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This article is not medical advice. It is intended for general informational purposes and is not meant to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. If you think you may have a medical emergency, immediately call your physician or dial 911.
What Causes Sleep Apnea
Obstructive sleep apnea is caused by a blockage of the airway, usually when the soft tissue in the rear of the throat collapses during sleep. Central sleep apnea is usually observed in patients with central nervous system dysfunction, such as following a stroke or in patients with neuromuscular diseases like amyotrophic lateral sclerosis . It is also common in patients with heart failure and other forms of heart, kidney or lung disease.
Hypothyroidism And Sleep Apnea: Can Your Thyroid Be Causing Sleep Apnea
Your thyroid plays a major role in your daily life. The hormones it creates regulate important bodily functions like your heart rate, body temperature, metabolism, and your breathing. When your thyroid secretes too much or too little of these key hormones, it can cause sleep apnea along with other sleeping disorders.
Hypothyroidism means your thyroid doesnt produce enough thyroxine. Without enough of this hormone, you may have swelling of your thyroid, weight gain, and loss of strength in the muscles that help you breathe properly all of which can lead to sleep apnea.
Sleep apnea and hypothyroidism share many symptoms so if youre already diagnosed with hypothyroidism, you might just chalk any exhaustion, apathy, weight gain, mood swings, or lack of concentration you may have experienced up to a hormonal imbalance. Thats why a sleep apnea test is important for thyroid patients that are having trouble sleeping at night.
In this article, you will learn about hypothyroidism, its common symptoms, how to find out if you have sleep apnea, and how these conditions are treated.
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Upper Airway Surgery For Sleep Apnea
If you have exhausted other sleep apnea treatment options, surgery to increase the size of your airway may be a possibility.
The surgeon may remove tonsils, adenoids, or excess tissue at the back of the throat or inside the nose, reconstruct the jaw to enlarge the upper airway, or implant plastic rods into the soft palate. Surgery carries risks of complications and infections, and in some rare cases, symptoms can become worse after surgery.
Lifestyle Treatments For Sleep Apnea
For mild cases of sleep apnea, lifestyle changes may be enough to treat the issue. Your doctor will let you know if thats the right starting point. But even if you are prescribed a medical treatment, the following changes can help reduce your sleep apnea episodes and improve your sleep.
Lose weight. If you are overweight, losing weight can have an enormous impact. While it is usually not a total cure, it can reduce the number of breathing episodes you experience, reduce your blood pressure, and decrease daytime sleepiness. Even a small amount of weight loss can open up your throat and improve sleep apnea symptoms.
Exercise. Even when exercise does not lead to weight loss, it can decrease your sleep apnea breathing episodes and improve your alertness and energy during the day. Aerobic exercise, resistance training, and yoga are all good choices for strengthening the muscles in your airways and improving breathing.
Sleep on your side. Lying on your back is the worst position for sleep apnea, as it causes the jaw, tongue, and other soft tissues to drop back toward the throat, narrowing your airway. Sleeping on your stomach isnt much better, since lying face down or twisting your head to the side both obstruct breathing. Lying on your side, on the other hand, helps keep your airway open. If you find side sleeping uncomfortable or you tend to roll on to your back after youre asleep, countered side pillows or body pillows may help.
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Tips To Improve Health And Comfort
Choose a CPAP device with a built-in humidifier. Most devices now include a built-in humidifier, which helps prevent the dryness and skin irritation that can sometimes occur.
If youre experiencing nasal congestion, you may prefer a full-face mask over a nasal or nasal pillow mask. Also be sure to keep your humidifier tank full, keep your tubing and mask clean, and make sure your filter is clean. Nasal sprays and antihistamines also help.
Keep your device clean. Its very important to clean your CPAP hose, nosepiece or mask, and humidifier tub regularly, as a dirty CPAP device can cause infections and even pneumonia. Your sleep doctor and device manufacturer will give you detailed cleaning instructions.
To ensure maximum comfort, ask your doctor about soft pads to reduce skin irritation, nasal pillows for nose discomfort, and chinstraps to keep your mouth closed and reduce throat irritation and dry mouth.
