Nasal continuous positive airflow pressure unfortunately is associated with low compliance by patients on a long-term basis however recent studies into its use have shown that due to two factors, better education and more advanced technology, more and more people are using it as a treatment option and staying on it for longer periods of time. Patients often note benefits to CPAP even if they only use it for approximately four hours per night. Some of the greatest benefits to patients include less tiredness noted during the daytime, a greater sense of alertness, better concentration and memory retention as well as more energy and overall better mood and sense of well being.

The second type of continuous positive airflow pressure is known as bilevel positive airway pressure and this system (sometimes abbreviated to BiPAP) is most beneficial to patients who either have tremendous amounts of carbon dioxide in their systems or those who already have pre existing lung disease. The bilevel positive airway pressure includes a “sensing feature that helps determine and vary the appropriate pressure depending on whether a person is breathing in or out.” In this case, upon inhaling a patient receives more pressure and when they exhale they receive less. The BiPAP machine due to its more advanced design costs a great deal more than the nasal continuous positive airflow pressure.

The most sophisticated CPAP machines are ones known as automatic titrating (auto)-CPAP pressure (or auto-CPAP) for short. These types are the most technologically advanced in regards to air pressure that is customized one way or another. The auto-CPAP machines can work in one of three ways. In the first case scenario the pressure of the machine can be kept to a low level until the patient experiences problems breathing. Once that happens the pressure can then be dramatically increased. Secondly, the pressure can be kept low and steady until a problem arises at which time it is raised in a gradual way. Thirdly, the pressure of the machine can be put up or down according to breathing problems. As well it can also detect when there is a problem developing in between “single breaths” of the patient.

First of all it may seem obvious but it is important to sit down and read the manual for the CPAP from cover to cover and make sure you understand everything. Familiarize yourself with the mask and the headgear and experiment with the buckles, straps and Velcro seams to see if you can get a comfortable fit. The leakage of air is often a common problem with CPAP but it has more to do with positioning than it does pressure. Pressure is important to seal it in place but take the time to guarantee that you have the mask properly in position before you begin tightening the straps. And remember tighter straps don’t necessarily allow the mask to fit better.

Some people find the use of a heated humidifier helps decrease the chance of CPAP being uncomfortable. If you find that your sinuses are drying out at a quick rate and the air in general is too dry then invest in a heated humidifier. Sometimes these can be costly but some manufacturers offer them at reasonable rates to work with specific CPAP models. Basically put a heated humidifier is, “a piece of plastic which you fill with water and place in between the machine and your mask.” How it works is the air makes it way over the water and as it does so it picks up a significant amount of moisture. In this way it works very much the same as an ordinary humidifier used around the home. Many patients strongly advise the use of a heated humidifier for comfort.

Continuous positive airway pressure is usually fairly quiet but some people find the sound of it which is comparable to “white noise” to be calming while others find it annoying. If you are one of the latter there are only two things that you can do to resolve the problem. First you can somehow find a way to block the noise (such as covering it with something or wearing ear plugs at night) or you can move the machine as far away from your bed as possible.

Some patients need help from a qualified health care provider or a family member or friend in order to decide on a mask that fits as well as possible. Some people try a few before they find one that is just right for them. Most of the side effects that patients experience when they first begin the treatment of CPAP are temporary and generally mild, such as headaches, sore, itchy eyes, bloating in their abdominal area and nasal congestion. The average patient becomes accustomed to CPAP treatment anywhere from two to twelve weeks after commencing the treatment and research into the use of CPAP has found that approximately less than half of patients who start it choose to not continue with it.

Now while a person sleeps it is an all together different story. In this case, not only are you giving your mind and body a rest and plenty of relaxation but the muscles that line your mouth and throat decide to relax also. This causes a narrowing of the air passages. For those without any sleep or breathing problems this doesn’t pose any extra concern whatsoever. However for those who suffer from sleep apnea a dangerous turn of events can be put into play. Sleep apnea often involves snoring and an obstruction of the airways and coupled with the relaxation mode that the mouth and throat have gone into, this causes the normal airflow to be partially and/or totally blacked. Due to this, regular breathing is unable to take place.

