Hello again gt06-ga!
Thank you for requesting me for this research. I?m glad that you like
the last answer. This question was a bit more difficult to research
than I originally anticipated, but I was able to find quite a bit of
information about sleep apnea and its treatments. This answer is not
intended to substitute for the opinion of a qualified health
professional that you trust. If you have any specific concerns or
questions you should discuss them with him or her.
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TYPES OF SLEEP APNEA
There are essentially three types of sleep apnea: Obstructive Sleep
Apnea (OSA), Central Sleep Apnea (CSA), and Mixed Sleep Apnea. The
last type is a form of sleep apnea that has characteristics of both
OSA and CSA. The treatment of Mixed Sleep Apnea involves a combination
of treatments used for OSA and CSA. These are described later in my
answer.
?[OSA is] he most common type of sleep apnea. [It is] Caused by a
breathing obstruction, which stops the airflow in the nose and mouth.
. . .
[CSA is] a much less common type of sleep apnea. The brain signal that
instructs the body to breathe is delayed. This central nervous system
disorder can be caused by disease or injury involving the brainstem,
such as a stroke, a brain tumor, a viral brain infection, or a chronic
respiratory disease. . . .?
http://www.helpguide.org/life/sleep_apnea.htm#Sleep_apnea_types
?Obstructive sleep apnea (OSA) affects primarily men between the ages
of 30 and 50. It occurs when air passage in the upper respiratory
tract becomes obstructed during sleep (obstruction is caused by soft
tissue of the pharynx relaxing and blocking the flow of air). It
prevents breathing until low levels of oxygen in the blood cause a
person to respond by waking up and taking a deep, snorting breath.
Being overweight or having a small tongue or mouth can contribute to
the obstruction. In children enlarged tonsils or adenoids are the most
common cause of obstruction.
Central sleep apnea is a rare type of sleep apnea where the region of
the brain and nerves that regulate breathing do not function normally
and cause breathing to be impaired. It can be caused by head injury or
stroke.?
http://www.doctorsforadults.com/topics/dfa_slee.htm
?The two previously known types of sleep apnea include obstructive
sleep apnea and central sleep apnea. In obstructive sleep apnea, the
more common form, the throat muscles relax and the airway is narrowed,
momentarily cutting off breathing and resulting in noisy snoring. With
central sleep apnea, the brain does not send proper signals to the
muscles that control breathing. The newly discovered type, complex
sleep apnea, is a combination of both obstructive and central sleep
apneas.
Patients with complex sleep apnea at first appear to have obstructive
sleep apnea and stop breathing 20 to 30 times per hour each night. But
unlike typical obstructive sleep apnea patients, their breathing
problem is not completely alleviated by a CPAP (continuous airway
pressure) machine, which functions like a pneumatic splint to open a
patient's airway. Instead, once the CPAP is applied to complex sleep
apnea patients, the obstruction seems to dissipate, but still they do
not breathe properly. Symptoms of central sleep apnea then appear and
fragmented sleep results, due to frequent pauses in breathing.?
http://www.medicalnewstoday.com/medicalnews.php?newsid=51105
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EFFECTS OF SLEEP APNEA
Regardless of the type of apnea, the ultimate effects are the same for
each. The key lies in determining the type of sleep apnea so that a
patient can undergo appropriate treatment.
?Because of the serious disturbances in their normal sleep patterns,
people with sleep apnea often feel very sleepy during the day and
their concentration and daytime performance suffer. The consequences
of sleep apnea range from annoying to life-threatening. They include
symptoms suggesting depression, irritability, sexual dysfunction,
learning and memory difficulties, and falling asleep while at work, on
the phone, or driving. Untreated sleep apnea patients are 3 times (or
more) likely to have automobile accidents; CPAP treatment reverses the
increased risk. It has been estimated that up to 50 percent of sleep
apnea patients have high blood pressure. It has recently been shown
that sleep apnea contributes to high blood pressure. Risk for heart
attack and stroke may also increase in those with sleep apnea.?
http://www.sleepfoundation.org/sleeplibrary/index.php?secid=&id=61
Here is a list of problems commonly associated with sleep apnea patients.
* Hypertension
* Insulin resistance
* Metabolic syndrome
* Oxidative stress
* Sudden death
http://www.emedicine.com/neuro/topic419.htm
?In rare cases, apnea can be fatal. Think about it: is something that
makes you stop breathing something you consider to not be dangerous?
