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Obstructive sleep apnea (OSA), a condition in which the upper airway collapses during sleep, causing breathing to periodically stop at night, is an under diagnosed disorder that can lead to serious health problems as well as impaired quality of life. However, with proper treatment, you can conquer your apnea and improve your heath tremendously. Here are some guidelines on what to do if you suspect that you have apnea.
Steps
- If you routinely wake up feeling unrefreshed, fall asleep during the day, feel a decline in your mental sharpness, notice yourself sometimes waking up gasping or out of breath every few minutes, or have feelings of depression, consider talking to your doctor about a sleep study. If you wake several times during the night, and maybe more frequently towards the end of your sleep cycle - when sleep apnea is at its worst. If you sometimes do not remember covering the last few miles while driving, or drift off most times you are the passenger in a car traveling any distance, you also should consider that discussion. These are all signs of unrestorative sleep, and OSA is a major cause of unrestorative sleep. You may have accepted any or all of these issues as part of your life, and so not be aware of their impact on your life's quality.
- Ask your sleeping partner if they hear you snoring loudly or a steady rise and fall of snore volume, snorting or stopping breathing entirely at any point during the night, or during nap times in the day. Sleep apnea can sound a lot like snoring, often mistaken for steady breathing. Apnea is, in fact, a small step beyond snoring, if you snore chances are you will eventually develop some form of apnea as you get older.
- If your doctor agrees you might have OSA, they will write a prescription for a sleep study. In a sleep study, you will go to a sleep laboratory and be hooked up to electrodes to monitor your breathing, blood oxygen saturation, sleep state, and general physical state overnight. Some sleep centers and insurance companies require two separate studies, one for diagnosis and a second, called the titration study, which will identify whether some variation on CPAP therapy will fix your OSA. In some cases, these two studies will be combined in one night, but the results of that first study are always used by a doctor to diagnose OSA.
- If you have OSA, your doctor may discuss treatment options with you. The most common treatment, CPAP (Continuous Positive Airway Pressure) machines and their variations, use air pressure in your airway to keep that airway open. Other treatments include several types of operations to remove part of the tissue that blocks the airway and tracheotomy for extreme cases.
- If your study results show that you have apnea, and your doctor believes a CPAP or variant is the right treatment for you, they will write you a prescription for a CPAP machine. You will then have to deal with your health insurance company and a DME (Durable Medical Equipment supplier) to get the equipment you need to successfully treat your apnea. The DME supplier will be responsible for supplying the equipment, setting it to your prescription, fitting whatever mask or nasal plugs you'll be using, fitting whatever headgear you will be using, and training you in how to clean and maintain your equipment. They should also check back regularly, to replenish filters, to replace masks and headgear as needed (roughly twice year, usually), to check the accuracy of your CPAP settings, and to answer any questions you might have.
- Find a mask that works well for you. Mask options range from nasal pillows to nasal masks to full face masks. Your DME may not provide you with a variety of options, but be assured that they are out there. Many people find fitting their mask properly to be the most crucial part of adapting to CPAP therapy.
- Request a heated humidifier and extra bacterial filters for your machine. Most DMEs do not provide these as a matter of course, but they should be standard to help protect the delicate mucous membranes of the nasal passages and lungs.
- Take it slowly. Many people find getting used to CPAP difficult. Try wearing your mask and machine for progressively longer periods during the day, until you are ready to sleep with it.
- Be patient and determined. It takes time to iron out the wrinkles in CPAP therapy, and you may not see the benefits immediately, especially if your body has a large "sleep debt" to make up. However, rest assured that your health and well-being will improve tremendously when your apnea is treated.
- Enjoy your new life as a properly rested person!
Tips
- Older people and those who are overweight are at a higher risk for developing sleep apnea, but the condition can happen to anyone, even those who don't fit the profile.
- Be assertive when dealing with your insurance company and DME. These people are out to make money for themselves, and they do not have your interests in mind. Stand up for yourself.
- If you have trouble with the high CPAP pressure, consider an APAP (Automatic Positive Airway Pressure) machine. This machine will stay on a lower pressure for most of the night and increase the pressure when it senses that your airway is collapsing. This machine can behave in a seemingly erratic fashion, sometimes causing irritation during pressure changes.
- People with muscles weakness affecting the diaphragm (whether from spinal cord injury, muscular dystrophy or other neuromuscular disorder) often experience nocturnal hypoventilation, a condition symptomatically similar to sleep apnea, in which breathing becomes too shallow at night. This problem can be easily treated with a BiPAP (Bilevel Positive Airway Pressure) machine on specific settings (high IPAP, low EPAP) to support breathing overnight.
- Seriously consider joining an online sleep apnea support group. These forums can be invaluable resources for new CPAP users.
- The blowing air from the CPAP can cause a painfully dry mouth. If this happens it may be your mouth falling open during sleep, most commonly during REM, a "chin strap" could be used to alleviate this problem. Also, you should have a humidifier that attaches to your CPAP. You can also use an OTC product like "Oasis" from Sensodyne to help keep your mouth moist.
- If you have to pay for a CPAP machine out of your own pocket, don't buy one from your doctor. Have the doctor write you a prescription and then buy the machine over the Internet. It can cost you two or three times as much to buy it from your doctor.
- Purchasing from an Internet vendor is the best choice for those who have no insurance, limited insurance, or a very high deductible. Some patients don't even realize they have this choice. Shop around. Prices vary greatly from site to site and customer service is paramount when dealing with your health.
- If you sleep alone, you can try recording yourself while you're sleeping. You can do this with a computer. Or a tape recorder and a timer - set the tape recorder to record and set the timer to go on when you know you'll be asleep (for example, 3am-4am). What you want to listen for is a stop in the snoring (maybe even up to a minute gap or longer) and possibly a gasp afterwards and snoring to start again. That gap could possibly be when you've stopped breathing altogether (and then the gasp for air). The longer the gap, the worse your sleep apnea might be. Of course, a sleep study is the sure way to know if you have sleep apnea but this may give you an indication.
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