Curling up at night with a mask over you face
might not be the most appealing idea in the world;
But if you suffer form sleep apnea – especially
obstructive sleep apnea – it miight be our best
bet for a restful, unterrupted night’ sleep.
The most widely-used, current therapeutic used to
treat sleep apnea is positive airway pressure,
whereby a breathing machine pumps a control
stream of air through a mask that you wear over
your nose, and mouth, or both. This additional
pressure slants or holes open the relaxed muscles,
just as air in a balloon inflates it. There are
several different versions of this positive
airway therapy.
CPAP or continuous positive airway pressure. In
this therapy, a controlled air compressor
generates an airstream at a constant pressure.
This pressure is prescribed by your physician,
based on an overnight test or titration.
There are newer CPAP models available which
slightly reduced the pressure when you exhale to
increase your comfort and compliance.
VTAP or variable positive airway pressure, which
is sometimes called by level or BiPAP, uses an
electronic circuit to monitor your breathing. It
actually provides two different pressures, a
higher one during inhalation and a lower pressure
during exultation. This system is more expensive
than a CPAP system and is sometimes used with
patients who have other respiratory problems or
who find that breathing out against an increased
pressure is uncomfortable or disruptive to their
sleep.
APAP or automatic positive airway pressure is the
newest form of these therapies. An APAP machine
incorporates pressure sensors and a computer
which continuously monitors your breathing
performance. It adjusts pressure continuously,
increasing it when you are attempting to breathe
but cannot, and decreasing it when the pressure
is higher than necessary.
Although FDA approved, these devices are still
considered somewhat experimental by some people
and are not covered by most insurance plans.
Finally, there is a second type of physical
intervention called a mandibular advancement
splint (MAS) that is sometimes prescribed for
those who have mild or moderate sleep apnea. This
device is a mouth guard similar to those used in
sports to protect the teeth. In the case of apnea
patients, the device is designed to hold the
lower jaw slightly down and forward relative to
the natural, relaxed position. This holds the
tongue further away from the back of the airway,
and may be enough to relieve apnea or improve
breathing. The FDA accepts only 16 oral
appliances for the treatment of sleep apnea.
This oral appliance therapy is less effective
than CPAP, but is more “user-friendly.”In
addition, there are drugs that are sometimes
prescribed to treat the patien’ts daytime
sleepiness.