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A life-saving therapy for those with sleep apnea

By Howard Seidman, Contributing Writer, myOptumHealth

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What if you could feel more awake during the day, lower your odds of having a car accident and reduce your risk of depression, heart disease, high blood pressure and stroke? And what if you could do it all without drugs or surgery?

If you have obstructive sleep apnea (OSA), you may be able to achieve all these things. Treatment for sleep apnea often involves using a continuous positive airway pressure (CPAP) unit every night.

What is obstructive sleep apnea?

Obstructive sleep apnea is a breathing disorder that causes you to stop breathing up to hundreds of times per night. The muscles inside the throat relax during sleep, and gravity causes the tongue to fall back and block the airway.

Breathing usually resumes only when the brain senses a drop in oxygen levels and jolts you awake. So even though you may be sleeping eight hours a night, your sleep is interrupted. You likely don't notice or remember these frequent awakenings. But, you may feel tired and unrested when you wake up.

Anyone can get sleep apnea, but it is most common in obese, middle-aged men. Weight gain causes thicker necks and raises the level of fat in the back of the throat. More fat means a greater chance of airway blockage.

What is CPAP?

A CPAP unit is a machine about the size of a lunchbox that generates air pressure. Air feeds into a tube connected to a mask that straps on the face. It covers the nose, mouth or both.

People with apnea need a way to keep their airways open. CPAP therapy does this by acting like an "airway splint." Air pressure that enters through the nose or mouth helps keep the airway open for normal breathing.

After their first night using CPAP, many people say they've had their first good night of sleep in years. For others, improvement may be gradual as they adjust to sleeping a new way.

Health risks of untreated sleep apnea

Sticking with CPAP therapy is important to help reduce the health risks associated with sleep apnea, including:

• Heart disease. Pauses in breathing cause low oxygen levels. The heart will beat faster while trying to deliver enough oxygen. People with sleep apnea have higher death rates than others, due to heart disease. Sleep apnea is also linked to high blood pressure. 
• Stroke. People with sleep apnea are two to four times more likely than others to have a stroke. 
• Type 2 diabetes. People with sleep apnea have higher rates of glucose intolerance and insulin resistance than others, which are factors in type 2 diabetes. Glucose intolerance has been linked to lower nighttime oxygen levels. 
• Motor vehicle accidents. Sleep apnea can cause daytime sleepiness and increase the risk of being involved in a deadly motor vehicle accident by up to 15 times.

Using CPAP

CPAP is the most common treatment for sleep apnea and is usually very effective. But not everyone sticks with it as directed. Up to 30 percent of people stop using it within a few months.

Some people feel claustrophobic or uncomfortable wearing masks. But new and improved masks and units have helped many to adjust to using CPAP.

Today's CPAP units are smaller, lighter and more quiet than before. Most units now have heated humidifiers to fight dry air and congestion. Most also have a "ramp" setting. This lets the machine start low and rise slowly until pressure reaches the right level, which may be easier for the body to adjust to.

To be effective, the CPAP unit must be used all night, every night and during naps.

View the original A life-saving therapy for those with sleep apnea article on myOptumHealth.com 

SOURCES:

• Schwartz DJ, Karatinos G. For individuals with obstructive sleep apnea, institution of CPAP therapy is associated with an amelioration of symptoms of depression which is sustained long term. Journal of Clinical Sleep Medicine. 2007;3(6):631-635.

• American Academy of Sleep Medicine. Benefits of CPAP. Accessed: 06/20/2008

• Lopez-Jimenez F, Sert Kuniyoshi FH, Gami A, Somers VK. Obstructive sleep apnea implications for cardiac and vascular disease. Chest. 2008;133(3):793-804. Accessed: 06/20/2008

• Albarrak M, Banno K, Sabbagh AA, et al. Utilization of healthcare resources in obstructive sleep apnea syndrome: a 5-year follow-up study in men using CPAP. Sleep. 2005;28(10):1306-1311.