Mask the sound of the CPAP machine. Most new CPAP devices are quiet, but if the sound of your CPAP machine bothers you, try placing it beneath the bed and using a sound machine to muffle the noise.
Medical Insurance For Oral Appliance Therapy
Although a dentist will be placing your customoral appliance, the great news is that oral appliances are generally covered under your health insurance plan, not your dental plan. Prior to treatment, you or your dentist may want to contact your health insurance, directly, for an estimate of insurance coverage. Due to variations in medical insurance plans, coverages do vary.
Medicare provides reimbursement for oral appliances for those 65 or older under the durable medical equipment benefit. In order to help Medicare patients with a portion of the reimbursement for oral appliances, many dentists around the country have enrolled as Medicare DME Suppliers for oral appliance therapy for obstructive sleep apnea.
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What Are The Risk Factors Of Untreated Sleep Apnea
While not common, untreated sleep apnea can lead to serious complications. Its therefore important to seek immediate treatment from a dentist near you if you experience any symptoms of sleep apnea.
Usually, medical treatment involves addressing the underlying conditions or/and preventing breathing disruptions when sleeping. If untreated, sleep apnea can cause complications such as:
Medications Available For People With Excessive Sleepiness
Although there are many medications available for people with excessive sleepiness, they are often recommended along with other types of treatments, therapies, and behavior modifications. The following are commonly prescribed medications for patients with EDS:
Consult your physician before starting or stopping any medication. Ensure they are fully aware of your health history, including allergies, and physical, and mental health diagnoses. Also, share with them any other medications, herbal supplements, or over-the-counter drugs you take, as these could interfere with your prescribed medication.
If you receive a prescription to treat excessive daytime sleepiness, carefully follow the directions provided by your physician and pharmacist. Avoid any potentially dangerous activities such as driving until you are sure of how the medication affects you.
Remember that these medications can have a variety of side effects. Take note of any side effects you experience and report them to your physician. In the case of an emergency, seek immediate medical attention.
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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, its 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.
Key Points About Obstructive Sleep Apnoea
See your GP as soon as possible if you feel very sleepy during the day while driving or your job involves operating machinery or aircraft.
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Adjusting To Oral Appliance Therapy
Since custom made oral appliances are adjustable, your dentist will work with you to maintain your jaw position by continuously monitoring your progress. It is important to maintain a prescribed follow-up schedule with your dentist to ensure the device is working, fitting properly and that you see an improvement in your symptoms. It usually takes only a few days to adjust to wearing the oral appliance all night while sleeping. Your dentist will review the details with you as well as the best way to maintain your oral appliance at home.
What Medications Are Similar
Although there are other medications that affect dopamine and norepinephrine in the brain, Sunosi is the only medication in the DNRI drug class that helps improve wakefulness in people with OSA and narcolepsy.
Experts generally recommend medications as second-line or add-on therapy options for OSA. Using a CPAP machine is a common treatment choice for OSA. However, if excessive daytime sleepiness is still an issue after a month of CPAP use, then Sunosi can be a potential add-on option.
Sunosi is also not the first treatment choice for narcolepsy. Modafinil a brain stimulant that is thought to work by raising dopamine levelsis often the initial option. However, a 2019 study suggests that the differences in side effects are minimal between Sunosi and modafinil. Although further research is necessary, Sunosi might become another first-choice treatment option for narcolepsy in the futuredepending on more data.
In addition to modafinil, the two other similar medications to help decrease excessive daytime sleepiness in people with narcolepsy are:
Since all of these medications influence similar brain chemicals, they are not usually taken together. If you have any questions, please talk with your healthcare provider.
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What Is Sunosi Used For
The Food and Drug Administration approved Sunosi to help improve wakefulness in people with OSA or narcolepsy.
However, Sunosi is not the first-choice treatment for OSA. The FDA recommends treatment with continuous positive airway pressure for at least a month. Then, if people with OSA still have severe daytime sleepiness, they may start taking Sunosi in addition to using CPAP therapy.
