Monday, April 21, 2008
Alternatives to CPAP treatment
| In my last post I mentioned that many who suffer from sleep apnea were unable to get their sleep apnea treated as they were unable to get used to the Continuous Positive Airway Pressure (CPAP) machine. I personally know of a few individuals who tried several times to be on the CPAP machine but gave up after a few attempts. Personally I did not have any problems getting accustomed to my CPAP machine. In fact, I am absolutely reliant on the CPAP machine now to ensure a good night’s sleep. My advice is that you should try your very best to use the CPAP upon the doctor’s recommendation. To be honest, I was also initially very fearful and apprehensive about the CPAP device. I was wondering how it could cure my obstructive sleep apnea and how on earth was I going to sleep with a mask over my face? I also looked like I have been admitted to the intensive care unit with the CPAP mask and hooked on to the CPAP machine. In those days CPAP machines are much larger than what it is these days. When the Resmed technician showed me the machine which was incidentally the latest Resmed Autoset Sprit that was way back in 2002, I didn’t know what the CPAP machine is and what it does. To me, it looked like a scene from the Emergency Room in the hospital. I believe it is this fear which turns most people off. I know, as I have been there before and have gotten through it. The other thing that went through my mind would be what my family members will be thinking? It would be like having a very sick person tied to a ventilator at home. It is this stigma and the initial fear which I personally feel is the main cause for the failure of taking to the CPAP machine. As a result of this, many would be immediately put off with using the CPAP machine or find ways and means not to use them citing all sorts of excuses. One of the main reasons would be discomfort and not being able to get use to the air pressure. Yes, there might be some slight discomfort initially, but so far, I have taken to the CPAP machine very well without any issues. I can also use the machine without the aid of a dehumidifier, but it could be due to the fact that I live in Singapore which is closer to the equator and the tropics so the humidity levels here are pretty high causing less discomfort compared to drier regions. The issue about alternatives to the use of CPAP machines is serious enough that there are websites dedicated to those individuals who cannot tolerate the use of CPAP machines. These sites advocate alternative treatments to CPAP therapy. Depending on the severity of your Obstructive Sleep Apnea (OSA), some alternatives to CPAP treatment might actually work. I have never explored these forms of sleep apnea remedies and sleep apnea alternative treatments. I think the main issue here is how we can treat sleep apnea and cure sleep apnea in general. It also all depends on the severity of your obstructive sleep apnea condition. Each individual might have different levels of sleep apnea severity and the condition can only be treated on assessment by a qualified sleep specialist or a medical practitioner. Doctors specializing in sleep apnea primarily Ear and Nose Specialists or ENTs expert in the field of sleep studies and obstructive sleep apnea will be able to determine what kinds of alternative sleep treatment there are currently in the market and which forms of sleep apnea treatment would be more beneficial to a specific individual. It is always best to consult a qualified medical professional about your current obstructive sleep apnea condition and the alternatives available to cure it. Each form of sleep apnea treatment like the use of the CPAP machine might vary from person to person. As mentioned earlier some individuals simply cannot tolerate the use of the CPAP machine. I did some research over the web and looked for some of the alternative treatments available to treat obstructive sleep apnea besides just the use of the CPAP machine. Let’s face it. Although CPAP machines have gotten smaller in size, if you’re totally reliant to the use of the CPAP, you’re hooked on to it for life. It has to be constantly with you at ALL times. The term “Don’t Leave Home Without It”! could be also used to describe a CPAP machine once reliant to CPAP therapy. I for one personally cannot sleep without the aid of the CPAP device. While I have gotten use to the fact that I constantly have to lug it around while traveling overseas which can be a great inconvenience at times, I would honestly have to say that if it was possible that I could do without such a device, it would be really a god sent. It’s also tough to sleep on the plane with a CPAP hooked on to you without bothering the person next to you. You will also need to invest on external battery for your CPAP device or a special power extension cords catered for use in the aircraft. Forget about an overnight camping or fishing trip in the outdoors without the use of electricity. You will have to carry an additional weight of your CPAP machine as well as supporting batteries as your backup power supply. All this inconveniences although considered minor could lead to severe complications if you’re totally reliant on a CPAP device to aid you with your sleep. This article will explore the different forms of alternative sleep apnea treatments and hope that this will give you a better idea of the options available to treat your sleep apnea and potentially cure obstructive sleep apnea condition without the aid of the CPAP device. Dental or Oral Sleep Apnea Treatment Obstructive sleep apnea has always been linked to the medical profession. Apparently now, some dental professionals and dentists are getting involved in treating sleep apnea as well. Some forms of minor sleep apnea can be treated with dental aids or oral aids. It was quite