Diagnosis and Treatment
Sleep apnea comes in varying degrees of severity and from a variety of causes. Accordingly, there are several different therapeutic options specifically designed to treat each individual patient most effectively. But the first step is to get a proper diagnosis.
If you and your doctor suspect that you may have sleep apnea, he or she may first refer you to a Sleep Disorders Center for a sleep test. Sleep Disorders Centers are staffed by physicians and technicians specifically trained in sleep disorders medicine. The physicians who direct the sleep labs are usually pulmonologists or neurologists. Pulmonologists deal primarily with the lungs and airways and are therefore well suited to help patients who have problems breathing while they are asleep. Neurologists have experience reading electroencephalograms (EEGs) and are therefore able to identify sleep stages and associated abnormalities. In some instances a psychiatrist, anesthesiologist, or ear-nose-throat surgeon may also be involved with diagnosing sleep disorders.
Sleep Disorders Centers are located within hospitals or at independent ambulatory centers. Study rooms are equipped with computerized systems for data collection and recording.
The usual tests include:
- Electroencephalogram (EEG)
- Electrocardiogram (EKG)
- Pulse oximetry
Proper diagnosis will usually require the use of an airflow sensor, respiratory effort sensors, a body position sensor, a microphone, and a video camera. These devices record many different values while you sleep. After the sleep test is over, your physician will review the measured values and may diagnose you with sleep apnea or Obstructive Sleep Apnea (OSA).
Your physician may determine that your sleep test can be performed at home. A home monitor can be used to record heart rate, how air moves in and out of the lungs, the amount of oxygen in the blood, and breathing effort.
If you have been diagnosed with sleep apnea, it’s time to take an important next step: appropriate treatment.
Treatment options may include:
- Nasal CPAP or BiLevel PAP
- Weight reduction
- Dental appliances
The most common treatment, and the treatment that is widely accepted as the most effective for OSA, is CPAP (pronounced “See-pap”). CPAP stands for Continuous Positive Airway Pressure. As the name implies, the CPAP device uses a blower to deliver a constant level of air pressure through a hose that attaches to the nose. This air pressure travels down the nose to the throat to prevent obstruction. In effect, the extra air acts like a splint to hold the airway open and allow for normal breathing. The amount of air pressure can be adjusted according to the severity of OSA and other personal factors.
For those who have difficulty breathing out against the CPAP pressure, an alternative is BiLevel PAP. BiLevel PAP allows for the pressure that the client exhales against to be lowered, which improves comfort while maintaining enough pressure to keep the airway open.
Click here for a list of sleep equipment available from Apria.
When a patient begins using a CPAP/BiLevel machine, the results are almost always immediate and improvement in quality of life is often quite dramatic. In fact, experts agree that the mainstay of OSA treatment is CPAP, while complaints — such as dry nose, mask discomfort or blower noise — are minimal and easily remedied.1
Only patients who have received CPAP treatment for their OSA can truly attest to the dramatic change in lifestyle they have experienced.
Good news. Yes, sleep disorders can interfere with your quality of life and keep you from attaining your goals, no matter how hard you try. But the good news is that with successful treatment of your sleep disorder you may:
- Improve your quality of life
- Add more years to your life
- Greatly reduce the risk of having a heart attack
- Greatly reduce the risk of having a stroke
- Improve your blood glucose levels
- Avoid falling asleep while driving
- Wake up refreshed each morning
- Wake up without a headache
- Be more intelligent and alert
- Have better relationships with those close to you
- Stop feeling depressed
- Lose weight much more easily
- Have more fun and enjoyment in life
- Have interest in and enjoy a better sex life
- Generally be back in control of your life
- Pagel, James, et al. Obstructive Sleep Apnea: Recognition and Management in Primary Care. Supplement to The Journal of Family Practice. August 2008, Vol. 57. No. 8.