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    Exploring Oral Appliance Therapy and Mouth Taping for Obstructive Sleep Apnea Treatment

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    Obstructive sleep apnea (OSA) is a prevalent sleep disorder that affects millions of people worldwide. Characterized by repeated interruptions in breathing during sleep, OSA can lead to a variety of health complications, including cardiovascular issues, fatigue, cognitive decline, and a diminished quality of life. While Continuous Positive Airway Pressure (CPAP) therapy remains the gold standard for treating OSA it is too often intolerable to use.  I am not against the use of CPAP, it can be a great treatment for many people, but unfortunately half the people that try CPAP cannot sleep with it for a variety of reasons.  If you can’t sleep with CPAP, you are not the “world’s biggest looser” – you are a member of a big club!  In addition, we understand there are thousands of people (maybe more) that will not even get tested for OSA because CPAP is the only treatment know and they do not want to try it.  In terms of the ability to open the airway during sleep, the next best treatment for OSA is Oral Appliance Therapy (OAT) – and it’s another non-surgical approach that is far more tolerable than CPAP. For most patients OAT treats their OSA as well as CPAP, but for others it reduces their OSA but leaves some residual OSA and/or symptoms untreated.  To optimize treatment with OAT other modalities can be added based on patient preference, problems and medical necessity to optimize treatment. Today’s blog will discuss adding Mouth Taping to OAT – we will talk about other adjunctive modalities, like nasal patency, lateral sleep aides, etc in another blog.

    Oral Appliance Therapy (OAT)

    What is Oral Appliance Therapy?

    Oral Appliance Therapy involves wearing a custom-fitted device in the mouth during sleep. These devices are designed to keep the airway open by repositioning the jaw and tongue forward during sleep. OAT is more effective for people with mild to moderate OSA but can also be used for those with severe OSA if they cannot tolerate CPAP or refuse to try one.  For others, it’s a great alternative treatment for travel, or when they are in places that make their CPAP difficult to use. Sometimes the more tools in the toolbox the better!

    How Does OAT Work?

    The primary mechanism behind OAT is the advancement of the lower jaw (mandible) and the stabilization of the tongue in a more forward position. By moving the jaw and tongue forward, oral appliances prevent the soft tissues in the throat from collapsing and blocking the airway during sleep. This leads to a more unobstructed breathing pathway, reducing apneas (total closures) and hypopneas (partial closures).

    Benefits of OAT:

    • Comfort and Convenience: Oral appliances are small, portable, and easy to wear, making them more comfortable than bulky CPAP machines.
    • Improved Compliance: Studies show higher long-term adherence rates with OAT compared to CPAP, largely due to its non-invasive nature and increased comfort
    • Non-Invasive: Unlike surgery, OAT does not involve any permanent alterations to the airway structure, making it a low-risk option.
    • Custom-Fit: These appliances are tailored to fit each patient, ensuring a snug and effective treatment.
    Woman with tape on her mouth.

    Mouth Taping for OSA

    What is Mouth Taping?

    Mouth taping is a technique where a piece of hypoallergenic tape is placed over the mouth to encourage nasal breathing during sleep. If you Google mouth taping you will find hundreds of specifically designed tapes. The theory behind mouth taping is simple: by keeping the mouth closed, individuals are forced to breathe through their nose, which can help reduce airway collapse.  In addition, it can also help prevent that dry mouth feeling during the night (because breathing through your mouth creates that dry mouth).

    Mouth Taping alone rarely treats OSA

    However, mouth taping can be a useful adjunctive therapy to use with your oral appliance or with CPAP.  Please only use mouth taping under the guidance of your healthcare practitioner.

    How Does Mouth Taping Help?

