PATIENT EDUCATION
Sleep Apnea
Home sleep apnea testing
In-lab sleep study
PAP Therapy
Oral Appliance Therapy
Inspire Therapy
Surgical treatments for sleep apnea
Narcolepsy
Restless legs Syndrome
Sleep Apnea
Moreover, if you snore loudly, wake up several times during the night, wake up every morning feeling worn out or irritable, or excessively sleepy during daytime, you might have sleep apnea. Early medical intervention with a prompt diagnosis not only ensures a healthier sleep at night, better performance during the day, and also delays the development of complications like heart attack, high blood pressure, brain stroke, and diabetes.
Home sleep apnea testing
After evaluating your symptoms that can be related to sleep apnea, your doctor may recommend certain non-invasive tests to monitor your breathing during sleep. At-home sleep apnea testing, a simplified version of an in-lab test, requires a portable breathing monitor kit that can conveniently be taken home and installed. This kit comes with a manual that helps with the setup and measures your oxygen levels, heart rate, airflow, and breathing effort as you sleep through the night.
The results of this testing can then be discussed with the doctor. Although home sleep apnea testing is less costly and more accessible for patients, due to the absence of the sleep technician, this test can lead to inaccurate results and a lot of other disorders of sleep may also go undetected.
In-lab sleep study
In-lab sleep studies are devised to diagnose sleep apnea alongside a wide range of other sleep disorders based on the symptoms that the patient has. This test, also called nocturnal polysomnography, is a non-invasive test where no blood samples are drawn however, you are required to spend a night in a comfortable private room with wires attached to your body that constantly record your breathing, brain activity, heart, and other vital signs while you sleep.
Moreover, the system also records changes in your breathing pattern, eye movements, posture, and limb movements. Although these tests are costlier than an at-home sleep test, the in-lab sleep study is gold-standard for diagnosing sleep apnea. Not only this, but this test also serves as the best option for people with other serious illnesses such as heart and lung diseases.
PAP Therapy
PAP, an acronym for Positive Airway Pressure, is a therapy that serves as the first non-surgical treatment option for many people suffering from sleep apnea. A PAP machine with a mask, a tube, and a monitor, uses mild air pressure to ensure that the airways remain open throughout sleep. There are multiple types of PAP machines including AutoPAP, CPAP, BiPAP, etc.
Your sleep technologist or the doctor makes the necessary pressure adjustments and helps with the machine set up to help with your symptoms and sleep. It reduces or eliminates snoring and improves your quality of sleep and life. However, using these machines may pose some difficulty and discomfort falling asleep in the beginning.
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Oral Appliance Therapy
Oral appliance therapy is an alternative option for managing the obstructive sleep apnea. The appliances can be categorized as mandibular repositioning devices (supports the lower jaw in a forward position keeping the airway open) or tongue retaining devices (prevent the tongue from falling back) based on the specific function these are designed to perform.
These oral appliances must be customized according to the size of your mouth to be effective. Oral appliance therapy is usually recommended to patients who have a less severe type of sleep apnea. The benefits of this therapy include improved night sleep, daytime alertness, and concentration. Moreover, the size of this appliance makes it easier to use and carry around. On the other hand, some dental and jaw discomfort are some of the side effects of this oral appliance therapy.
Inspire Therapy
Another FDA-approved treatment option for obstructive sleep apnea includes Inspire therapy. It involves an implantable device, like a pacemaker, that works to stabilize the throat of a person to prevent any obstruction while he/she sleeps. The device is implanted in the right upper chest with small incisions usually performed as an outpatient procedure. Once the device is activated, a sleep test is carried out to ensure its proper functioning. You turn on this remote-controlled device before sleeping and based on your breathing patterns it generates gentle stimulation to the airway muscles involved in breathing.
The most attractive aspect of this therapy compared to CPAP is the complete absence of a mask or a machine while being effective for moderate to severe cases of OSA. Furthermore, unlike CPAP therapy, there are no noises for you and your partner to get accustomed to, and the only thing you carry around is a small remote that fits in your pocket.
