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Sleep apnea solutions that lower cardiovascular risks

cpap sleep apnea solutions
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Devices to treat nighttime breathing problems may help lower blood pressure and reduce the harm to your heart.

Peaceful slumber is often a pipe dream for people with obstructive sleep apnea. More than 25 million Americans have this problem, in which the tongue or throat tissue temporarily blocks the airway during sleep. The resulting pauses in breathing (called apneas) lead to explosive snoring or gasping for breath—sometimes more than 30 times per hour.

These recurrent episodes often cause daytime sleepiness and raise the risk of cardiovascular problems. “The nightly stress of not breathing causes repeated surges in blood pressure, which damages the lining of the blood vessels and disrupts your insulin, glucose, and lipid levels,” says Dr. Susan Redline, the Peter C. Farrell Professor of Sleep Medicine at Harvard Medical School. These changes can lead to clogged arteries and poor heart muscle function. Sleep apnea has also been linked to the heart rhythm disorder known as atrial fibrillation.

Positive airway pressure (PAP)

The gold standard for treatment of sleep apnea is continuous positive airway pressure (CPAP) therapy, which involves wearing a face mask connected to a small machine via a lightweight tube. The machine delivers a stream of pressurized air into your nose or mouth that prevents your airway from collapsing.

However, many people who try CPAP therapy find it uncomfortable or awkward and don’t stick with it. To help over-come these barriers, PAP devices have become more sophisticated over time. For people who find it hard to exhale against the pressure of CPAP, a refinement called bilevel PAP may be easier to use. It delivers air under higher pressure as you inhale and switches to a lower pressure during exhalation to make it easier for you to breathe out. AutoPAP machines take this improvement a step further by including an internal regulator that adjusts the pressure up or down to deliver the lowest level of pressure possible. Here are other tips to make these devices easier to use:

  • Obtain the device from a sleep specialist, who can coach you in its use.

  • If the mask irritates your skin, ask about special moisturizers for CPAP users.

  • If the mask irritates your nose, try nasal pillows, which fit into the nostrils and take pressure off the bridge of the nose.

  • If your nose gets stuffy, ask whether nasal sprays or surgery might help correct the problem.

  • If you breathe through your mouth at night, a full-face mask to cover both nose and mouth plus a chin strap may work best for you.

Oral and nasal appliances

People who have milder sleep apnea or are unable to use a PAP therapy may be able to get help from a dental device similar to a sports mouth guard that opens the airways by positioning the lower jaw slightly forward and down. Although not as effective for people with severe sleep apnea, these appliances can help treat sleep apnea and lower blood pressure when used consistently over time, says Dr. Redline.

Other devices include Provent, which features nose plugs that create pressure when air is exhaled, and Winx, which sucks the tongue forward to keep the airway open. However, not much is known about the long-term effectiveness of these therapies.

Upper airway stimulation

The Inspire device, approved by the FDA in 2014, tackles the condition with a new technique known as hypoglossal nerve stimulation. The unit consists of a generator implanted in the upper chest, similar to a pacemaker. An internal wire connects to a nerve on the underside of the tongue. The system continuously monitors your breathing as you sleep and applies mild stimulation to the upper airways to move the tongue and other tissues out of way if breathing becomes obstructed. Because it requires a small surgical procedure, the device is currently approved only for people who can’t get relief through PAP therapy. However, says Dr. Redline, early research looks promising in terms of both resolving sleep apnea and improving quality of life, so it may be more widely used in the near future.

Do you have sleep apnea?

To assess your risk for sleep apnea, go online to MyApnea.org, a national network aimed at improving sleep apnea diagnosis and treatment, and click on “Check your risk now.” If you’re worried you might have apnea, ask your doctor about a home overnight sleep study, which can confirm the problem. Learning to sleep on your side and losing weight can improve sleep apnea; so can treating nasal stuffiness, getting more exercise, and avoiding alcohol near bedtime.

Posted by: Dr.Health

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