Lifestyle changes
First and foremost, nearly everyone with sleep apnoea needs to lose weight. Studies have shown that the frequency of breathing interruptions increases 32 percent for every 10 percent you're over your ideal weight. So losing just 10 percent of your weight could reduce apnoea episodes by 26 percent. You'll also want to avoid alcoholic beverages and sedating medictions (such as antihistamines or sleeping pills) in the evening. Both can relax your throat muscles and make them more likely to sag into your windpipe.
Another key suggestion for mild sleep apnoea is to sleep on your side or stomach, not on your back. The reason is gravity: when you sleep on your back, it pulls on the upper part of your airway . encouraging the soft palate tissue to droop down and block air flow. One good way to stay on your side is to sew a tennis ball into a small pocket on the back of your pyjamas or a T-shirt. It will irritate you if you inadvertently roll onto your back.
Perhaps the most effective and widely used home treatment for obstructive apnoea, however, is an artificial breathing device called a CPAP machine (the letters stand for 'continuous positive airway pressure'). Consisting of a bedside generator, connecting tube and nasal mask (see illustration opposite), the device blows a steady stream of pressurised air into your nostrils, which helps keep your throat open during sleep. One key drawback is that you'll have to use the device for life because your apnoea will return as soon you stop. Regular CPAP users, however, report feeling better, mainly because they're less tired and in a better mood during the day. Partners are happy too, because they get some sleep for a change.
Procedures
Sometimes the CPAP machine, weight loss or other lifestyle measures don't eliminate the problem. Or you may be diagnosed with severe sleep apnoea or have a cardiac condition or frequent respiratory distress. In such cases, your doctor might recommend surgery.
One of the most widely used procedures for treating apnoea is uvulopalatopharyngoplasty (UPPP). Despite its name, this is a fairly simple surgery in which tissue is removed from the uvula and other soft palate tissues at the back of your throat, including your tonsils if you still have them. The goal is to make your airway wider and also reduce abnormal muscle movements that may interfere with your breathing. While snoring is greatly reduced by the procedure. UPPP eliminates apnoea in only about 50 percent of those who undergo it. Another less invasive procedure is radiofrequency ablation, in which a surgeon uses radiowaves instead of a scalpel to destroy tissue at the base of your tongue. A number of treatment sessions are required, each taking about 20 minutes, for this procedure to work. Ablation is used only for mild obstructive apnoea, but the success rate is high.
For many years a tracheostomy was the only treatment for sleep apnoea. While nearly 100 percent successful, the procedure is recommended today only when apnoea is life threatening. It involves opening a permanent, 5-cent-piece-sized hole in your windpipe and inserting a tube. The tube stays closed during waking hours so you can speak normally. Then you open it before bedtime, so that sairflows directly into your lungs, bypassing the obstructed airway.
>HEART ATTACK IS A SERIOUS RISK if you have sleep apnoea, but the warning signs are easily missed. It's common with apnoea to have perfectly normal heart-beats during the day. When most ECGs are performed. But once you're asleep, during apnoea episodes your heartbeat can slow dramatically (and in some cases stop completely for a few seconds). The heart, like any muscle, uses oxygen for fuel. Take away the fuel and the heart muscle sputters to a halt. The good news is that heart irregularities may disappear for good once the sleep apnoea is properly treated.
BETTER BREATHING WITH BETTER CPAP MASKS
The CPAP machine is among the most effective methods for treating obstructive sleep apnoea. But many people won't use it or stop after just a few months (statistics show that one n three users fails to continue). The problem may be that the face mask doesn't fit very well, making it uncomfortable to wear. But there are a number of solutions:
Style. Discuss different head-gear styles with your doctor, then experiment until you find a mask that fits properly. The hoses for most machines will fit any style of mask. You can also have a mask custom-fit to your face and head size.
Variety. Buy more than one style of mask and rotate them to prevent skin irritation
on your face. Ensure you have the air flow set to the proper level for you and that the mask is fitted correctly.
Heat humidification can help if drying out of nasal mucosa is a problem.
Materials. Try one of the newers masks made with gel-like materials. These cause less facial irritation than the hard, plastic masks. Transparent masks are also available.
