Rest easy, snorers: A CPA works wonders
My friend was looking forward to a 20th anniversary cruise with her husband, except for one problem: He snored. They hadn’t slept in the same room for years, and the prospect of sharing a tiny stateroom with him for 10 days was horrifying.
CPAP to the rescue! After a sleep study, her husband was found to have obstructive sleep apnea and was prescribed a CPAP (continuous positive air pressure) device a few weeks before the cruise. Wonder of wonders, both got good nights’ sleep. After the first night using the CPAP, the husband exclaimed it was his best night’s sleep in years.
By some estimates, 33 million U.S. adults use CPAP or its cousin, BiPAP (bi-level positive air pressure) because of sleep disorders. Those who adapt to it experience the first good night of sleep they’ve had in years. Those who can’t adapt — well, that CPAP is probably sitting in a closet somewhere.
But if you have one of the three kinds of sleep apnea, don’t give up too easily, because it can be the root of many serious health conditions. Obstructive sleep apnea — which causes someone to actually stop breathing tens or even hundreds of times a night — raises the risk of coronary artery disease, heart attack, heart failure and stroke. And night after night of broken sleep is implicated in everything from diabetes to dementia.
How do you know if you have sleep apnea?
Excessive daytime fatigue, an inability to stay awake, loud snoring and being awakened by gasping for air are some signs (though everyone who snores doesn’t have sleep apnea). The only way to know for sure is to have a sleep study done, either in a sleep center or at home.
Obstructive sleep apnea, the most common type, is caused by the throat muscles relaxing and blocking the airway. Risk factors include overweight and high blood pressure. Alcohol and sleeping pills may make it worse. Central sleep apnea occurs when a person experiences apnea episodes alternating with normal breathing. And complex sleep apnea is apnea that continues even with treatment.
People abandon their CPAP for a variety of reasons. Masks that cover the nose and mouth can feel constricting. The machines makes a continuous whooshing sound that may be disturbing. And some folks can’t handle the feel of air being sent down their throats all night — it’s been likened to driving 45 miles an hour with your head out the window and your mouth open.
Besides all that, the hoses and headgear have to be regularly cleaned and replaced several times a year.
CPAP troubles are very common, but there are things you can do to improve your tolerance. You might try wearing the mask during the day to get the nerves and muscles of your face used to it. It’s also important to have a sleep specialist adjust the settings on the machine to make it as comfortable as possible.
A BiPAP is another possible solution. While the air pressure through a CPAP is, as the name says, continuous, a BiPAP adjusts the pressure with your breathing, making it easier to exhale.
That said, compliance with CPAP usage remains relatively low, so doctors are looking at non-CPAP treatments for sleep apnea. Before getting a CPAP, your doctor or sleep specialist may suggest other options, such as weight loss, a dental appliances or, in the case of an obstruction in the airway, surgery.
In 2014, an implanted device was approved by the Food and Drug Administration that provides upper airway stimulation to keep airways open and prevent lapses in breathing. It’s implanted during a minimally invasive outpatient procedure in which two incisions are made: one under the chin where a small nerve cuff is placed, and one in the upper chest to accommodate the device.
After recovery, the patient returns to the doctor’s office to set up the device and determine the proper level of stimulation. Then, before bed, the patient uses a remote control to turn on the device. It’s been on the market for about 10 years, and studies suggest it has better compliance than CPAP. It’s covered by Medicare if it’s considered a reasonable and necessary treatment for sleep obstruction.
Sleep apnea has serious health implications. However you deal with it, it’s important to get it treated with a solution that works for you and those around you.
• Teri (Dreher) Frykenberg is a board-certified patient advocate. A critical care registered nurse for 30+ years, she is founder of NShore Patient Advocates (www.NorthShoreRN.com). Her book, “How to Be a Healthcare Advocate for Yourself & Your Loved Ones,” is available on Amazon. She is offering a free phone consultation to Daily Herald readers; email her at teri@northshorern.com.