surprising to me that oral devices which are pretty small and compact in nature could be use to cure sleep apnea. If so, could they be a better alternative to the CPAP machines? According to what this video above demonstrates, by using the dental/oral aid many individuals who had difficulty sleeping due to sleep apnea were cured. How successful in treating sleep apnea and to what extent is still unknown to me. But its seems to be a pretty straight forward procedure and non intrusive compared to surgery or the use of the CPAP device. This article about Snorkil which manufacturers this dental anti snoring aid highlights the effectiveness of anti snoring dental devices. Incidentally, Singapore is one of the countries Snorkil is being piloted in to combat sleep apnea. It’s good to find out that we now have other alternative to CPAP devices here in Singapore. Surgical Sleep Apnea Treatment Besides the use of the nasal CPAP devices and oral dental aids, the next alternative available treatment for sleep apnea would be surgery (more about surgery and sleep apnea treatment here) From what I understand from my doctor, surgery does NOT always cure your obstructive sleep apnea problems. In some cases, the CPAP devices is still required after a very expensive surgical procedure. According to this article, the success rate for surgery is rarely higher than 65% often deteriorating over time averaging to around 50% in later years to come. One of the surgery procedure Uvulopalatopharyngoplasty (UPPP) which will be discuss later is considered to be one of the most painful treatments for sleep apnea as well as been reported have potentially serious complications. A study has shown that 42% of patients had complaints about this procedure. More information about the success rate of Uvulopalatopharyngoplasty (UPPP) for sleep apnea treatment and its complications here. Higher success rates have been with the use of CPAP devices and oral dental aids to cure sleep apnea problems with any pain, side effects or complications. Sleep apnea dental oral aids versus CPAP machines statistics here. Before going under the knife to correct your obstructive sleep apnea, seek the expert opinion from your sleep specialist or doctor. They will go thought all the options available and give good sound advice about the different options you have available, how they will go about each of these procedures and the percentages of success and the risks involved. From my research these are some of the current surgical procedures for obstructive sleep apnea treatment: • Uvulo-Palato-Pharyngo-Plasty (UPPP) • Laser Assisted Uvulo-Palato-Plasty (LAUP) • Orthognathic Surgery Uvulopalatopharyngoplasty (UPPP) is a procedure that removes excess tissue in the throat to make the airway wider. This sometimes can allow air to move through the throat more easily when you breathe, reducing the severity of obstructive sleep apnea (OSA). More information about Uvulopalatopharyngoplasty (UPPP) here. Another great article about what you should know and expect about Uvulopalatopharyngoplasty surgery here. Laser Assisted uvulo-palato-plasty (LAUP) surgery. LAUP is performed under local or general anesthetics. Its considered to be a safer and cheaper procedure compared to UPPP. It uses laser to vaporize the soft palate and uvula. Unlike UPPP, the LAUP process can be repeated to achieve the desired effect. Procedure varies with individual patients, some requiring as much as four sessions for the sleep apnea treatment to be effective. Although LAUP surgery has fewer complications compared to LAUP, post operative pain has been reported as being severe. In clinical trials comparing both the UPPP and LAUP procedures, there was no significant differences where post operative pain was concerned. Due to the severe post operative pain, patience compliance could be undermined at times. Unlike UPPP, which is a one time process, LAUP had to be done over a few sessions causing severe pain over a period of time. Similar with UPPP, the success rates for LAUP has been generally low. 2 years after a successful LAUP surgery, only 55% reported that their bed partners were satisfied with the results. More information about LAUP surgery here. Orthognathic surgery is where the bones of the upper and lower jaw may be repositioned to increase the size of the airway. This is a more complex Procedure compared to UPPP or LAUP. There is a clinic here in Singapore specializing in Orthognathic surgery for sleep apnea. Studies in general have shown that surgery have around a 50% to 65% chances of success but this all depends on the patient’s sleep apnea condition. CPAP devices, dental and oral aids are cheaper and painless alternatives which enjoy a higher success rate should you be able to tolerate these devices. The oral aids for sleep apnea seems to be the most inexpensive solution compared to CPAP or surgery. As mentioned before, see you sleep specialist or doctor for a full recommendation as well as the alternative treatments available to cure your obstructive sleep apnea. Please bear in mind that this article is strictly for personal research purposes. I have NOT personally used any of these devices (with the exception of the CPAP machine) or have undergone through any of these surgical procedures to treat my obstructive sleep apnea. I have NOT validated any of these claims. I am also neither promoting, advocating or advertising the services of these companies or their products. This article was written more with research in mind, rather than from any commercial perspective. You should always do your own research and consult a fully qualified medical practitioner in the medical or dental field specializing in sleep apnea or snoring treatment. Labels: alternatives to cpap, cpap, sleep apnea alternative treatment, sleep apnea cure, sleep apnea treatment |
Tuesday, April 8, 2008
