By Benjamin Macapugay

Causes and treatments of sleep apnea

(This article is provided for general informational purposes only. It should not be considered as a substitute for medical treatment or advice from a qualified physician. You should consult your doctor for any medical needs.)

Lou and his wife used to joke about it. “I come from a family of snorers,” he explained. “I warned my wife before she married me, so she had no excuse! Maria knew what she was getting into!” They used to joke how it was a good thing that they used to live near a train track so the sound of the trains at night would block out Lou’s snoring.

But as time went on, Lou noticed that he started to feel more and more fatigued during the day. “Around my late 30s, I started to feel tired all the time, even when I made sure to go to bed early the night before,” he said. “I would look in the mirror, and I looked way older than I was. It didn’t feel normal.” His wife noticed this before he did.

“At night his snores would stop, and his breathing would stop, like he was choking,” she said. “And then he would gasp for air, like a plug was pulled out of his throat. It was scary.”

What Lou and Maria would eventually learn was that Lou was exhibiting the classic symptoms of obstructive sleep apnea syndrome (OSA). Simply put, sleep apnea is when a person’s breathing becomes interrupted when his or her airway is blocked during sleep. If a person has an unusually thick neck, or large tonsils, or even a larger than usual tongue, these can fall into a person’s airway as their muscles relaxed during sleep, cutting off the flow of air to the lungs. The disrupted sleep and breathing typically results in fatigue, headaches, irritability, excessive sweating during sleep, and general difficulty in concentrating or focusing for the sufferer. These symptoms can even lead to depression, cardiovascular disease and sexual dysfunction. In children, OSA can lead to bedwetting, fatigue, and difficulty in school.

OSA occurs in both men and women, but tends to affect more men. The young and old can be affected, but more often so in adults. Obesity can increase the occurrence of OSA, as can smoking, diabetes and high blood pressure.

Of course, if you suspect that you might suffer from OSA, you should consult a physician. He or she may prescribe that you undergo a sleep study, either at a sleep lab or at your home, where you would be monitored during sleep to track your breathing patterns, oxygen levels, brain activity, eye movements and heart rate. A physician can make a proper diagnosis based on the collected data.

Sometimes, the treatment of OSA can be as simple as changing the position that that you take when you sleep. Sometimes losing weight can alleviate the symptoms. In some extreme cases, the specialist may even suggest surgery to keep the patient’s airway open. Or, it may be determined that the best way to treat the patient is with a continuous positive air pressure machine (CPAP). The CPAP regulates the air pressure around the patient’s airway to keep it open via a mask that the patient wears on his or her face. While these machines have proven to be effective tools for treating OSA, they are not fool-proof. Sometimes it can be tricky to get a proper fit with the mask, and some patients have complained about excessive discomfort from wearing them, making sleep difficult.

An alternative to the CPAP is Inspire Therapy, a clinical treatment for OSA recently approved by the FDA. Unlike the CPAP which is worn externally, Inspire Therapy is a miniaturized system fully implanted in the patient’s body. A breathing sensor and a stimulation lead are placed in the body to sense when the patient’s breathing pattern is interrupted during sleep, and then apply appropriate stimulation to the muscles around the patient’s airway to keep them open. These are powered by a tiny generator, which is also placed within the patient’s body. The whole system is controlled by a hand-held remote.

“We believe that this therapy represents a major advance in sleep apnea treatment, especially for vulnerable patients who cannot achieve benefit from CPAP,” said Dr. Brian Weeks of Alvarado Hospital, the first San Diego physician trained to offer this procedure and the only physician offering it currently. “Inspire therapy provides us with an effective new treatment to use in a select group of our CPAP-intolerant patient population.”

—Benjamin Macapugay is regional manager of marketing and communications for Alvarado Hospital and Paradise Valley Hospital.