Obstructive Sleep Apnea
There are different types of sleep apnea. In OSA, individuals struggle to breathe because of relaxing soft tissue in the back of the throat that blocks the movement of air. So, people with OSA tend to experience the following symptoms:
- Trouble breathing
- Loud snoring with periods of silence followed by gasps
- Daytime sleepiness
- Trouble concentrating
Like OSA, there are also different types of narcolepsytype 1 and type 2. In both types, daytime sleepiness is a common symptom. Sunosi is indicated for use to reduce excessive daytime sleepiness in people with narcolepsy.
Since Sunosi only improves wakefulness, however, some people with narcolepsy might take additional medications for other symptoms.
In addition to EDS, other symptoms of narcolepsy include:
Verywell / Zoe Hansen
Diagnosing And Treating Sleep Apnea For Better Health
Its 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 apneasuch 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 . 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
- 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 youre 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.
Not very relaxing, right? Luckily, its treatable.
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Sleep Hygiene And Excessive Daytime Sleepiness
A broad, nonpharmacologic step everyone with EDS can take is improving sleep hygiene. Proper sleep hygiene can lessen the effects of sleep-related disorders and promote overall health and wellbeing. To improve sleep hygiene:
- Ensure the sleep environment is dark, cool, and quiet
- Use the bed only for sex and sleep
- Exercise regularly during daytime hours
- Reduce consumption of alcohol, caffeine, and drugs
- Establish a consistent and relaxing bedtime routine, free from electronics whose bright screens emit light which includes the blue wavelengths
- If you cannot sleep after 20 minutes of lying in bed, get out of bed and find a quiet, relaxing activity until you are sleepy
Continuous Positive Airway Pressure
This is the most effective treatment for moderate or severe obstructive sleep apnoea syndrome. It may be used to treat mild sleep apnoea if other treatments are not successful. This treatment involves wearing a mask when you sleep. A quiet electrical pump is connected to the mask to pump room air into your nose at a slight pressure. The slightly increased air pressure keeps the throat open when you are breathing at night and so prevents the blockage of airflow. The improvement with this treatment is often very good, if not dramatic.
If CPAP works then there is an immediate improvement in sleep. Also, there is an improvement in daytime well-being, as daytime sleepiness is abolished the next day. Snoring is also reduced or stopped. The device may be cumbersome to wear at night but the benefits are usually well worth it. Comments like “I haven’t slept as well for years” have been reported from some people after starting treatment with CPAP.
Lifelong treatment is needed. Sometimes you can have problems with throat irritation or dryness or bleeding inside you nose. However, newer CPAP machines tend to have a humidifier fitted which helps to reduce these problems.
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Try Using The Ramp On Your Machine
When you use the ramp on your sleep apnea equipment, your CPAP machine starts out at a lower pressure and gradually increases until it reaches your set pressure. Using this gradual technique can increase your comfort level, as well as help you get used to wearing your mask each time you put it on.
Always make sure to talk to your doctor before making any changes to your CPAP routine. Since the side effects of sleep apnea outweigh the CPAP side effects of using a CPAP mask and machine, its important to find a solution so you can wear your CPAP comfortably and consistently.
How To Spot The Symptoms Of Sleep Apnea
- Gasping or choking during sleep
- Experiencing pauses when you breathe at night
- Mood issues
- Waking up throughout the night to go to the bathroom
If you have any of these symptoms, or have newly-diagnosed atrial fibrillation and high blood pressure with or without daytime sleepiness, its important to talk to your doctor about the possibility of sleep apnea, says Mendez. Women often have insomnia but not snoring, and some people get tipped off that they might have a sleep problem because of an activity tracker like a Fitbit, he says. Bottom line: Be open to the possibility of sleep apnea, even if you dont think you present in the typical way.
If your doctor suspects you have sleep apnea, he or she can then order you an at-home sleep apnea test, which eliminates the need to go to a sleep center to be analyzed, says Mendez. Its far more convenient and accessible to patients. Getting this test could potentially be a lifesaving decision, he says.
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