Sleep Apnea Diagnosis
I was diagnosed with Obstructive Sleep Apnea (OSA) since early 2002 and have been long suffering from sleep apnea for years. It went undetected because no one knew about it as there was lack of understanding about sleep apnea here in Singapore. Nobody knew much about sleep apnea in Singapore and its potential underlying dangers that it can cause to an individual both physically and mentality. Sleep apnea has the potential to cause harm not only to yourself but others from driving accidents. Not forgetting to mention that it will have disastrous effects on your career by always looking tired and inattentive to your colleagues and bosses (late night of partying huh?) Try studying for that major exam tomorrow if you had not slept a wink for days? Eventually, if left untreated, sleep apnea will not only destroy your career but your health as well. You also become a bane to your family members or your partner due to excessive snoring. You might think that you are the only one who suffers from the lack of sleep. That’s where you’re wrong! Your partner would also be deprived from the lack of rest due to your excessive snoring that will keep them awake throughout the night! So do yourself a favor by getting treated for sleep apnea and snoring as soon as possible. To date, not many individuals realizes the full gravity and extent of sleep apnea and how it can seriously damage one’s life. I hope the information provided here will persuade and convince yourself, or someone you know, to get treated for this sleep disorder today.It was not until I’ve learnt about sleep apnea that it peaked my interest to start writing about my personal experiences, as well as wanting to have a sleep apnea resource site with the sole aim of provide information about sleep apnea and its related sleep disorders. Writing from a personal experience is also much easier, as you know what sleep apnea is all about and how to deal with this condition. I hope to give sufferers of sleep apnea like myself, encouragement and information on how to deal with this problem. I have learnt to live with this condition, and have gotten back to a normal life except for being totally reliant now on a CPAP machine. I also no longer drive in fear of falling asleep at the wheel! Due to the severity of my sleep apnea, I have since stopped driving totally as the risks involved are great. Individuals with sleep apnea double the risk of traffic accidents. Sleep apnea induced driving death statistics found here. You can also get more information about sleep apnea and driving here.  According to my parents, I have been snoring since I was 4 or 5 years old. My guess was that I had sleep apnea as a kid, but they didn't noticed it or realized the severity of the issue until 20 years later. Studies have shown that there have been large number of cases of child obstructive sleep apnea or OSA in very young children and infants. I remember that when I was around that age, I was constantly having problems breathing when trying to sleep, so my dad asked me to try to sleep breathing through my mouth. It helped somewhat, but this also attributed me to start snoring even louder due to an open mouth. Its only when I was later diagnosed that my ENT (Ear Nose & Throat Specialist) who is an expert in sleep apnea found out that I had a very narrow throat that had culminated with my obstructive sleep apnea (OSA). That would have accounted for that fact why I was always tired and falling asleep while trying to study and could not concentrate well enough during my younger days. It was only until much later on after I was diagnosed as having sleep apnea that I realized why I was often tired while doing my revision and homework. At school, I'd always have difficulty concentrating and grasping new ideas. It was however not until much later on that the full effects for obstructive sleep apnea (OS) started haunting me resulting in many problems. My condition was left untreated for close to around 20 years until my life started spiraling out of control.As a child while growing up, I think generally much of the lack of true sleep was compensated by a the raw bundle of energy attributed from youth. But as I've noticed when you start growing older, your lifestyle starts changing and so does your body mechanism and metabolism. When I was around 18 to 22 years of age I still could manage to cope with sleep apnea being undetected and untreated. I was however feeling the strain and constantly struggling when I was in the army trying not to fall asleep. I was still very fit and active then. My sleep apnea condition was more evident and pronounced after I started with a job. Working longer hours, I had less time for exercise. Sitting all day behind a desk didn't really help. I began to put on some weight. As you gain weight, being able to exercise starts becoming more difficult due to laziness and having to work extra hard to shed those additional pounds. The extra weight also made you tire easily and you tend to want to rest more, but due to sleep apnea, you can’t get proper rest. As a result of that, you tend to want to rest more than try to exercise. My condition started deteriorating. Soon, the only thing that I was constantly preoccupied with was sleep. My whole day soon started revolving around sleep. Time at the office dragged as you constantly had to force yourself to stay awake. Minutes felt like days to me and I was constantly falling asleep at my desk. I was hardly able to concentrate and no matter how much sleep I tried to get at home and over the weekends it was never enough. My weekends were just spent sleeping and resting. But it was never enough, my body was constantly deprived of sleep and exercise. My weight started increasing, I hardly could enjoy a movie or the news on tv without falling asleep. A trip on the bus or in the