The goal of sleep apnea treatment is to relieve symptoms, maintain capacity to work, improve quality of life, prevent and relieve other related diseases and prevent premature mortality.
It is advisable to treat sleep apnea to improve the quality of sleep so that the person can recover and rejuvenate during sleep. In untreated sleep apnea patients, the risk of cardiac mortality and accidents is multiple compared to people without sleep apnea.
For the treatment of mild sleep apnea, lifestyle changes, losing weight, improving nutrition, and exercising, which are the basis of treatment in all other sleep apnea patients, are usually sufficient.
Treatments for sleep apnea are always weight loss, nutrition and exercise. Some need CPAP treatment or oral mouthpieces for sleep apnea. Some of the overweight people also benefit from weight loss surgery.
According to a study, the risk of cardiovascular disease is not higher than normal in mild sleep apnea. However, because sleep apnea causes a lot of serious related diseases, the progression of sleep apnea should be treated as early as possible in order to avoid complications. According to the study, year-long lifestyle change and weight loss will improve most of the symptoms of sleep apnea. Nasal congestion and smoking will undermine treatment results. It is advisable to seek help if quitting smoking feels too hard. Mild sleep apnea can therefore be treated best by simply improving lifestyle.
A person who complains about his fatigue and after a diagnosis of mild sleep apnea has been instructed by his physician to attach a tennis ball to the back of his nightshirt may experience his condition being underestimated. However, this isn’t the case. Sleeping on his back doesn’t do any good for sleep apnea patient because it aggravates the airway obstruction. The simplest way of treating a mild sleep apnea is to attach something on the back of a shirt, which makes it uncomfortable and unpleasant to sleep on your back, for example a tennis ball. Sleep apnea belt is an inflatable belt made specifically for snoring and will stay better in place and will be even more effective.
In mild and in moderate sleep apnea, sleep apnea mouthpiece can also be used. Nose or throat surgery is only needed in rare cases. The treatment for severe sleep apnea and some moderate to mild sleep apnea is a continuous positive airway pressure (CPAP) that prevents blockage of the upper respiratory tract by continuous positive airway pressure.
After a sleep apnea diagnosis, the patient will receive a self-adjusting CPAP device if needed. It is used to determine the level of pressure required for treatment. Sleep apnea treatment can be continued with an auto-adjustable device or switched to a custom-built pressure system.
Central sleep apnea is treated with a dual-pressure ventilator, an adaptive servo-ventilator (ASV) capable of treating breathing breaks and calming overbreathing. It can also be used to treat mixed forms of obstructive and central sleep apnea.
Lifestyle changes that help treat sleep apnea
Even a few pounds of weight loss will benefit both sleep apnea patients as well as other overweight people. If there is a lot of overweight and fatigue affects everyday life, the thought of losing weight may seem distressing. Setting realistic goals can help you lose weight and keep it off in a healthy way. Losing even a small amount of weight (5 to 10 percent of your total body weight) is important. That is already considerable beneficial for your health.
There are many guides on healthy nutrition. However, the main thing about weight loss is basically simple: you need to consume more than you eat.
It is also good to maintain a regular eating schedule and eat sensible amounts of food. You should avoid unnecessary fat, especially saturated (hard) fat. Low-salt diet is recommended. It is advisable to monitor the amount of salt in all basic foods, because we get a lot of “hidden” salt. For example, there is a lot of salt in children’s breakfast cereals, likewise sugar. Only few of us no longer use six pieces of sugar in their coffee, but enjoy the same amount of sugar easily, for example in yoghurts, juices and soft drinks.
White wheat bread and buns contain a lot of fast carbohydrates that quickly raise blood sugar. The problems with eating bread also include that it’s easy to eat things that are not so healthy with it. A thick layer of butter, a thick slice of cream cheese, and a couple of slices of salami make the bread a dangerous energy bomb that no one should think of as a small snack.
Low-fat options should be considered. Adding fruits, vegetables and berries to your diet would be desirable. Berries, such as blueberries, can be considered a true superfood. A good amount of berries and vegetables every day is also part of the memory-friendly diet. Berry smoothies, shakes, fruits and root vegetables are recommended snacks.
Although losing weight can reduce sleep apnea, many people fail in permanent weight loss. This is partly due to the fact that obesity is often hereditary and the patient is not always able to influence it. The pursuit of healthier weight readings is encouraged, but weight loss should not be a requirement, for example, for starting CPAP treatment, as it is for obesity surgery. Adequate and regular nighttime sleep is important in the management of both fatigue and excess weight, therefore, the treatment of sleep apnea and sleep deprivation is important, as sleep deprivation aggravates sleep apnea. When you sleep adequately and know how to manage stress, you will probably also succeed in weight management, as it is easier to live with your cravings or rather to fight against it.
