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Devices, procedures can relieve sleep apnea

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Canada AM: Dr. Jeffrey Lipsitz, sleep expert
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Date: Tue. Mar. 20 2007 9:55 AM ET

Sleep apnea, the condition in which sleepers actually stop breathing for a few seconds at a time, can be more than just annoying. It can leave a sufferer feeling tired all the time from continual waking. And left untreated, the sleep disorder can actually lead to high blood pressure, heart attacks or strokes.

Sleep expert Dr. Jeffery Lipsitz of the Sleep Disorders Centre of Metropolitan Toronto says there are a number of effective treatments for the condition. First among them is weight loss.

Obstructive sleep apnea is most common among those who are overweight. So the most effective treatment is to lose weight to reduce the extra fat around the throat. Even a weight loss of just 10 per cent can make a difference.

"That's probably the most effective thing that we can do before we get into more heavy duty treatments for sleep apnea," Lipsitz told Canada AM.

A sleep expert may also recommend apnea sufferers avoid alcohol and medications that relax the central nervous system, such as sedatives and muscle relaxants, and quit smoking.

Lipsitz says there are also procedures and devices that can help both with apnea and its annoying related effect, snoring. Sleep apnea is often referred to as the 'snoring disease' because most people diagnosed with it snore regularly.

One is called the Pillar procedure. It involves implanting small rods into the soft palate at the back of the roof of the mouth. Airflow in the back of the mouth can cause loose palatal tissue to flutter or vibrate causing snoring, or the tissue can collapse and obstruct the upper airway causing apnea. The Pillar implants are designed to add structural support and stiffen the soft palate tissue, thereby reducing or eliminating this tissue flutter, vibration or collapse.

"It's the fluttering that causes the snoring," says Lipsitz. "And so it seems to be very effective at reducing the snoring. It's not entirely clear how effective it is for sleep apnea, but certainly there's a role for snoring."

The Pillar procedure is done in the office of an ear, nose and throat specialist, under local anesthetic.

There are also a couple of dental appliances that people who have sleep apnea or who snore can use. They're custom-made appliances that have the effect of holding the lower jaw forward slightly while you sleep.

"For anyone who snores, if you're lying in bed and have nothing better to do, put your thumbs behind the angles of the jaw and push forward. You find when you advance your lower jaw it's harder to make the snoring noise," says Lipsitz.

Some of dental devices fit inside your mouth, much like an athletic mouth guard or orthodontic appliance. Others fit around your head and chin to adjust the position of your lower jaw.

"They're quite effective in treating snoring and sleep apnea," says Lipsitz.

The gold standard for sleep apnea is an air pump device called a C-PAP, which stands for Continuous Positive Airway Pressure.

"They're simply air delivery systems," explains Lipsitz. "It has motors that will deliver regular room air -- not oxygen -- under a slight pressure, into the upper airway through a nasal mask."

Older versions of the device used a full mask to cover the nose and mouth. Newer versions simply sit over the nose so it's much more comfortable. Newer versions are also quieter than their predecessors.

Many CPAP units are also able to track hourly usage and produce detailed data for your doctor. Some machines can also keep track of mask leaks and snoring. Depending on the model, users may be able to download this information to a computer or store it on a data card.

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Canada AM Sleep Special

Dr. Jeffery Lipsitz

Sleep apnea often goes undiagnosed

Many of us wake up tired every day. The problem may be sleep apnea -- a condition many of us don't even know we have.

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