Sleep Apnea

Sleep Apnea is defined as near 100% loss of oxygen flow for at least 10 seconds during sleep.  There are two types of Apnea.  The first, Central Sleep Apnea, is the least common and occurs because the central nervous system “forgets” to tell your body to breath.  There is no gasping or choking, but the episode does interrupt the normal sleep cycle.  The second and most common apnea is Obstructive Sleep Apnea (OSA).  In OSA the upper airway collapses and blocks the flow of air to the lungs.  These episodes can happen hundreds of times in a night and last for more than a minute.  The magnitude of these incidents determines the severity of a patients OSA.  When the flow of air is blocked, the blood oxygen levels drop and patients choke or gasp for air.  Even though the patient may not even be aware of it, they are startled awake hundreds of times a night and never get the necessary sleep needed to function normally during the day.  OSA is literally a psychological, emotional, and physical killer.  The scientific evidence is staggering.  Untreated OSA patients suffer many symptoms, excessive daytime tiredness, snoring, headaches, GERD, hypertension, weight gain, diabetes, heart attacks and stroke at a far greater rate than patients with normal sleep patterns.  All patients exhibit different symptoms and compensate differently to their impaired sleep rhythms.  Often times they do not even realize they are not getting the necessary sleep.  As an initial step, patients and their significant others are given questionnaires to establish weather they are at risk of OSA.  These are very short forms that combined with clinical observations determine if a patient should undergo more extensive analysis with a sleep study.  

In the past 5 years sleep study has undergone an amazing transformation in respect to diagnosis and treatment.  Some of the necessary bodily functions that occur during healthy sleep patterns include immune responses, energy conservation, and hormone release.  Memory is highly dependent on healthy sleep patterns.  Basically, sleep can be divided into two types, REM and NREM. There are different stages to NREM sleep but the important point to understand is that each part of your sleep pattern is specific, and responsible for necessary bodily functions.

A multitude of disturbances can affect normal sleep patterns. Some of these include grinding teeth, sleep walking, snoring, restless leg syndrome, insomnia, and sleep apnea.  If normal sleep patterns are interrupted the negative effects on your health can range from memory issues, psychosis, diabetes, weight gain, and even hypertension.  It is absolutely remarkable to analyze the adverse affect these issues can have on the emotional, financial, and  physical well being of patients.  

Diagnosis of sleep disorders has improved dramatically in several respects.  Laboratory sleep studies monitor brain activity, eye movement, heart rhythm, muscle movement and oxygen saturation of blood.  This data is interpreted by specialists and condensed into a polysomnography report which is returned to your doctor.  Recently, a battery powered take home device called Embletta has been developed.  It is worn by patients sleeping at home and the data is downloaded into our computer and a report is generated.  It is very important to analyze insurance coverage and requirements before starting diagnosis and therapy so that you can receive the maximum reimbursement for any therapy.

Another exciting development is acoustic technology which significantly improves treatment in snoring and sleep apnea cases.  Acoustic Rhinometers and Phayngometers allow us to map your nasal and oral pharyngeal airways to determine where obstructions occur.  Proper fit of appliances can then be customized to get the best possible results using the sound mapping of the acoustic devices.

It is an exciting time for us because the sleep therapies we have at are disposal can dramatically improve our patients lives.  Our paramount concern is to develop the best treatment for each case.  This is achieved by careful analysis of data and a cooperative approach to diagnosis and treatment with sleep labs and sleep doctors.