    Mouth taping helps mitigate sleep apnea symptoms by promoting nasal breathing. Breathing through the nose has multiple benefits for OSA sufferers:

    • Nasal breathing activates the diaphragm, which leads to deeper, more stable breaths.
    • The nose filters and humidifies air, making breathing smoother and less prone to obstruction.
    • Mouth breathing can lead to snoring and throat relaxation, which may exacerbate OSA symptoms.
    • By keeping your mouth closed and breathing through your nose your airway will stay slightly more “inflated” during sleep – thus helping to reduce airway collapse which is the “apnea”.

    It is important to note that mouth taping should be done cautiously and under professional guidance.  Mouth taping needs to be done using a relatively weak adhesive that so that it is easily removed and it always has to be done so that you can still breathe through you mouth if your nose gets clogged during sleep.

    Benefits of Mouth Taping:

    • Non-Invasive: No equipment or devices are needed other than a small piece of tape.
    • Inexpensive: Mouth taping is a low-cost option compared to other treatments.
    • Improves Sleep Quality: Promoting nasal breathing can lead to fewer sleep interruptions and better overall sleep quality.

    Downsides:

    • Not a Standalone Solution for OSA: Studies show mouth taping alone is unlikely to treat sleep apnea effectively, even mild OSA.
    • Risk of Nasal Obstruction: Those with nasal congestion or structural issues, like a deviated septum, may struggle with mouth taping.
    • Discomfort: Some users may find the sensation of having their mouth taped shut uncomfortable or claustrophobic.

    Combining OAT and Mouth Taping: A Holistic Approach

    As we discussed above, for some patients, although the use of oral appliance therapy improves their OSA, residual OSA or symptoms persist.  This dual approach can potentially improve the effectiveness of treatment by addressing multiple factors that contribute to OSA.

    A study performed in our office in conjunction with the Brigham and Women’s’ Hospital/Harvard Medical School showed that the use of both together can improve the efficacy of treatment for some patient (https://www.atsjournals.org/doi/10.1513/AnnalsATS.202109-1050OC). You will not know until you try!          

    Before combining treatments, however, it is crucial to consult with a healthcare provider or sleep specialist. They can help determine the best course of action based on the severity of the apnea and individual needs.

    Conclusion

    Oral Appliance Therapy and mouth taping represent two alternative treatment options for people struggling with OSA, especially for those who cannot tolerate CPAP. While OAT is backed by robust clinical evidence and is widely recognized as an effective treatment for OSA, mouth taping is still relatively new in the OSA treatment space but shows promise as an adjunct therapy. Both options have their benefits and potential downsides, and individual results will vary. Consulting with a healthcare provider is essential to determine the most appropriate treatment based on the severity of your condition.

    If you or a loved one suffer from sleep apnea, consider exploring these alternatives as part of a comprehensive treatment plan that can improve your sleep quality and overall health.

    Disclaimer: Always consult with a licensed healthcare provider before making any changes to your sleep apnea treatment plan.

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    Energy Drinks Linked to Poor Sleep Quality, Insomnia Among College Students

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    Original Article | Chelsie Derman

    Male college students were found to consume more energy drinks than female college students, and they had a greater risk for a short sleep duration due to energy drink consumption.

    College students may consume energy drinks to stay alert, but the beverage may make people sleepier—a new study found energy drinks are linked to poor sleep quality and insomnia among college students.1,2

    “Even small amounts of [energy drinks] had an impact on sleep where daily [energy drinks] consumption increased the risk of sleep problems across all parameters for both sexes,” wrote the investigators.

    A study, led by Siri Kaldenbach, from the Innlandet Hospital Trust, in Lillehammer, Norway and the department of clinical medicine at the University of Oslo in Oslo, Norway, sought to investigate the frequency of energy drink consumption and the association between energy drink consumption and sleep characteristics in Norwegian college and university students. They also evaluated whether males or females consumed more energy drinks and how energy drinks affected their quality of sleep.