If regular breathing is disrupted then there is very little if indeed any air flowing through that can bring about the required pressure on the airway muscles to keep everything running smoothly. When this happens it is dangerous because the air passages can narrow and collapse even further, thereby limiting all of the air that is attempting to pass through. Air then has no route from which to reach the lungs and with this, the level of oxygen in the blood begins to drop.

The brain is now on overdrive trying to let the lungs know that they must get air and return to a normalized breathing pattern. Unfortunately the lungs are unable to do as they are told as the air passages are collapsed and will not allow air to flow through. Finally the brain realizes that its oxygen supply is depleted as well and it then goes about the task of letting the body know by waking the person up in order for them to restore the required amount of muscle tone to their air passages and kick start regular breathing.  Some people who suffer from sleep apnea awake with a choke, a gasp or a snort as they attempt to force breath into their lungs.

Once the cycle of regular breathing commences, the oxygen levels rise again to their normal place and then the person falls back to sleep, and into the rapid eye movement (REM) deeper stage of sleep. However this causes the cycle of the muscles in the airways to collapse and become obstructed again thereby perpetuating the cycle.

Research into this cycle shows that it brings about disrupted sleep over a consistent period as the body requires in particular a sufficient amount of REM sleep per night in order for a person to feel rested and energized the following day. This cycle causes the brain to not get the necessary rest as well as it constantly needs to awaken the sleeping individual to alert him or her to the breathing problem at hand.

Obese people tend to be more susceptible to sleep apnea because the weight of their neck tissues may depress the esophagus, causing the airway to be narrowed and eventually blocked. Other reasons that the airway of a person may be blocked include sleeping on their back, having nasal deformities, drinking alcohol, having large adenoids or tonsils, and allergies. While some of these causes for apnea can be solved in the home, doctors often recommend the use of a CPAP machine to aid a problem with obstructive sleep apnea.

CPAP stands for continuous positive airway pressure, which is what the machine provides. A steady stream of air is pumped into a mask which is worn by the afflicted person while they sleep. In this way, there is a continuous supply of air provided directly to a person’s airway. This can decrease the number of apneas that a person may face throughout the night, and consequently allow them to get more much-needed REM sleep. The lack of REM sleep from obstructive sleep apnea is one of apnea’s most destructive affects.

The body needs sleep to recover, and not getting enough can cause a host of problems, including irritability, a lack of concentration, and a general grogginess that can be very threatening to one’s quality of life. Also, those with untreated apnea are subject to heightened blood pressure, increased risk for stroke, and heart disease. For that reason, CPAP is usually a necessary part of the treatment for a sleep apnea sufferer. Approximately two out of three people who have apnea that is treated with CPAP experience some problems with the machine, and we will address these problems so that those using the machine can get a better night’s sleep.

Some people find that they have difficulty breathing in the air that is forced through the machine. To aid this, you should employ the machine’s functionality that allows it to increase its air pressure throughout the night to ease you into the air flow. Other people who use the machine dislike it due to the fact that it gives them a dry, stuffy nose. To help this problem, it can be useful to purchase a CPAP machine that is equipped with a heated humidifier.

If you are using a CPAP machine to help treat your obstructive sleep apnea problem, it’s important not to get frustrated and give up on the device. Whatever problems you may be having at the current time, you can usually adjust to the changes with a little perseverance. Using the machine nightly is necessary so that you can adapt to breathing properly with it. The benefits that the machine can give to your health and happiness far outweigh the inconveniences in its design.

For that very reason doctors have discovered that a partial or “near-complete” removal of the tissues of the tonsils (in the area of ninety to ninety-percent) can prove every bit as effective as the complete removal, while eliminating some of the postoperative complications. With this idea in mind the PITA Technique (Powered Intracapsular Tonsillectomy and Adenoidectomy).

