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Treatment of Obstructive Sleep Apnea

Written by Dr. Anitha Paderla, MBBS | Medically Reviewed by Dr. Sunil Shroff, MBBS, MS, FRCS (UK), D. Urol (Lond) on Jul 28, 2021
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Treatment of Obstructive Sleep Apnea

Treatment focuses on rectifying nighttime breathing, in order to positively impact the problems of loud snoring and daytime sleepiness. This will also cut the risks of associated medical conditions, like high blood pressure, heart attack and stroke.

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Treatment for Obstructive Sleep Apnea also helps patients with maintenance of appropriate weight. Obese victims of OSA find immense relief with weight loss. Even a modest 10 percent weight loss may eliminate apneic episodes by reducing the fat deposition around the airway and increasing the size of the airway. However, this treatment option is usually not very successful because only a small fraction of people can loose weight and maintain it.

1.Positional therapy is based on beating the effects of gravity on the airways when lying down flat on the bed.

Most people with sleep apnea have bad symptoms if they lie flat on their back during sleep and this is due to gravity enhancing the airway collapse. There are several strategies which can help patients who have mild apnea only when lying on their back.

Sew or attach socks filled with tennis balls, length-wise down the back of their pajama top or nightshirt. This ensures that the victim lies on the back. Additionally, positional pillows can be employed to help the victim sleep on the side rather than the back. Positional therapy has its own limits, and is found to benefit a few patients.

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2.Positive Pressure Therapy

Positive airway pressure is very effective in treating obstructive sleep apnea, involving three strategies - continuous positive airway pressure (CPAP), auto titration, and bi-level airway pressure.

a)CPAP, is by far the most popular therapy to treat sleep apnea.It is administered with the help of a facial or nasal mask that is attached to a tiny air compressor. Administered at bedtime, this apparatus conveys the air with a slight pressure through the tube and into the mask. The apparatus ensures that the upper airway does not close, which helps prevent apnea. A polysomnogram is used to determine each patientís optimum airway pressure.

CPAP

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sunny1

See this recent publication that indicates that obstructive Sleep Apnea - Obstructive sleep apnea (OSA) is associated with coronary artery disease (CAD). We hypothesized that OSA is independently related to the risk of CAD or death from any cause. In this observational cohort study, patients referred for OSA underwent polysomnography, and subsequent CAD events (myocardial infarction, coronary angiography or bypass graft surgery) or death were recorded. Patients were divided into exposure (AHI 15) and comparison groups (AHI Increased Risk of Coronary Artery Disease and Death, Shah NA et al New Haven, CT

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