|
|
|
|
|
|
|
|
|
Treatments There are several different kinds of therapy. There are nasal dilators, dental appliances, surgery and CPAP machines. There are 2 kinds of nasal dilators. The first kind is simply strips of adhesive material that are worn over the nose during sleep. We have seen commercials on TV for similar devises. The second kind is more durable. It is a springy piece of plastic that is wider at the ends. The ends are actually inserted into the nostrils. These dilators cost ~ $20 each and have to be replaced every 2 - 3 months. They can be rather uncomfortable and may irritate the inside lining of the nose. The effectiveness of these two devices are rated at under 5 % of the sleep apnea sufferers. A dental appliance is a small plastic device, similar to an orthodontic retainer or a athletic mouthguard. It is worn in the mouth during sleep to prevent the soft throat tissues from collapsing and obstructing the airway. Dentists with training in dental appliance therapy can design, construct, and fit these special appliances to meet their patient's individual situations and conditions. In recent clinical studies, physicians and dentists have found that, in a majority of patients, a well-made, well-fitted dental appliance will effectively reduce or eliminate snoring, and significantly relieve symptoms of mild and moderate OSA. Dental appliances work in three ways: by bringing the lower jaw forward, by holding the tongue forward, and by lifting a drooping soft palate. A combination appliance may perform two or more of these functions at the same time. Dental appliance therapy is not a new idea. It was in use as far back as the early 1900s. But it was not until the 1980s that physicians and dentists began to work together to study and develop this alternative form of treatment, enabling more patients to benefit from it. The price can range from $50 to $2,000. The CPAP (Continuous Positive Airway Pressure) device is basically a computerized air pump. It is calibrated by a respiratory therapist to produce the amount of pressure necessary to maintain an open airway. This pressure was determined by the Sleep Lab. CPAP is a method of applying a positive pressure to the inside of the throat to prevent it from collapsing during sleep. The individual wears a special mask over the nose that is connected to a pump. The pump applies pressure through the mask to keep the throat from collapsing. The cost ranges $1,000.00 to $3,000.00+
Another device is the BiPAP. It is similar to the CPAP(BiPAP stands for BI-level positive airway pressure) however, it is used when the prescription is set at two levels, one for inhalation (called I-pap) and the other for exhalation (called E-pap). The difference is that with the BI-level it is easier to exhale. The E-pap is set at a lower pressure than the I-pap. It still keeps the airway open but it is easier to exhale against that lower pressure. Because it is difficult to exhale/breath when you reach higher pressures, the use of BiPAP is often prescribed for patients who require significantly higher pressures. Note: the cost of the BiPAP is about twice that of CPAP. Insurance usually will not pay unless proven to be medically necessary, i.e.: unable to tolerate CPAP. Obesity is one of the most common risk factors associated with sleep apnea. Often times, if the weight can be controlled, the apnea will go away. There are several ways to loss weight but in the chronically obese person, oftentimes only surgical intervention will help them to achieve a permanent solution to both their sleep apnea and obesity. Alcohol and sedatives may also contribute to sleep apnea. They can cause abnormal relaxation of the throat muscles which causes the sleep apnea to occur. Simply not using these product often will bring some relief. In some cases the cause is a physical obstruction in the air way. If the problem is excess tissue in the throat, a procedure called an Uvulopalatopharyngoplasty is done. The figure here shows what is removed.
You can see where the part of the throat that hangs down has been removed. Sometimes the problem may be that the tonsils or adenoids are enlarged and need to be removed. If they both are enlarged, then a T&A is done. Operations can also be performed to straighten deviated septums, remove polyps, remove nasal cartilage, or strip the lining of the nose. If the sleep apnea is severe and life threatening, then a Tracheotomy must be performed. |
This is a picture of one type of CPAP masks.