On a traditional basis what is known as a T&A or a combined tonsillectomy and an adenoidectomy is done. What this means is that a Bovie tonsillectomy and a curette adenoidectomy are undertaken surgically. While the procedures are generally both successful and safe to perform they are also less than precise than the PITA Technique and tend to involve a great deal of pain for the patient afterwards. The pain that follows a T&A procedure can make for an unusually long healing period, which can cause great distress to patients. As well dehydration can often result. Lacking in precision can also cause negative results in the form of a voice with a very strong nasal quality to it.

The PITA Technique is a revolutionary medical procedure that makes use of a powered instrument known as a microdebrider. The microdebrider allows for more precision as well as control on the part of the surgeon due to its small rotating tip. In other words the surgeon is able to take out the maximum amount of adenoid tissue that is obstructing the airway or causing disease while also leaving enough tissue from the tonsils as they are. Leaving a small percentage of tonsil tissue intact “protects the delicate throat muscles, decreases postoperative pain, and shortens the convalescent period.”

By leaving five to ten percent of the tonsil tissue as it naturally is and by leaving a thin section of adenoid tissue in place nearby tissues help to speed up the recuperation period and cause less pain to occur. With the PITA Technique patients can return to school or work sooner and they can also resume their normal day-to-day activities at a faster rate. As well the area that was operated on is less susceptible to thermal injury, inflammation, oozing of fluid and bacteria which can lead to infections. With traditional tonsil and adenoid surgical procedures patients often experienced a great deal of swelling as well as pain. The pain sometimes could become so bad that patients stopped eating and drinking fluids which led to cases of dehydration. As well a conventional curette adenoidectomy can sometimes by accident bring about damage to the underlying tissue of the muscle which can then lead to chronic neck pain.

Obstructive sleep apnea occurs when there is some sort of blockage in a person’s airway, causing them to be unable to get the air that they need while they are asleep. This can be due to many reasons, with obesity being a common cause. Overweight people have deposits of fatty tissue in the neck area, which can weigh on the esophagus and cause a lack of sufficient room for air to get through. Other causes of obstructive sleep apnea include allergies, nasal deformation, large adenoids, large tonsils, and sleeping in an awkward position. Snoring is often present in those who have obstructive sleep apnea, since the sound of snoring represents your body trying as hard as it can to get the oxygen that it needs.

Central sleep apnea is a similar disease but with different causes. Cases of central sleep apnea are rare, occurring much less often than diagnoses of obstructive sleep apnea. In central sleep apnea, the afflicted person has a problem with their brain’s timing. The brain subconsciously tells the body when it should perform its regular functions, and sometimes the timing can be off when it comes to telling the body when to breathe. So, like obstructive sleep apnea, central sleep apnea sufferers do not get enough oxygen while they sleep.

Both disorders cause the sufferer to wake up numerous times throughout the night, gasping for air and even choking. The afflicted often wake with headaches and sore throats due to the lack of oxygen and their body’s struggles with trying to get some. This lack of sleep can lead to many other problems, both physical and mental. Since sleep apnea causes the sufferer to wake up so much throughout the night, the person rarely gets enough REM sleep to fully refresh their body.

This can leave them in a permanent state of grogginess, leading to a lack of concentration, increased irritability, and a much higher risk of being involved in an automobile accident. These problems with alertness can cause an apnea patient to lose productivity in the workplace and in the home, causing a host of problems in the sufferer’s life. Also, the lack of sufficient oxygen taken in by apnea sufferers while they sleep can lead to some very serious physical problems.

Higher blood pressure is often present in those with both types of sleep apnea, and those who have an untreated case of sleep apnea have a significantly higher risk of suffering from a stroke or heart disease than those who have their condition treated. For that reason, if you or someone you love has any of the symptoms described above, it’s important to consult a health care professional to ensure that sleep apnea is not present. The test for apnea is painless, and involves an overnight sleep study. The test is also usually covered by insurance, so there is no need to worry about costs assuming you have an insurance provider.

So what is sleep apnea or OSA.

Sleep apnea is a distressing condition that many people suffer from though they may well be unaware of the fact. Basically the person goes to sleep, but the muscles in the upper part of the airway become very flabby and start to fall in on themselves. The person then cannot breathe properly and can actually stop breathing for a number of seconds before his brain kicks him into action by reminding him that he had better wake up or else. The person wakes up usually with a loud snore or snort which can be distressing for both him and his partner or even those who are within hearing range.