One study states that many people do not want to listen to the lectures of health professionals about their lifestyle. No one hardly wants criticism, but many who’re struggling with weight loss and lifestyle changes desperately need the advice and support of the professionals. Healthcare should definitely pay attention in this activity, as it could affect the eating habits of overweight people and prevent major diseases.
Bariatric surgery (or weight loss surgery) is effective procedure for weight loss. Weight loss reduces the symptoms of both sleep apnea and cardiovascular disease. Obesity Surgery means a permanent change in eating. As a result of gastric bypassing or reducing the size of the stomach or removal of a portion of the stomach, patients cannot eat a large quantity of food at a time. Weight loss achieved through obesity surgery can be ruined as easily as any other weight loss. The stomach will stretch to the same level as it used to be, unless the patient makes changes in his eating habits.
One study investigated the effect of obesity surgery on people with sleep apnea. According to the study, the treatment of obesity should be the primary treatment for sleep apnea. Already 5-10% weight loss really has effects.
In the study of obesity, the study dealt with gastric bypass surgery, which is intended for treatment in severe or morbid obesity, when conservative alternatives, like lifestyle changes and possible medication have not helped. With surgery, the patient is able to eat only small portions, and a smaller portion of the eaten food is absorbed by the body. In addition, the surgery produces favorable hormonal changes, especially for the metabolism of sugar. The study found an average weight loss of 25% 12 months after surgery. The prevalence of sleep apnea decreased from 71% to 44%. With gastric bypass surgery sleep apnea improved or eased by over 90% of operated patients.
In particular, the amount of sleep apnea, that is relevant to the increased morbidity and mortality of cardiovascular diseases, was reduced. Another important point in the study was that 20% of the operated patients still had moderate or severe sleep apnea after surgery. One researcher thinks that sleep apnea study should be done for everyone who’s considering obesity surgery.
In addition to nutrition, it is good to pay attention to increasing energy consumption. It is wise to implement at least by increasing physical activity. Physical activity is good for the body in many ways, it is easy to understand. All exercise, such as walking, for example, also improves physical fitness. Exercise is also of great benefit in the treatment of related diseases of sleep apnea such as hypertension, diabetes, cardiovascular diseases, cerebrovascular disorders or musculoskeletal disorders such as osteoarthritis. Exercise does not cure depression, but it helps to increase mood. Its benefits have been found in different studies to be at least comparable to antidepressant or antihypertensive drugs. Moving outside in the morning at a bright light will also help tune the circadian rhythm. Exercise also improves the body’s ability to regulate heat, which helps to fall asleep.
What is CPAP? (Continuous Positive Airway Pressure)
Medium to severe sleep apnea is treated primarily with the use of an overpressure inhaler (CPAP) during sleep, where the AHI, mainly consisting of obstructive events, is over 15 per hour. The device keeps the upper airways open by blowing air at low pressure. The device is used for sleeping with a nasal or full-face mask. CPAP does not cure the disease, but it alleviates the symptoms. If the device is used every time you go to bed, the symptoms will stop completely. However, discontinuing the use of the device will restore the symptoms unless, for example, the overweight person has dropped weight significantly.
The CPAP device is an excellent device for treating sleep apnea. However, it is good to understand that it only works for sleep apnea, but not for other sleep problems such as insomnia. Overpressure respiratory therapy can help to reduce sleep apnea and reduce the risk of cardiovascular disease, stroke and diabetes. It seems that in some cases, women with mild sleep apnea should be treated with CPAP.
It may take some time to find the individual correct CPAP pressure. Newer auto-adjust devices will regulate the equipment by itself for a suitable pressure. The device reacts to the patient’s snoring, flow restriction and breathing breaks, and increases pressure if necessary. The general advice is that the CPAP device should be used at least four hours a night. However, the benefit of treatment is the better the longer it is used at night. It is advisable to use the device all night long.
Mark, 59, is an example of how the diagnosis and treatment of sleep apnea can bring life back on track. His sleep apnea was diagnosed in spring 2015.
“Symptoms were unusual fatigue, difficulty concentrating, and mood problems. The situation made the work much more difficult. My father had a mild sleep apnea, so I suspected sleep apnea, but I couldn’t bring it up. Finally, the doctor decided to send me to the examinations.
For the treatment I got a CPAP device, the use of which has worked virtually without problems. My current state is excellent. After a good night’s sleep I feel rested and energetic. Work, social life and hobbies seem more meaningful. ”
CPAP device does not cure the disease, but it alleviates the symptoms. If the device is always used at bedtime, the symptoms will be fully controlled at best.