    The investigators conducted a cross-sectional study and obtained data from the Students’ Health and Wellbeing Study 2022 (SHOT2022), a national survey. The survey, comprised of mental health and lifestyle questions, was distributed electronically between February 8 – April 19, 2022, to full-time Norwegian students. The study included 53,266 students enrolled in higher education in Norway, aged 18 – 35 years (mean age: 24 years) with 66.4% women.

    The survey evaluated energy drink consumption, with the option of daily, 4-6 times a week, 2-3 times a week, 1 time per week, 1-3 times per month, and seldom/never. The survey also assessed sleep-related questions, and students reported usual bedtime and bed-rise time. The investigators evaluated sleep onset latency and wake after sleep onset.

    Of the participants, 4.7% of men and 3.3% of women reported consuming energy drinks daily. Moreover, men were associated with consuming more energy drinks than women. Women (49.6%) were more likely than men (39.6%) to never or seldom consumed energy drinks.

    Additionally, 5.5% of women reported consuming energy drinks 4 -6 times a week and 3.3% consumed them daily. In contrast, 7.8% of men consumed energy drinks 4-6 times a week with 4.7% consuming the drinks daily.

    Kaldenbach and colleagues observed a larger frequency of energy drink consumption was linked to sleep pattern issues such as sleep onset latency and wake-after-sleep onset. The strongest association was observed between daily energy drink consumption and short sleep duration, with men (risk ratio [RR], 2.07; 95% CI 1.77 – 2.42) exhibiting a greater risk of short sleep duration than women (RR, 1.87; 95% CI 1.64 – 2.14).

    Investigators called attention to an association between energy drink consumption and insomnia. Among women, insomnia was present among 51% reporting energy drink consumption compared to 33% among those who never or seldom consumed energy drinks. Among men, insomnia was present among 37% reporting energy drink consumption compared to 22% among those who never or seldom consumed energy drinks.

    “Most of the associations between [energy drinks] and sleep were similar for male and female students but with a few notable exceptions,” investigators wrote. “For bedtime and risetime, we observed a significantly stronger effect for men compared with women.”

    Because of the observational design, the investigators stated they could not infer causality. Moreover, the team said did not know what time the energy drink was consumed or the specific amount of the beverage—they only had access to the frequency of energy drink consumption—so that could have affected results. Another limitation, as pointed out by the team, was the “modest response rate” of 35.1% and limited information about the participants who did not complete the survey other than their age and sex.

    “The results from the current study show that there is a robust association between the frequency of [energy drinks] consumption and the different sleep parameters,” investigators wrote. “Identifying modifiable risk factors for sleep problems among college and university students is vital and our results suggest that the frequency of [energy drinks] consumption could be a possible target for interventions.”

    References

    1. Kaldenbach S, Hysing M, Strand TA, et al. Energy drink consumption and sleep parameters in college and university students: a national cross-sectional study. BMJ Open 2024;14:e072951. doi:10.1136/ bmjopen-2023-072951
    2. Energy Drinks Linked to Poor Sleep Quality And Insomnia Among College Students. EurekAlert! 2024. https://www.eurekalert.org/news-releases/1031709?. Accessed January 22, 2024.
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    Philips Suspends U.S. Sales of Breathing Machines After Recall

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    Original Post | New York Times

    Under a settlement with regulators, the company must revamp some operations before resuming sales of its CPAP and ventilator devices in the United States.

    Philips Respironics announced on Monday that it would halt sales of all of its breathing machines in the United States after reaching a settlement with the Food and Drug Administration over continuing problems with the devices.

    Millions of the company’s ventilators and CPAP machines, used to ease breathing at night, were recalled after reports that they blew bits of foam and potentially toxic gases into consumers’ airways.

    Under the settlement, Philips said it would have to meet a list of standards in a “multiyear” plan before it could resume business in the United States. The company said further details would be disclosed when the agreement was finalized in court. But it added that it would continue to repair existing devices and provide service for people using them.