Surgical Treatment for Sleep Apnea
Surgical treatment options for sleep apnea are aimed at improving the airway patency by targeting the sites that are leading to obstruction of the airway during sleep. Since several areas of throat can be the underlying cause, different surgical procedures have been developed. If you are not able to tolerate PAP therapy or there is an anatomical cause of obstruction that can more conveniently be fixed by a surgical procedure, these surgical treatments are indicated. With respect to the site involved procedures like tonsillectomy, adenoidectomy, mandibular advancement, and uvulopalatopharyngoplasty are carried out by ENT or oral surgeons.
Moreover, since obesity contributes majorly to sleep apnea symptoms, Bariatric surgery may also be planned to treat OSA in morbidly obese patients. These procedures not only manage OSA but can also improve overall health. While most of these surgical procedures are effective, like any other surgical intervention these also pose risks to the patient undergoing surgery. Therefore, a systemic and in-depth clinical evaluation, treatment planning, and surgical management by a specialist are highly recommended to reach the best possible outcome.
Narcolepsy
Narcolepsy is a life-long sleep disorder that not only deteriorates one’s quality of life but also greatly affects their performance and alertness during the daytime. Overwhelming daytime drowsiness, vivid hallucinations, extreme loss of muscle tone even causing paralysis and sudden attacks of sleep are some of the characteristic symptoms of Narcolepsy. The cause of this disease is unknown however, in one type of narcolepsy low levels of neurotransmitter hypocretin are found which regulates wakefulness in a person. A certified sleep medicine physician carefully takes the history of the patient and recommends sleep studies to reach this diagnosis.
Once diagnosed, there are certain lifestyle modifications and medications that make the symptoms manageable. A prompt diagnosis and treatment are necessary to avoid risks and complications of this disease. This can also lead to life threatening accidents due to excessive daytime sleepiness and/or paralytic attacks.
Restless legs Syndrome
Restless legs syndrome is a disorder of the nervous system where, as the name suggests, you have an unexplainable urge to move your legs. Irresistible sensations of burning or itching in your legs may be felt as soon as you go to bed which settle if you get up and walk or move the legs. In severe cases, this irresistible sensation can be present in forearms too. Due to this overwhelming urge to move your legs, especially when lying down, the sleep cycle is adversely affected and you wake up sleepy, tired, and irritable.
The causes of this disease are unknown in most cases. However, if any member of your family has this disease, you are at a three to six times greater risk of developing it before you reach forty-five. Other triggering factors of this disease include iron deficiency, diabetes, and pregnancy. After seeking medical attention and reaching the diagnosis, lifestyle changes like regular exercise, leg massages, reducing smoking and alcohol, and medication to help relieve the symptoms are advised.
Idiopathic Hypersomnia
Idiopathic hypersomnia is an uncommon sleep disorder that causes you to be excessively sleepy during the day even after a good or prolonged night’s sleep. It also often causes difficulty waking up after you’ve been asleep at night or for a nap. Naps generally aren’t refreshing.
The need to sleep can strike at any time, including when you’re driving a car or working, which makes idiopathic hypersomnia potentially dangerous.
The condition often develops over weeks to months.
REM Sleep Behavior Disorder
Normally during REM sleep, the body experiences temporary paralysis of most of the body’s muscles while the brain is active and dreaming. This allows us to dream quietly and safely throughout the night. For individuals with REM sleep behavior disorder, paralysis does not occur during the REM stage. Instead, their body and voice perform their dreams while they remain asleep.
Less than one percent of people are estimated to have REM sleep behavior disorder1. It usually begins after age 50, and the disease is associated with other neurodegenerative disorders, including Parkinson’s disease, Lewy body dementia, and multiple system atrophy. Symptoms often worsen with time. The condition usually requires treatment because it increases the risk of injury to oneself and their bed partner.