As this may happen quite a number of times during the night, the sufferer tends not to have a completed sleep pattern. This means he is drowsy and tired the next day, and a vicious cycle is set into motion.

The symptoms from Sleep apnea can range from being minor to quite relentless. If it is felt the problem should be controlled, there is an index which can be used to determine the severity of the problem. This is called the Apnoea/hypopnoea index and it is used to decide the severity of the problem. Hypopnoea is the reduction of airflow which is passing through the airways, and the index calculates the number of apnea attacks with the number of hypopnoeas per hour of sleep.  A scale is then used to determine the severity of the problem.

The Apnoea hypopnoea scale

An AHI of fewer than 10 suggests the problems being shown by the person who is snoring and snorting is not liable to have any clinical underlying problems. This is a good thing, because the person (or his family) can then start to think of other methods to stop the terrible din.

If the AHI is above 10, it is indicative of underlying problems, and it is suggested these are investigated further. These further investigations can include a specialist sleep study where the sufferer has to spend a night in hospital whilst special equipment is used to monitor the quality and type of sleep the person is getting. If it is found that he is being deprived of oxygen, it poses problems of Adult sudden death syndrome and also cardiac and stroke problems.
One way of combating sleep apnea is for the person who is suffering from the problem to wear an oxygen mask whilst asleep which will assist him with breathing.

Sleep apnea is no fun either for the people who suffer from it or their families who have to listen to the noise they make whilst asleep.

The most commonly undertaken surgical procedure for sleep apnea is uvulopalatopharyngoplasty. This is also known in its abbreviated form as UPPP (or “UP3″). In some cases, sleep apnea takes place because of too much tissue in the area of either the soft palate or the uvula (which is the “tissue that hangs from the middle of the back of the roof of the mouth”). In a standard UPPP operation, the airway is made larger by the process of opening the airway at the soft palate. In other cases, a section of the soft palate known as the uvula and tissue from the sides of the mouth is taken out and this may or may not include the tonsils. An oscillating blade is used to perform UPPP surgery. Closely following on the heels of UPPP is laser-assisted uvulopalatopharyngoplasty (or LAUP). This type is exactly like UPPP only it takes place with a laser instead of a blade.

A tonsillectomy and/or an adenoidectomy are undertaken if a patient has either tonsils or adenoids that are infected and/or excessively large and are obstructing the airway while they sleep at night. In this situation either the tonsils or the adenoids or both are surgically removed. This is often an option undertaken for young sleep apnea sufferers. When it comes to adult patients sometimes this operation is performed on its own or else it is done along with a LAUP or UPPP operation.

A tracheostomy is the final surgery that physicians recommend for patients as it can not only be risky health wise but it can give rise to other health problems. However this extreme form of surgery is very successful at ridding a person of sleep apnea. In this case the doctor makes a hole in the patient’s trachea (or windpipe) and then a tracheotomy tube is placed in the hole to allow air to freely flow through, thereby allowing the patient to breathe properly.

Mandibular advancement or mandibular myotomy is a way to reposition a patient’s tongue in order to keep it from causing problems with breathing. When it comes to this type of surgery, “the jawbone is broken, moved forward and fixed temporarily to move the chin and tongue away from the back of the throat.” Generally this guarantees that the tongue is brought anyway from six to ten millimeters forward. Another form of surgical advancement, known as hyoid advancement is when a bone that is found in the neck known as the hyoid bone is moved or “advanced” forward in order to properly open the airway in the neck region.

In some people their tongue is so large that it obstructs breathing and encourages sleep apnea to occur. There is a surgical procedure known as a radiofrequency ablation of the tongue that can improve this situation. A radiofrequency probe is applied to the back of the throat area over the course of five treatments. The heat from the probe works to shrink the overall volume of the tongue thus making air obstruction less likely.