First and foremost, nearly everyone with sleep apnoea needs to lose weight. Studies have shown that the frequency of breathing interruptions increases 32 percent for every 10 percent you're over your ideal weight. So losing just 10 percent of your weight could reduce apnoea episodes by 26 percent. You'll also want to avoid alcoholic beverages and sedating medictions (such as antihistamines or sleeping pills) in the evening. Both can relax your throat muscles and make them more likely to sag into your windpipe.
Another key suggestion for mild sleep apnoea is to sleep on your side or stomach, not on your back. The reason is gravity: when you sleep on your back, it pulls on the upper part of your airway . encouraging the soft palate tissue to droop down and block air flow. One good way to stay on your side is to sew a tennis ball into a small pocket on the back of your pyjamas or a T-shirt. It will irritate you if you inadvertently roll onto your back.
Perhaps the most effective and widely used home treatment for obstructive apnoea, however, is an artificial breathing device called a CPAP machine (the letters stand for 'continuous positive airway pressure'). Consisting of a bedside generator, connecting tube and nasal mask (see illustration opposite), the device blows a steady stream of pressurised air into your nostrils, which helps keep your throat open during sleep. One key drawback is that you'll have to use the device for life because your apnoea will return as soon you stop. Regular CPAP users, however, report feeling better, mainly because they're less tired and in a better mood during the day. Partners are happy too, because they get some sleep for a change.
Procedures
Sometimes the CPAP machine, weight loss or other lifestyle measures don't eliminate the problem. Or you may be diagnosed with severe sleep apnoea or have a cardiac condition or frequent respiratory distress. In such cases, your doctor might recommend surgery.
One of the most widely used procedures for treating apnoea is uvulopalatopharyngoplasty (UPPP). Despite its name, this is a fairly simple surgery in which tissue is removed from the uvula and other soft palate tissues at the back of your throat, including your tonsils if you still have them. The goal is to make your airway wider and also reduce abnormal muscle movements that may interfere with your breathing. While snoring is greatly reduced by the procedure. UPPP eliminates apnoea in only about 50 percent of those who undergo it. Another less invasive procedure is radiofrequency ablation, in which a surgeon uses radiowaves instead of a scalpel to destroy tissue at the base of your tongue. A number of treatment sessions are required, each taking about 20 minutes, for this procedure to work. Ablation is used only for mild obstructive apnoea, but the success rate is high.
For many years a tracheostomy was the only treatment for sleep apnoea. While nearly 100 percent successful, the procedure is recommended today only when apnoea is life threatening. It involves opening a permanent, 5-cent-piece-sized hole in your windpipe and inserting a tube. The tube stays closed during waking hours so you can speak normally. Then you open it before bedtime, so that sairflows directly into your lungs, bypassing the obstructed airway.
>HEART ATTACK IS A SERIOUS RISK if you have sleep apnoea, but the warning signs are easily missed. It's common with apnoea to have perfectly normal heart-beats during the day. When most ECGs are performed. But once you're asleep, during apnoea episodes your heartbeat can slow dramatically (and in some cases stop completely for a few seconds). The heart, like any muscle, uses oxygen for fuel. Take away the fuel and the heart muscle sputters to a halt. The good news is that heart irregularities may disappear for good once the sleep apnoea is properly treated.
BETTER BREATHING WITH BETTER CPAP MASKS
The CPAP machine is among the most effective methods for treating obstructive sleep apnoea. But many people won't use it or stop after just a few months (statistics show that one n three users fails to continue). The problem may be that the face mask doesn't fit very well, making it uncomfortable to wear. But there are a number of solutions:
Style. Discuss different head-gear styles with your doctor, then experiment until you find a mask that fits properly. The hoses for most machines will fit any style of mask. You can also have a mask custom-fit to your face and head size.
Variety. Buy more than one style of mask and rotate them to prevent skin irritation
Heat humidification can help if drying out of nasal mucosa is a problem.
Materials. Try one of the newers masks made with gel-like materials. These cause less facial irritation than the hard, plastic masks. Transparent masks are also available.
No comments:
Post a Comment