAP machine are –

● Colorful Display

The CPAP comes with a large navigation dial combined with a full-color display that is easy to read even in ambient light

● Auto-adjusting Pressure

The DreamStation is enabled with a pressure variation feature that distinguishes it from the others. The device analyzes the user throughout the sleep duration and continues delivering air at the lower pressure range. In any event of cessation, the pressure automatically climbs up to the higher pressure range thereby maintaining the therapy’s effectiveness.

● Opti-Start Technology

This feature disables the likelihood of any apneic event happening during the course of the therapy. It begins the therapy session 90% closer to the user’s previous session. This ensures you almost never come across any apnea event during the night

● Heated Humidification and Heated Tube

The advanced feature monitors the temperature and humidity of the room and maintains the selected relative humidity level – despite changes in environmental conditions. The heated tubing, when used along with the heated humidifier, perfectly balances the humidity level.

● Bluetooth tracker

The DreamStation comes with an integrated Bluetooth function that is connected to the DreamMapper app to track the progress of therapy.

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Respironics DreamStation BiPAP Auto DSX700T11

The DreamStation DSX700T11 from Philips is one of the Best-in-class BiPAP machines integrated with advanced features to help control CSA.

Some of the best features of the BiPAP Machine are –

● Auto Adjusting BiLevel Therapy

The feature enables the machine to set up two-variable pressure ranges for inhalation and exhalation, depending upon the breathing pattern of the user

● Heated Humidifier

This advanced feature helps the machine track the exact room humidity and temperature and maintain the same level of humidity regardless of changes in the external climate.

● Opti-Start

This interesting feature uses the previous sleep performance as an input for the next sleep therapy session. It helps prevent any apnea event by making the most suitable pressure adjustments. This feature can be enabled/disabled during sleep therapy

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Here are a few good reasons why the Philips Respironics DreamStation is a great choice!

ResMed AirCurve 10 VAuto with Heated Humidifier

The ResMed AirCurve 10 is a revolutionary VPAP machine that provides the user with a comforting sleep therapy session through its advanced features:

● AutoSet Algorithm

The feature analyzes the individual’s breathing pattern and automatically adjusts the inhalation and exhalation pressure thereby ensuring a comfortable sleep session.

● Humidifier

The integrated, yet optional feature helps improve the therapy by allowing the user to adjust the humidification level for an improved therapy

● VSynk

This intelligent feature monitors for any air leakage from the mask and compensates by adjusting the baseline pressure to maintain the effectiveness of the therapy

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Key Takeaways

Get Regular Exercise – This helps you in overcoming fatigue and stress. It also controls obesity, a major contributor to Obstructive Sleep Disorder

Healthy Eating Habits – Ensure you don’t consume high quantities of junk food. Also, avoid heavy meals just before sleeping. Say no to smoking and alcohol for a good night’s sleep.

Getting Adapted to Masks– Individuals new to sleep therapy often find it challenging to wear face gear and adapt to the treatment. Over time it gets easier!

Have Apnea? Get it treated!Sleep therapy often results in overcoming a number of heart problems and stroke. The treatment helps you with blood pressure being stable and gives you boosts for a great day after a sound sleep!

Mixed Apnea CSA is far less common than the OSA and the combination of both – MSA does exist! Consult a physician if you find yourself gasping for breath during sleep. Diagnosis will help you get perfect treatment!

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