    The company initially began the recall of millions of devices in June 2021 and paused sales of new sleep therapy machines to the United States, according to Steve Klink, a spokesman for Philips. At the time, the company and the F.D.A. cited the potential for serious injury or permanent impairment from the potentially cancer-causing chemicals emitted from the devices.

    The company has since released results of additional testing, saying the devices were “not expected to result in appreciable harm to health in patients,” and it said it was continuing to conduct tests. The F.D.A. has pushed back on some of the company’s updated claims, and at one point called them “unpersuasive.” Philips has also faced continuing scrutiny and undertaken more recalls in its attempts to upgrade the devices.

    Dr. Jeff Shuren, director of the F.D.A.’s device division, said the agency could not comment until the agreement was finalized and filed with the court.

    The initial recall affected about 15 million breathing machines produced since 2006, though roughly five million were still in circulation in mid-2021.

    With replacements not immediately available, the recall caused confusion and upset for many doctors and patients. Many struggled to weigh the risk of continuing to use a faulty device against the peril of sleeping with impaired breathing.

    Millions of people suffer from sleep apnea, or interrupted breathing, which is associated with elevated rates of strokes, heart attacks and possible cognitive decline. Recalled machines included CPAP, or continuous positive airway pressure, machines; BiPap devices; and ventilators.

    Philips, which is based in Amsterdam, disclosed that it had reached an agreement, or a consent decree, that was brokered with the U.S. Justice Department and the F.D.A., along with the announcement of its fourth-quarter earnings. The company said it wrote down about 363 million euros related to the cost of completing the settlement requirements. Its stock, which trades in the United States, was down about 7 percent Monday morning.

    The company said it would continue to sell its products in other countries.

    Thousands of patients have since sued Philips, claiming that the machines led to a wide range of respiratory and other ailments, including allegations of deaths from lung cancer. In September, the company reached a $479 million settlement with plaintiffs that was meant to cover the financial losses related to repairing or replacing the machines. Litigation over illnesses and medical costs is still pending.

    Christina Jewett covers the Food and Drug Administration. She is an award-winning investigative journalist and has a strong interest in how the work of the F.D.A. affects the people who use regulated products. More about Christina Jewett

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    Dangers of Uncontrolled Sleep Apnea

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    Original Article | JohnsHopkins.org

    You’ve probably heard that regular exercise and a heart-healthy diet are the most important things you can do for your cardiovascular health. As it turns out, though, the quality of sleep you receive is also critical to your heart’s wellbeing. 

    In particular, undiagnosed sleep apnea is directly tied to an increased risk in cardiovascular and metabolic health. The scariest part? You might not even know you have this very common problem.

    “Sleep apnea happens when upper airway muscles relax during sleep and pinch off the airway, which prevents you from getting enough air. Your breathing may pause for 10 seconds or more at a time, until your reflexes kick in and you start breathing again,” explains Jonathan Jun, M.D. , a pulmonary and sleep medicine specialist at the Johns Hopkins Sleep Disorders Center.

    Sleep apnea occurs in about 3 percent of normal weight individuals but affects over 20 percent of obese people, Jun says. In general, sleep apnea affects men more than women. However, sleep apnea rates increase sharply in women after menopause. Sleep apnea is often linked to heart disease and metabolic issues like diabetes.

    What are the signs of sleep apnea?

    There are two kinds of sleep apnea: obstructive sleep apnea and central sleep apnea. Obstructive sleep apnea happens when air can’t flow into or out of the nose or mouth, although you’re trying to breathe. Central sleep apnea happens when the brain fails to send the right signals to your muscles to make you start breathing. (This type is less common.)

    “Sleep apnea may be noticed more by the bed partner than by the sleeper,” says Jun. “Your bed partner might notice that your breathing pauses, or they may complain of your loud snoring.”

    That said, snoring itself—though annoying—isn’t the same as sleep apnea. Snoring is just the vibration sound created by airway resistance. You can snore loudly and not have sleep apnea, and you may even have sleep apnea without much snoring.