It has also been linked to high blood pressure and to increased
chances of heart disease, stroke, and irregular heart rhythms
(arrhythmias). Unfortunately, not all of the long-term effects of
untreated sleep apnoea are known, but specialists generally agree that
the effects are harmful. If nothing else, the continual lack of
quality sleep can affect your life in many ways including depression,
irritability, loss of memory, lack of energy, a high risk of auto and
workplace accidents, and many other problems.?
http://www.newtechpub.com/sleep/apnea/faq/index.html#danger
?The effects of sleep apnea on major health conditions are currently
under debate. Among the problems that have been associated with this
sleep disorder are the following:
* High blood pressure
* Stroke
* Heart attack
* Heart failure
* Pulmonary Hypertension
* Diabetes
* Kidney failure?
http://www.reutershealth.com/wellconnected/doc65.html
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TREATMENT OPTIONS
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OBSTRUCTIVE SLEEP APNEA (OSA)
Because OSA is by far the most common type of sleep apnea, most
treatment options are aimed at OSA. Here are a number of references
discussing potential treatments for OSA.
Behavioral or ?self-help? treatments are the first things that a
patient can try. These include:
* Weight loss
* Eliminating tobacco, alcohol, and sedatives (such as sleeping pills)
* Sleeping on your side
* ?Stabilizing? sleep routine (i.e., go to bed at the same time each
night, try to sleep for a consistent number of hours, etc.)
* Learning to play the didgeridoo.
?Swiss medical scientists found that regular playing of the didgeridoo
(an Australian wind instrument) improved snoring, sleep apnea, and
daytime sleepiness, and reduced sleep disturbances to bedroom
partners. The reason for this improvement may be that training to play
the didgeridoo decreased the collapsibility of the upper airways.?
http://www.helpguide.org/life/sleep_apnea.htm#Sleep_apnea_treatment
Here is another article about didgeridoo playing as a treatment for OSA.
http://www.laoutback.com/images/parts/SnoringPopUp.html
?A custom-fit plastic mouthpiece will be made by a dentist or
orthodontist. . . . The mouthpiece will adjust your lower jaw and your
tongue to help keep the airway in your throat open while you are
sleeping. Air can then flow easily into your lungs because there is
less resistance to breathing.?
http://www.nhlbi.nih.gov/health/dci/Diseases/SleepApnea/SleepApnea_Treatments.html
Surgery is an option for many people with OSA. There are a number of
different surgeries used in OSA, so your physician can determine which
would be most appropriate.
* Tonsillectomy, if the tonsils are enlarged enough to cause the obstruction.
* Uvulopalatopharyngoplasty (UPPP) removes the tonsils, uvula (the
tissue hanging from the back of the roof of your mouth), and a portion
of the soft palate.
* Laser-assisted uvulopalatoplasty (LAUP) uses laser to remove the
uvula and part of the soft palate. It can stop snoring, but may not
stop OSA.
* Tracheostomy is used in patients with severe OSA. A hole is made in
the windpipe through which a tube is inserted. This is basically a
?last resort? used when all else has failed.
* Rebuilding the lower jaw
* Surgery on the nose
* Surgery to treat obesity
http://www.nhlbi.nih.gov/health/dci/Diseases/SleepApnea/SleepApnea_Treatments.html
The following website has links to articles discussing various
surgical options for treating OSA.
http://www.entcolumbia.org/osa.htm
?Oxygen and medications may have adjunctive roles in the treatment of
obstructive sleep apnea in some patients. They rarely are used as
primary treatments.
Oxygen therapy is only partially effective. Although it helps to treat
the oxyhemoglobin desaturation that occurs with some respiratory
events, it does not reverse obstruction. When supplemental oxygen is
used, apneas occur less frequently but may last longer.28 Oxygen
therapy may be useful in patients for whom no other treatments are
acceptable, but carbon dioxide retention is a risk in patients with
severe underlying lung disease.
Because of fatigue and sleep deprivation, depression is a common
complication of obstructive sleep apnea. Protriptyline (Vivactil) is a
tricyclic antidepressant that depresses rapid eye movement (REM)
sleep, the period during which the most significant apneas often
occur. However, the drug is not used often because of its
anticholinergic side effects. A large number of newer antidepressants
also decrease REM sleep and, thus, have the potential to improve sleep
apnea. As yet, however, no clear evidence supports their use.?
http://www.aafp.org/afp/20040201/561.html
HolisiticOnline.com has an article listing a few ?alternative?
treatments for OSA. These include:
* Exercise and weight loss
* Homeopathy (Lachesis and Homeopathic Opium)
* Herbal treatment (specifically Vervain)
* Serotonin
* Behavioral techniques (breathing exercises, sleep positioning,
avoiding alcohol and tobacco)
http://holisticonline.com/Remedies/Sleep/sleep_apnea_alternative.htm
?Few drug-based treatments of obstructive sleep apnea are known
despite over two decades of research and tests.
