4 Things to note about sleep apnea and CPAP

The snoring of a bed companion is among the noises that no one likes to hear. That sharp, rasping sound, however, may sometimes be more dangerous than merely bothersome. Obstructive sleep apnea (OSA), a disorder that really interferes with breathing, is connected to heart disease, and may even be deadly, affects around half of the 90 million Americans who snore. What’s more, you may not even be aware that you have the disorder.

Unsurprisingly, a lot of individuals don’t seek sleep apnea treatment for snoring since they don’t consider it to be a serious problem. Or they do, but they don’t want to participate in an overnight lab sleep test (which is how OSA is typically diagnosed). Or they fear that if they get a diagnosis of OSA, they will need to adopt the most popular and famously uncomfortable form of treatment: a continuous positive airway pressure machine, or CPAP.

Additionally, there is rising uncertainty among many people with OSA regarding whether or not they should even use a CPAP because one firm recently had to recall some of their CPAP machines.

We consulted Yale’s Center for Sleep Medicine director Henry Yaggi, MD, MPH, a pulmonologist, and Andrey Zinchuk, MD, MHS, the head of Yale’s Advanced Apnea Management Program, to help sort out the muddle.

They worked with us to compile a list of seven essential facts concerning CPAP technology advancements, alternative OSA therapies, and obstructive sleep apnea.

1. Definition of obstructive sleep apnea

The most prevalent kind of sleep apnea, in which your breathing regularly stops and begins while you are asleep, is called obstructive sleep apnea. Additionally, central apnea occurs when the brain fails to appropriately control breathing. and combined obstructive and central apneas, known as mixed apnea.

When you’re sleeping, the muscles at the back of your throat relax to the point where they might constrict or shut due to OSA. As you attempt to breathe while you’re asleep, you can snore, snort, or make other sounds. Your blood oxygen level may drop as a consequence of the air loss, which may cause your brain to give you a signal to get up.

Some OSA sufferers have hundreds of bouts of halted or interrupted breathing each night, whether or not they are aware of it, and this may have a significant negative influence on their quality of life throughout the day.

2. CPAP machines have seen advancements

A little history. The “gold standard” for treating sleep apnea, the CPAP machine, is designed to control breathing while you sleep. However, it is infamously seen as unpleasant and doesn’t work for certain individuals because of this.

A tube connecting a CPAP machine, which is approximately the size of a tissue box and contains a motor, to the mask you wear over your mouth and nose. While you sleep, the machine softly breathes air down the tube and then into your airways via a mask. A sleep tech may modify the machine to ensure that the mask fits comfortably and that the optimum quantity of air is being blown through. According to Dr. Zinchuk, “there are as many masks as there are shoes, and we can typically locate the correct one for each individual.”

Both Drs. Yaggi and Zinchuk concur that modern CPAPs are “better,” with more comfortable masks, automated pressure adjustment capabilities, built-in modems that provide data to the doctor, and bi-directional capabilities that let techs make modifications remotely. However, according to Dr. Zinchuk, “the gadget is still fundamentally the same. We’re attempting to get rid of the items that discourage users from utilizing it. However, the underlying idea remains the same.

3. Contextualizing the latest CPAP recall

The most recent recall of certain CPAP equipment is one issue that may be on people’s minds right now. Due to possible health dangers, one CPAP manufacturer, Phillips Respironics, voluntarily recalled a number of ventilators, BiPAP, and CPAP equipment in June 2021.

The polyurethane foam with a polyester basis that is utilized in these devices to lessen noise and vibration might degrade, according to the Food and Drug Administration (FDA). If this happens, the individual using the gadget could ingest or breathe in black foam fragments or other invisible substances. These problems may cause major damage that may be life-threatening and need medical attention to avert irreversible harm.

The findings of the tests indicate that emissions drop down after the first usage of the device, therefore the real danger is unknown, despite the fact that these particles may possibly have harmful or carcinogenic consequences.

Some people may ask how to calculate their personal risks in light of this. According to the FDA, discontinuing use of the recalled or repaired device may carry a higher risk for certain patients than keeping it in use. Dr. Zinchuk says that many individuals may not need to cease using their Respironics device, particularly those [with serious diseases] who depend on ventilators at home for survival or those who have severe sleep apnea and symptoms.

It is essential to examine the advantages and disadvantages of continuing or discontinuing CPAP treatment with your sleep specialist.

A list of commonly asked questions about the recall is available from the FDA, and Philips also has a toll-free hotline with a Spanish language option at 877-907-7508.

4. Alternatives to CPAP are offered as therapies.

For individuals who cannot tolerate the CPAP machine, there is good news: According to Drs. Yaggi and Zinchuk, there have been advancements made to different sleep apnea therapies, and some patients may find that these are more effective (a sleep study may aid with this).

• For mild instances of OSA, lifestyle modifications are the initial line of defense. This might include giving up or limiting alcohol use, decreasing weight, and giving up smoking.
• Your doctor may prescribe oral appliances, which are something you put in your mouth to keep your airways open. They function by moving the jaw forward and resemble retainers. They prevent the tongue and other tissues from falling back into the airway while the wearer is lying down.
• By strengthening weak muscles that contribute to sleep apnea (such as those in the tongue and throat), doing upper airway exercises may help some patients eventually go without the need of a CPAP machine. According to Dr. Yaggi, think of it as respiratory physical therapy.
• Sleeping on your stomach or side as opposed to your back might help you breathe more easily. There are several tools available to support maintaining a secure posture.
• Surgery, including routine treatments on the palate (the soft tissue in the back of your mouth and throat) or the nose, tongue, or other facial organs, may be helpful. The surgical insertion of a pacemaker-sized device called the hypoglossal nerve stimulator is one viable CPAP substitute.

Two incisions are necessary to insert the device: one on the right chest wall and one in the neck, below the jaw line. A generator is connected to two electrodes, one of which is fastened to the portion of the hypoglossal nerve that regulates tongue propulsion forward and the other of which is positioned in the space between the rib muscles. The hypoglossal nerve is stimulated while the respiration is monitored by the gadget. By doing this, the upper airway muscles are able to maintain the airway open. You don’t need a mask.