    People with sleep apnea might also suffer from unexplained fatigue and mood swings, because their breathing interruptions continually wake them and prevent them from settling into a deep, nourishing sleep.

    The consequences can be significant, Jun says. “We’re talking about car accidents in the daytime, lost productivity at work, mood swings, waking up feeling groggy and falling asleep in class.”

    Other sufferers might wake up with a dry mouth, since sleep apnea tends to make you breathe with an open mouth, drying out your saliva. Some awaken with a headache, which may be caused by low oxygen or high carbon dioxide levels during sleep.

    How is Weight Control Linked to Sleep Apnea?

    “Weight control is very important. There are many studies showing that losing weight can either completely cure you of sleep apnea or at least make it less severe,” Jun says.


    Sleep apnea, cardiovascular risk and metabolism

    Several studies have shown an association between sleep apnea and problems like type 2 diabetes , strokes , heart attacks and even a shortened lifespan, says Jun. Why this connection? For one thing, obesity is common in sleep apnea patients, and obesity greatly increases risks of diabetes, stroke and heart attack, he says. “In most cases, obesity is the main culprit behind both conditions,” Jun explains.

    Still, it’s important to note that not everyone with sleep apnea is obese. Furthermore, evidence suggests an independent link between sleep apnea and diabetes. “Our lab and others have shown that sleep apnea is associated with higher risks of diabetes, independent of obesity, and that sleep apnea can increase blood sugar levels,” says Jun.

    For people who are overweight or obese, weight loss is key for treating or avoiding sleep apnea. People who accumulate fat in the neck, tongue and upper belly are especially vulnerable to getting sleep apnea. This weight reduces the diameter of the throat and pushes against the lungs, contributing to airway collapse during sleep.

    Women in particular should be careful as they age. While premenopausal women tend to put on weight in the hips and in the lower body instead of the belly, this shifts with time. Weight begins to accumulate in traditionally “male” areas like the tummy, and this leads to a greater chance of sleep apnea.

    “After menopause, hormones change and women tend to start looking like men in terms of where the weight gets put on. It’s a time to be paying attention to the risks of sleep apnea because women begin to catch up to men in the rates of apnea after menopause,” Jun says.15

    Diagnosing and treating sleep apnea for better health

    It’s important to treat sleep apnea, because it can have long-term consequences for your health. While there have been some high-profile deaths linked to sleep apnea—such as with Judge Antonin Scalia —Jun says that the true risk is from damage done over time.

    Obstructive sleep apnea can range from mild to severe, based on a measurement system called the apnea-hypopnea index (AHI). The AHI measures the number of breathing pauses that you experience per hour that you sleep.

    Obstructive sleep apnea is classified by severity:

    • Severe obstructive sleep apnea means that your AHI is greater than 30 (more than 30 episodes per hour)
    • Moderate obstructive sleep apnea means that your AHI is between 15 and 30
    • Mild obstructive sleep apnea means that your AHI is between 5 and 15

    Whether or not you need treatment for sleep apnea depends on its severity, whether or not you have symptoms such as sleepiness and other health conditions. For example, if you have risk factors for heart disease, your doctor might opt to treat you even for mild sleep apnea. On the other hand, if you have a severe case of sleep apnea, your doctor might insist on treatment even if you’re not sleepy.

    The main choice of therapy is a breathing device called a CPAP, or continuous positive airway pressure machine. A CPAP machine pipes humidified air through the nose, which creates air pressure to keep your throat open while asleep. This prevents pauses in breathing.

    “CPAP is the first-line treatment, and it’s very effective,” Jun says. A recent Johns Hopkins study looked at what happens to metabolism at night when sleep apnea patients don’t wear their CPAP. The study found that the resulting apnea caused a spike in blood sugar, heart rate, blood pressure and stress hormones—a response similar to what might happen if you were asked to get up in front of a crowd to speak. “It’s very similar to that type of a stress response,” says Jun. “I would liken sleep apnea to something like that happening on a nightly basis.”

