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| ==Overview== | | ==Overview== |
| Secondary prevention of sleep apnea involves lifestyle changes, continuous positive airway pressure (CPAP), placement of an oral device. These methods reduce the severity of sleep apnea on the patient. | | Secondary prevention of sleep apnea involves lifestyle changes. These methods reduce the severity of sleep apnea on the patient. |
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| ==Sleep Apnea Secondary Prevention== | | ==Sleep Apnea Secondary Prevention== |
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| *Reduce sedative use | | *Reduce sedative use |
| *Smoking cessation | | *Smoking cessation |
| *Sleeping on side if sleeping position supine | | *Possibly owing to changes in pulmonary oxygen stores, sleeping on one's side (as opposed to on one's back) has been found to be helpful for central sleep apnea with [[Cheyne-Stokes respiration]].<ref name="pmidpmid16944673">{{cite journal| author=Szollosi I, Roebuck T, Thompson B, Naughton MT| title=Lateral sleeping position reduces severity of central sleep apnea / Cheyne-Stokes respiration. | journal=Sleep | year= 2006 | volume= 29 | issue= 8 | pages= 1045-51 | pmid=pmid16944673 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16944673 }} </ref> |
| *Optimize treatments that may exacerbate sleep apnea e.g. asthma, allergic rhinitis
| | *Optimize treatments that may exacerbate sleep apnea e.g. [[asthma]], [[allergic rhinitis]] |
| *Assess risk for hypertension, diabetes cardiovascular disease, cerebrovascular disease, or renal disease
| | *Assess risk for [[hypertension]], [[diabetes]], [[cardiovascular disease]], [[cerebrovascular disease]], or [[renal disease]] |
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| ===Continuous positive airway pressure===
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| *For moderate to severe sleep apnea, [[CPAP]] therapy is extremely effective in reducing apneas and less expensive than other treatments
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| *It 'splints' the patient's airway open during sleep by means of a flow of pressurized air into the throat
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| *The patient typically wears a plastic facial mask, which is connected by a flexible tube to a small bedside CPAP machine<ref name="cpap-machines">[http://www.cpap-machine-reviews.com General Information about Sleep Apnea Machines]</ref>
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| *The CPAP machine generates the required air pressure to keep the patient's airways open during sleep
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| *Many patients refuse to continue the therapy or fail to use their CPAP machines on a nightly basis because they find it uncomfortable<ref name='Hsu2003'>{{Cite journal|author=Hsu AA, Lo C |title=Continuous positive airway pressure therapy in sleep apnoea |journal=Respirology |volume=8 |issue=4 |pages=447–54 |year=2003 |month=December |pmid=14708553 |doi=10.1046/j.1440-1843.2003.00494.x}}</ref>
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| *One way to ensure [[CPAP]] therapy remains comfortable for patients is to ensure the CPAP face mask fits well
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| *It is not clear that CPAP reduces [[hypertension]] or cardiovascular events in patients who do not have daytime sleepiness; however, the lack of benefit may be partly due to [[Compliance (medicine)|noncompliance]] with therapy<ref name="pmid22618923">{{cite journal |author=Barbé F, Durán-Cantolla J, Sánchez-de-la-Torre M, ''et al.'' |title=Effect of continuous positive airway pressure on the incidence of hypertension and cardiovascular events in nonsleepy patients with obstructive sleep apnea: a randomized controlled trial |journal=JAMA |volume=307 |issue=20 |pages=2161–8 |year=2012 |month=May |pmid=22618923 |doi=10.1001/jama.2012.4366 |url=http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.2012.4366}}</ref>
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| ===Oral appliances===
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| *Mandibular Advancement Splint
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| :*A oral appliance placed by general dentists
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| :*A custom-made mouthpiece that shifts the lower jaw forward and opens the bite slightly, which opens up the airway
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| :*Oral appliance therapy (OAT) is usually successful in patients with mild to moderate obstructive sleep apnea<ref>{{Cite journal|author=Machado MA, Juliano L, Taga M, de Carvalho LB, do Prado LB, do Prado GF |title=Titratable mandibular repositioner appliances for obstructive sleep apnea syndrome: are they an option? |journal=Sleep & Breathing |volume=11 |issue=4 |pages=225–31 |year=2007 |month=December |pmid=17440760 |doi=10.1007/s11325-007-0109-y}}</ref>
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| :*OAT is a relatively new treatment option for sleep apnea in the United States, but it is much more common in Canada and Europe
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| ===Alternative Therapies===
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| *Strengthening the muscles around the upper airway may combat sleep apnea | |
| :*A 2009 study published in the American Journal of Respiratory and Clinical Care Medicine found that patients who practiced a series of tongue and throat exercises for 30 minutes a day showed a decline in sleep apnea symptoms after three months. Patients experienced an average of 39% fewer apnea episodes after successfully completing the treatments.<ref>{{cite journal |author=Guimarães KC, Drager LF, Genta PR, Marcondes BF, Lorenzi-Filho G |title=Effects of oropharyngeal exercises on patients with moderate obstructive sleep apnea syndrome |journal=Am. J. Respir. Crit. Care Med. |volume=179 |issue=10 |pages=962–6 |year=2009 |month=May |pmid=19234106 |doi=10.1164/rccm.200806-981OC |url=http://ajrccm.atsjournals.org/cgi/pmidlookup?view=long&pmid=19234106}}</ref>
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| :*A 2001 study investigated changes after Tongue Muscle Training (ZMT®) in respiratory parameters during night-time sleep of patients with increased respiratory disease index. The apnea, hypopnea and desaturation indexes were reduced in 26 of the 40 patients (65%) by an average of approximately one half.<ref>Gessmann HW et al: The Tongue Muscle Training (ZMT®) in nCPAP Patients with Obstructive Sleep Apnea Syndrome (OSAS). PIB Publisher Duisburg, Germany 2001</ref>
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| ==References== | | ==References== |
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| {{Reflist|2}} | | {{Reflist|2}} |
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| [[Category:Sleep disorders]] | | [[Category:Cardiology]] |
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| [[Category:Pulmonology]] | | [[Category:Pulmonology]] |
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