Oral administration of the methylxanthine theophylline (chemically
similar to caffeine) can reduce the number of episodes of apnea, but
can also produce side effects such as palpitations and insomnia.
Theophylline is generally ineffective in adults with OSA, but is
sometimes used to treat Central Sleep Apnea, and infants and children
with apnea.
When other treatments do not completely treat the OSA, drugs are
sometimes prescribed to treat a patient's daytime sleepiness or
somnolence. These range from stimulants such as amphetamines to modern
anti-narcoleptic medicines. The anti-narcoleptic modafinil is seeing
increased use in this role as of 2004.?
http://en.wikipedia.org/wiki/Sleep_apnea
There are a number of purported treatments for OSA that attempt to
stop snoring, with the thinking that eliminating snoring will improve
respiratory effort, and then improve the sleep and the symptoms of
sleep apnea. This site has lists of homeopathic products available to
help with snoring/OSA.
http://www.putanendtosnoring.com/pills.htm
Here is another link from the same site discussing other alternative
treatments, including hypnosis, magnet therapy, acupressure and more.
http://www.putanendtosnoring.com/hypnosis.htm
The following link is to an abstract discussing the use of
San?o-shashin-to, a product used in Kampo, the Japanese form of
traditional Chinese medicine. In this case report, researchers show
clinical data supporting the use of this product in sleep apnea.
(http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10459719&dopt=Abstract
Another herbal combination product used in treating OSA is a product
called Snoreless.
?[It] helps stop snoring and clinical studies on Snoreless' ability to
help sleep apnea is very impressive. Clinical studies in China showed
that taking Snoreless showed 72% effectiveness on sleep apnea patients
and an additional 24% had improvement.?
This site claims that Snoreless:
* Helps correct abnormal secretions of the throat.
* Helps increase secretion of fluid from trachea membrane, the roots
of the tongue and soft palate
* Improves circulation in the small vessels of the respiratory center
* Helps the larynx tissue area shrink, reducing mechanical obstruction
Here is a list of substances included in Snoreless:
Leonurus japonicus Houtt
Arctium Lappa L
Ligusticun chaunxiong Hort.
Platycodon grandiflorus
Glycyrrhiza urulensis Fish.
Boswellia carterii Birdw.
Mentha canadaensis L.
http://www.herbalhealer.com/newsletters/n1104.html
Here is a Chinese herbal combination aimed at treating snoring and
OSA. It contains:
* Fructus Arctii
* Radix Cynanchi Atrati
* Cadix Glycyrrhizae
* Radix Boehmeriae
* Radix Aucklandiae
* Herba Schizonepetae
* Caulis Bambusae in Taeniam
* Rhizoma Polygonati
* Gypsum Fibrosum
http://www.herbchina2000.com/therapies/JSN.shtml
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CENTRAL SLEEP APNEA (CSA)
CSA is not as common as OSA, and available treatments are more
limited. Here is a list of possibilities from the Mayo Clinic website.
* Treatment for associated medical problems (such as neuromuscular disorders)
* Oxygen
* CPAP machine
* Bilevel PAP machine. The air pressure increases during inhalation to
strengthen weak respiratory muscles.
* Adaptive Sero-ventilations (ASV). This machine records breathing
data and then ?automates? respiration while you sleep, mimicking
normal breathing patterns.
http://www.mayoclinic.com/health/sleep-apnea/DS00148/DSECTION=8
CSA is usually due to some other medical condition (like stroke),
oxygen deprivation, medication interaction, and the like. For this
reason, the primary treatment is to treat the underlying cause.
?In adults with central sleep apnea, the apneas are treated by
treating the underlying heart disease, medication interaction, high
altitude, or other primary problem.?
http://www.medicinenet.com/sleep_apnea/page2.htm#tocd
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SUMMARY
The most consistently used treatment for OSA is CPAP. While the
machine can be operated independently by the patient, without direct
intervention from any physician or medical professional, obtaining the
machine in the United States is only possible with a doctor?s order or
prescription. Other ?aggressive? treatments such as surgery obviously
require a physician to perform this procedure. Lifestyle modification,
behavior techniques, homeopathy, herbal supplements, and other
?alternative? treatments can be used without a medical professional?s
recommendation or prescription, but nearly all sites that I found
recommended that patients who have sleep apnea seek out professional
medical advice because of the serious implications of the disease.
Again, if you have specific concerns or questions, be sure to discuss
them with a qualified health practitioner that you trust.
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I truly wish you well in what you pursue and I applaud your commitment
and drive in finding answers. I think it?s great when patients take a
stand for their own health. I hope that you find this information
useful! If you have any need of further clarification, please let me
know how I can help.
Sincerely,
Boquinha-ga
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