    CPAP is not the only alternative.

    Many cannot tolerate the CPAP machine and are able to obtain the help they need from a Sleep Apnea Dental Specialist. Their use of an oral appliance has helped hundreds of thousands resolve their medical issues as they pertain to Sleep Apnea.

    Get the Medical Equipment You Need at Home

    Many studies show that regular use of CPAP or oral devices reduces blood pressure and improves wakefulness during the day. People with sleep apnea who use sleep apnea therapeutic devices also report improved quality of life. In some observational studies that compare people with apnea who seek sleep apnea remedies versus those who don’t, those seeking treatment have lower risk of stroke and heart attack and lower blood glucose, Jun notes.

    If you or your partner has noticed signs of sleep apnea, visit your doctor. A sleep specialist can order a sleep apnea test, which uses equipment to monitor your breathing and oxygen levels while you sleep. Often, you’ll visit a laboratory to spend the night for monitoring. Other times, it’s possible to use a portable, take-home kit. You’ll rest easier knowing the results.

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    Sleeping five hours or less increases risk of chronic illnesses, study warns

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    Original Article | By Judy Packer-Tursman

    Getting a good night's sleep of more than five hours can help older people avoid developing multiple chronic illnesses, a new study suggests. Photo by Wokandapix/Pixabay

    Getting a good night’s sleep of more than five hours can help older people avoid developing multiple chronic illnesses, a new study suggests. Photo by Wokandapix/Pixabay

    Oct. 18 (UPI) — Older people who get five hours of sleep a night or less may face a far greater risk of developing two or more chronic illnesses, such as heart disease, cancer or diabetes, compared to people who sleep longer, a new study suggests.

    The research, published Tuesday in the journal PLOS Medicine, tracked the impact of sleep duration on the health of more than 7,000 men and women at the ages of 50, 60 and 70.

    This was done via a 25-year follow up of participants in the Whitehall II cohort study involving members of the British civil service.

    The British and French researchers, led by University College London, found that sleeping for five hours or less at the ages of 50, 60, and 70 was linked to a 30% to 40% increased risk of developing multiple chronic diseases versus people who slept for up to seven hours.

    The investigators also examined the relationship between each participant’s length of nightly sleep and mortality. They found that nightly sleep that lasted five hours or less at age 50 was associated with a 25% increased risk of death over the 25 years of follow-up.

    This is primarily because short sleep duration increases the risk of chronic illness that in turn increases the risk of death, the release said.

    The scientists also analyzed whether sleeping for nine hours or more affected health outcomes, but they found no clear link between this sleep duration and developing chronic diseases for healthy people at age 50.

    RELATED Getting enough sleep key to a healthy immune system

    However, for those individuals already diagnosed with a chronic condition, such long sleep was associated with roughly a 35% increased risk of developing another illness, possibly due to underlying health conditions affecting sleep, they said.

    “As people get older, their sleep habits and sleep structure change. However, it is recommended to sleep for seven to eight hours a night — as sleep durations above or below this have previously been associated with individual chronic diseases,” Séverine Sabia, the study’s lead author said in the release.

    A researcher/epidemiologist at University College London’s Institute of Epidemiology & Health and at Inserm, Université Paris Cité, Sabia advised having good sleep hygiene, such as ensuring the bedroom is quiet, dark and a comfortable temperature before going to bed.

    RELATED Going to bed too early or sleeping too much can increase dementia risk, study says

    She also suggested avoiding large meals before bedtime.

    The study used self-reported data on sleep, which the researchers noted is likely to be subject to reporting bias.

    Sponsors of the research included the National Institute on Aging, a part of the National Institutes of Health, the U.K. Medical Research Council and the British Heart Foundation.

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    Sleep Apnea. Bad for Your Brain.