“In June 2015, I was diagnosed with sleep apnea that had developed into a severe stage. My fatigue was thought to be associated with poor physical fitness and hard work. But when the cause was found, also the right treatment was found and that was a sleep apnea mask, CPAP device. No new drugs, just a breathing mask that keeps the airways open. After a few nights I was wondering if it could be that simple. Sure, sleeping with sleep apnea mask requires little learning, but the result is worth it.”
CPAP device care is also suitable for sleep apnea patients suffering from other respiratory illnesses to facilitate sleep and nighttime breathing. There are studies and information about both asthma and lung cancer patients.
The CPAP device’s boost on alertness- effect has been demonstrated in a US study, where the effect of treatment on moderate sleep apnea was monitored. Changes were measured in the study with pedometers. If the quality of sleep is weak, the person is always tired and doesn’t move or exercise sufficiently. Hence, improved sleep should be seen as increased steps. That’s what happened. Three months after the start of CPAP treatment, the number of steps had increased by an average of 840 per day, and after seven months the number of daily steps was already 1,400 more than in the initial measurement.
The doctor who presented the study summarizes the study as follows: “CPAP treatment is an effective treatment for daytime fatigue, and after the fatigue has disappeared, the patient’s lifestyle can often be corrected. Patients can better focus on thinking about what they eat and also be more active, so at best they lose weight.” Every one of us trying to change our lifestyle knows how much the change in the right direction motivates to try more.
Sleep apnea mouthpieces and mouthguards
A dentist may be an essential person in the diagnosis of sleep apnea because he or she is familiar with the congenital structural abnormalities of the jaws, such as micrognathia (very small lower jaw), large tongue, thick and soft palate, narrow upper jaw, misaligned bite. In order to prevent structural sleep apnea associated with the mouth and dentition, the anomalies of the jawbone and bite should be intervened with the help of orthodontic treatment.
In mild to moderate sleep apnea, the patient can also benefit from an individual custom-fitted mouthpiece or mouthguard. The lower jaw and tongue muscles are pushed forward on the rail, whereby the throat expands at the level of the tongue. This allows the muscles of the throat to be activated, whereby the tissues become tightened and the soft palate does not clog the airways.
Sleep apnea mouthpiece is usually suitable for those suffering from mild sleep apnea with a Body mass index, or BMI up to 30-35. Mouthpieces are primarily used to treat snoring, but can also be used when sleep apnea is mild or CPAP treatment is not successful.
Sometimes the mouthpiece is made by a dentist or dental technician as custom-made. If necessary, your dentist will write a referral to a specialist dentist or hospital for dental and oral diseases.
A mouthpiece is not suitable for patients with severe dental problems or if several teeth are missing. The use of a mouthpiece may increase salivation especially at the beginning of treatment, and teeth and jaw joints may feel sore in the mornings.
The latest sleep apnea mouthpieces are small and easier to use than previous versions. The mouthpieces have evolved and attention has been paid to comfort. Previously, mouthpieces were mainly useful in mild sleep apnea, but nowadays, patients with moderate sleep apnea can benefit from mouthpieces and mouthguards.
Sleep apnea surgery – surgical procedures
Snoring and sleep apnea have been previously attempted to reduce the number of guitar cuts and palate modifications made by the ear physicians.
Snoring and sleep apnea have previously been treated with tonsillectomy (procedure to remove the tonsils) and making modifications to the palate. Removal of enlarged tonsils can help with snoring, but tonsillectomy is unlikely to affect breathing breaks. Surgical treatment may be helpful when other forms of treatment for sleep apnea, i.e. weight loss, CPAP or a mouthpiece, have not helped or the patient has clear structural abnormalities in the throat or face area. The nasal region may be facilitated by nasal septum repair surgery or by removal of polyps. Usually, nasal cavity ventilation expansion surgery do not correct sleep apnea, but they can make it easier to use CPAP.
Previously, there were more pharyngeal surgeries in which the tissue from the pharynx and the palate was removed to expand the airway. Nowadays, surgery is used only in exceptional cases, because predicting the surgical results is difficult and the long-term results have not been very good.
Currently, RFA (Radiofrequency Ablation) is also available. It stiffens the throat tissue, nasal concha and soft palate with electrosurgical procedures, where the tissue is heated by an electric current. As a result of the thermal treatment, the tissue stiffens and shrinks, resulting in reduction of snoring (soft palate) and a reduction in nasal mucosa swelling and mucus secretion. This is not the way to treat large numbers of people, because the benefits of this may not be sufficient, as the benefits of this may not be sufficient.
The newest form of treatment is neural stimulation of the tongue muscle, where the pacemaker makes the tongue push out when sleeping.