Sleep apnea secondary prevention
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Saarah T. Alkhairy, M.D.
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.
Sleep Apnea Secondary Prevention
Lifestyle Changes
- Weight loss
- Reduce alcohol
- Reduce sedative use
- Smoking cessation
- Sleeping on side if sleeping position supine
- Optimize treatments that may exacerbate sleep apnea e.g. asthma, allergic rhinitis
- Assess risk for hypertension, diabetes cardiovascular disease, cerebrovascular disease, or renal disease
Continuous positive airway pressure
- For moderate to severe sleep apnea, CPAP therapy is extremely effective in reducing apneas and less expensive than other treatments
- It 'splints' the patient's airway open during sleep by means of a flow of pressurized air into the throat
- The patient typically wears a plastic facial mask, which is connected by a flexible tube to a small bedside CPAP machine[1]
- The CPAP machine generates the required air pressure to keep the patient's airways open during sleep
- Many patients refuse to continue the therapy or fail to use their CPAP machines on a nightly basis because they find it uncomfortable[2]
- One way to ensure CPAP therapy remains comfortable for patients is to ensure the CPAP face mask fits well
- 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 noncompliance with therapy[3]
Oral appliances
- Mandibular Advancement Splint
- A oral appliance placed by general dentists
- A custom-made mouthpiece that shifts the lower jaw forward and opens the bite slightly, which opens up the airway
- Oral appliance therapy (OAT) is usually successful in patients with mild to moderate obstructive sleep apnea[4]
- OAT is a relatively new treatment option for sleep apnea in the United States, but it is much more common in Canada and Europe
References
- ↑ General Information about Sleep Apnea Machines
- ↑ Hsu AA, Lo C (2003). "Continuous positive airway pressure therapy in sleep apnoea". Respirology. 8 (4): 447–54. doi:10.1046/j.1440-1843.2003.00494.x. PMID 14708553. Unknown parameter
|month=ignored (help) - ↑ Barbé F, Durán-Cantolla J, Sánchez-de-la-Torre M; et al. (2012). "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". JAMA. 307 (20): 2161–8. doi:10.1001/jama.2012.4366. PMID 22618923. Unknown parameter
|month=ignored (help) - ↑ Machado MA, Juliano L, Taga M, de Carvalho LB, do Prado LB, do Prado GF (2007). "Titratable mandibular repositioner appliances for obstructive sleep apnea syndrome: are they an option?". Sleep & Breathing. 11 (4): 225–31. doi:10.1007/s11325-007-0109-y. PMID 17440760. Unknown parameter
|month=ignored (help)