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    Original Article | BottomLine INC
    Chris Iliades, MD is a regular contributor to Bottom Line Health. He was an ear, nose, throat, head, and neck surgeon before becoming a full-time medical writer.

    According to the American Heart Association and the American Academy of Neurology, obstructive sleep apnea (OSA) is bad for brain health. Studies show that OSA causes cognitive impairment, which is the loss of your brain’s ability to remember, think, concentrate, learn, and make decisions.

    Sleep Apnea

    What happens during OSA?

    In people with OSA, the oral or nasal airway collapses during sleep and breathing stops for a short period. This is called apnea. Blood oxygen levels decrease and carbon dioxide levels increase. Rising carbon dioxide triggers your brain to wake you up enough to breathe. Almost everyone with OSA snores, usually loudly, so a sleeping partner may hear loud snoring followed by quiet, and then sudden gasping for air. In mild-to-moderate OSA, there may be between five and 30 episodes per hour. In severe OSA, these instances can occur more than 30 times per hour.

    A 2021 study reported at the American Academy of Neurology annual meeting showed that people with OSA were 60 percent more likely to score in a lower range on cognitive testing than people without it. The worse the OSA, the worse the cognitive decline. The average age of study participants was about 70.

    Further, OSA increases the risk of heart attack, stroke, heart arrhythmia, high blood pressure, and type 2 diabetes.

    Are you at risk?

    The American Heart Association estimates that OSA may affect close to 40 percent of U.S. adults and up to 80 percent of people with cardiovascular disease. It is more common in men and in people who are overweight. You could be at higher risk if you have a family history of OSA. Other risk factors include smoking, drinking alcohol, taking sleeping pills, and having any type of narrowing of the nasal or oral airway, like a deviated nasal septum or large tonsils or adenoids.

    Reduce risk, improve health

    Lowering risk can be as simple as exercising. An important study presented at the 2021 meeting of the American Heart Association showed that exercise reduces the risk of both OSA and cognitive decline.

    In the study, 47 patients with varying degrees of cognitive loss were tested for a cognition score. Half of the patients were given a six-month-long supervised exercise program. After six months, the exercise group had fewer OSA episodes, a 32 percent improvement in their cognitive scores, and better glucose metabolism in the brain.

    In addition to exercise, lifestyle changes that reduce the risk or improve symptoms of OSA include not drinking, not smoking, and losing weight. Sleeping on your side and propping up your upper body during sleep may also reduce OSA. In some cases, surgery can be used to correct a deviated septum or remove tonsils and adenoids if they are contributing to OSA.

    Diagnosis

    Mark Twain said, “There ain’t no way to know why a man can’t hear himself snore,” but there is a way to find out if you have sleep apnea. If your sleeping partner describes periods of snoring and apnea, or you wake up groggy with a headache and feel sleepy all day, you should have a sleep study.

    During the sleep study, you spend a night in a sleep lab, where specialists called polysomnographers document sleep apnea and grade the severity. Sleep study kits you can use at home are now available, so you may not need to spend the night sleeping in a laboratory.

    Treatment

    For mild sleep apnea, lifestyle changes, sleeping position, and sometimes an oral appliance that keeps your tongue from blocking your oral airway may be all you need. For more severe OSA, the treatment of choice is CPAP. During CPAP treatment, you wear a mask while you sleep that provides humidified oxygen through your nose to force open your airway. It is very effective but takes some getting used to, and you may need to experiment with different types of masks, levels of air pressure, and humidification devices to find the most comfortable option.

    A new technology called hypoglossal nerve stimulation may eliminate the need for CPAP for some people who can’t tolerate it. With this treatment, a pacemaker implanted in the chest stimulates the hypoglossal nerve to open the back of the throat.

    OSA is that it is both common and dangerous. If you have the symptoms, tell your doctor and get OSA under control now. Your brain and your sleeping partner will thank you.