taxi would find me dozing off and snoring away to the amusement of the taxi drivers and commuters. To this day, I still see sleep apnea suffers in the buses or trains having this problem and I also see people looking and laughing at them. I don’t laugh at these people, but shake my head and sympathize with them. Shuddering at the thought that I used to be one of these people that had been mocked and laughed at before I was treated for obstructive sleep apnea. Check out public service announcement from the American Sleep Apnea Association below. The question that often comes to mind is that Why they don't get help? Why don’t their friends and family members help them? Together with awareness, this problem can be cured and you can live close to a normal existence with a few minor inconveniences. With proper treatment you will get the quality of life back. Victims are generally men who are more obese in nature. But it has been proven that sleep apnea does NOT only afflict obese individuals, a study has shown that it doesn’t matter if you’re obese or thin, obstructive sleep apnea (OSA) will still affect both individuals if conditions are right. My blood pressure started increasing but my doctor then did not suspect it was sleep apnea and continue prescribing me medications for hypertension. My blood pressure was getting worst and I was always waking up with cold sweats every night and constantly going to the bathroom with the urge to urinate. The doc gave me some medication to make me urinate more in the morning so that I didn’t have this urge to go in the right, but this did not help, as I kept on having to visit the toilet averaging between 3 to 4 times a night. My life slowly began to fade away with this nightly routine. Going to work every day was absolutely a dread, keeping awake was an absolute torture. I was falling asleep during meetings and on my desk at 9am in the morning! The situation had gotten so bad that my boss had asked me if I was keeping late nights or if I had any problems at home causing me this day time sleepiness. Home and the bed was the only heavenly solace I had, well at least that was what I presumed. Can you imagine life as a walking living zombie? Worst, I started getting nightmares about choking and having not enough air to breath, my wife and family members were saying that I was talking to myself in my sleep while snoring away. Then began the reflux attacks. I initially thought it was heart burn or gastic. While I was sleeping all of a sudden I could feel like I was vomiting out the contents from my stomach which incidentally smelt like puke. It got regurgitated on the my pillow. Again my doctor prescribe Mylanta to ease my “gastric problems” These attacks happened a couple of times. Only much later until after I was diagnosed with sleep apnea did I learnt that this was a case of acid reflux or gastroesophageal reflux disease (GERD) which is often commonly associated with sleep apnea. Naturally, I had no energy to exercise and my weight was steadily increasing and so did all the complications that came with it. It was slowly turning into a was a vicious cycle with my health spiraling out of control. The last straw came when on a holiday with my parents almost by accident (as I don’t stay with them now) noticed me snoring loudly and stopped breathing for close to 15 to 20 seconds and thought I had died or past out. My dad shook me awake and when I suddenly woke up, he told me that whatever I was having, it was serious! They watched me grow up snoring but never experience me stop breathing so this was severe. He had read an article about this medical condition called "sleep apnea" and suspects that I might have this condition. I went back to my regularly doctor and told him about this, he initially dismissed this. It was only after I insisted that he referred me to see my current ENT specialist Dr John Abisheganaden a senior consultant at the Tan Tock Seng Hospital -Department of Respiratory Medicine here in Singapore. Dr John Abisheganaden examined me initially and said that he suspected I had Obstructive Sleep Apnea (OSA) from the symptoms described. He however could not tell me how severe my condition was until I did a sleep study or sleep test to determine the severity of my sleep apnea. He offered me two suggestions, to do the sleep test at the hospital or at home. The home option would be a much cheaper and a more convenient solution, as I wouldn’t need to stay at the hospital for a night incurring additional costs, as well as being in more comfortable environment to fall asleep compared to an unfamiliar surroundings such as a hospital. The home option was also not performed by the hospital, but from a qualified technician from one of the major manufacturers of CPAP device RESMED dealing with the sleep equipments or CPAP machines. The sleep test itself consists of a probe to your nose to measure your breathing, some straps to your chest as well as a blood pressure monitor that was attached to one of my fingers. All the data was recorded in small box like device the size of a compact disc player. It was relatively light and did not hinder any of your movements. In short, it was a relatively painless exercise done at the convenience of your own home. The technician from Resmed came sometime in the evening around 10pm set up the sleep test device. Setting up took around 5 minutes, he gave me some instructions on how to disable and dismantle the device should I need to go to the toilet in night. He left for the night and returned the following morning to collect the device which contained all the vital data collected. It will determine how severe my sleep apnea condition was. My initial response to the data collecting device? I was worried that I could not fall asleep, but the technician assured me that they only needed to capture a couple of minutes