Septoplasty is one form of nasal surgery that is performed by way of the nasal passages. The septum is the piece of cartilage that divides the nostrils into two separate passages.  Those with a crooked (or deviated) septum can experience problems with their airways as it works as an obstruction to breathing. A septoplasty is undertaken by surgeons to correct this problem. How it works is that a tiny incision is made inside one of the nostrils and then the septum bone and cartilage are both straightened to do away with the problem.

Turbinate reduction is another form of nasal surgery. Each nostril contains three turbinates and they are the lower, middle and upper. Each turbinate is composed of bone that is encased by soft tissue and the purpose of them is to soak up the air that is breathed in and then warm and moisturize it as it required. When a turbinate is too large it can obstruct the airways. The nasal airway can work to its optimum best if an enlarged turbinate is made smaller surgically. The process of turbinate reduction can be done by way of lasers, a cautery unit, radio-frequency energy or surgical instruments.

Other types of nasal surgery include endoscopic sinus surgery and the removal of polyps from the nose. Sometimes the development of small growths in the nose called polyps can bring about obstructions of the airways. In other cases a succession of sinus infections can bring on nasal problems in the form of air obstruction. If either of these situations are the case then it is necessary for a patient to undergo sinus surgery or polyp removal surgery.

Upper airway surgery is undertaken for the purpose of “narrowing the upper part of the airway involving the soft palate, uvula, tonsils, or adenoids.” Uvulopalatopharyngoplasty (UPPP) is undertaken when a patient has an elongated soft palate as well as an enlarged uvula. UPPP surgery is performed under general anesthesia and is done by way of conventional surgical instruments or a laser. What happens during the surgery is that the uvula is taken out and then the bottom edge of the soft palate is trimmed down as is necessary and then if the patient has tonsils they are taken out. Stitches accompany this surgery and most doctors use the kind that dissolve in the mouth.

Laser-assisted uvulopalatoplasty (LAUP) is used to treat not only OSA but consistent loud snoring as well. When it comes to this surgery the back edge of the soft palate is removed and the uvula is reduced in size. If the tonsils are part of the problem they are treated by way of a laser. LAUP is performed under local anesthesia in a doctor’s office. Most doctors use a carbon dioxide (CO2) laser to perform the procedure. This is not a one-time thing. LAUP consists of anywhere from one to four treatments and takes approximately fifteen to twenty minutes at a time. Most patients need to continue treatments for anywhere from four to six weeks. It generally takes that long for there to be an improvement noted in symptoms.

It is estimated that anywhere from twelve to twenty million American citizens suffer from sleep apnea in varying degrees. There are three kinds of sleep apnea- obstructive, central and mixed, of which obstructive sleep apnea is the most widespread by far. Obstructive sleep apnea can be mild, moderate or severe. It can easily go from mild to moderate or moderate to severe. Sleep apnea is not “age-specific” and affects individuals of every age, including children. Both men and women develop sleep apnea although it is more common in men then women, especially middle-aged men who are overweight. Part of this is believed to be due to the fact that men have a thicker neck circumference than women.

Breaking sleep apnea down even further by gender approximately twenty-four percent of men suffer from the sleep disorder while the percentage for women is nine percent. Women who have not entered menopause yet are less likely to suffer from sleep apnea than are women who are presently experiencing menopause or women who have already gone through it. However after menopause women are approximately as likely as men to develop sleep apnea.

Obstructive sleep apnea is the most common of all sleep disorders. It is estimated that half of the patients who suffer from sleep apnea also suffer from loud, habitual snoring and are overweight. According to the National Commission on Sleep Disorders Research, approximately 38,000 deaths occur on an annual basis that relate to cardiovascular problems that in one way or another are connected to sleep apnea. These problems include high blood pressure, hypertension and stroke, among others. An estimated six million American residents suffer from sleep apnea that is moderate to severe and may necessitate a late night visit to the e=emergency room. Unfortunately a great many people do not, as previously mentioned, even realize that they suffer from sleep apnea. This number is somewhere around 500,000 individuals.

Of the men and women that suffer from sleep apnea, approximately four percent of men and two percent of women meet what is deemed as the “diagnostic criteria” for the sleep disorder, which averages an estimated ten bouts of apnea (or apneic events or episodes) in the course of an hour while they sleep.