worth of data to get an indication of how bad my obstructive sleep apnea was. Incidentally, this would be the same process done at the hospital only by the hospital attendants. Not being to sleep for somebody suffering from sleep apnea was an obvious understatement. Very soon, I was asleep and snoring away providing vital data to the sleep test survey and all the valuable information was recorded into the sleep test device. Resmed sent the results of the test to Dr John and during my next visit he explained the findings to me. The initial prognoses was not good. He told me my OSA was severe and that I was fortunate to have seen him soon to have been diagnosed. I do not have a the actual results off hand, but I did remembered asking him how severe on a scale of one to ten and he said nine! He said the blood oxygen level in my body was very low due to the apneas. I had stopped breathing many times during the course of the night due to the my airway collapsing before I gasped for air when I sleep. He also explained to my family members which I was always cranky and moody as technically, I have not slept restfully, all this while which explains the constant tiredness and mood swings. He told me that I have two options to consider, either surgery which goes not guarantee 100% results or try using a device called a CPAP machine. His recommendation was to try the Continuous Positive Airway Pressure machine or CPAP machine for short and see how I take to it and to this day I have been on a CPAP machine ever since which has been my savior and lifesaver. Since ResMed were the ones who did the Sleep Study for me, I went to them to get my CPAP machine. At that time, they had a rental policy to try the machines out before actually purchasing them. From what I understand, some people have problems adjusting to the machines so it wouldn’t be practical to buy the machines off hand and dumping about two thousand dollars on a machine that you cannot take to or use in the future. So I guess this rental trial program made more sense and was more practical. For me, I took to the CPAP machine rather easily. To this day, I can’t understand why some people are still having issues getting use to it. I guess maybe it’s just plain stubbornness or not having an open mind. Remember, this is a small price you have to pay to improve the quality of your life and its worth every penny and sacrifice for the results it will give you. I'd have to admit for someone new to the CPAP machine, it takes awhile adjusting to it, but you’ll need to come with an open mind to accept it. I had friends and relatives having been diagnosed with sleep apnea, but simply were just too stubborn to try to get accustomed to it. They gave up eventually and their sleep apnea has been left untreated. Personally for me I adjusted well without any issues and have been on it ever since. On the first night with the cpap machine, I naturally had trouble adjusting to it, but I fell asleep after some time. It took me maybe a week or so to get adjusted to the new machine which was a Resmed AutoSet Sprit. For the first time, I noticed that I didn’t wake up to have to go relieve myself until the next morning compared to an average 3 to 4 times every night. I also realized that I was becoming less tired and feeling that I had more energy as I was finally getting some real sleep! I have been deprived from real sleep for nearly 20 odd years, so it was nice to finally experience what a real restful night's sleep felt like! I only noticed another major thing that I hadn’t realized in the past. The office started getting very noisy. I attributed it to the fact that I was always in a dazed and confused sleepy state that I hadn’t really been paying much attention on what’s going on in the office and what’s happening in the background. All of a sudden, being finally rested, I realized that the office was indeed a lively place instead of a dull and quite place that I have always seen it to be. I also found out that I had much more time do so many more things that I had always wanted to do over the weekend. In the past I had been living to sleep. All my spare time or any available time I had was consumed by sleep. Now I didn’t need to sleep that much any longer as I was finally getting some real sleep. I found that I had much more time to start doing many things like going for a movie, getting more exercise doing shopping with my wife without falling asleep! Clearly, the standard of living has gotten better. I was more attentive and more productive at work and could think clearly without thoughts of home and going to bed. The vicious downward spiral has shifted upwards. All thanks to the the CPAP machine. With more energy now, I started being more active and participating in sports and exercises, I began to lose weight and slowly my health started improving. Being diagnosed and treated for sleep apnea with the CPAP machine has clearly reversed my fortunes. I am now living for the sake of living and my quality of life has been greatly enhanced. I could never have imagined what life would have been without having being diagnosed and treated for sleep apnea. Or consider life without the assistance of the CPAP machine. I shudder to think what would have happened if i did not get diagnosed or treated for sleep apnea. I would have been most likely either very dead or very sick by now. Definitely out of a job or maybe would have been prison for running over a person while falling asleep at the wheel. I am indebted for being diagnosed and freed by the CPAP machine. With my new found energy I started the sleep apnea site to convince everybody who has the means to be treated to get themselves well again. Why compromise on the quality of life and let you sleep apnea take over your life? Labels: cpap, gerd, osa, resmed, sleep apnea diagnosis, sleep apnea treatment |