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Sleep apnea

Description

An in-depth report on the causes, diagnosis, treatment, and prevention of sleep apnea.

Highlights

Sleep Apnea and Heart Disease

• Sleep apnea can increase the risk of stroke, even if patients do not have high blood pressure. A 2005 study in the New England Journal of Medicine ( NEJM ) suggested that patients with obstructive sleep apnea are twice as likely to have strokes as patients without apnea. The more severe the sleep apnea, the greater the risk.
• Many patients with heart failure also suffer from sleep apnea. Another 2005 NEJM study found that continuous positive airway pressure (CPAP) treatment does not improve survival for patients with heart failure and central sleep apnea.

Sleep Position and Sleep Apnea

• Sleeping on the back, instead of the side, is a major cause of sleep apnea. In a 2005 study, researchers observed positional sleep apnea in 49% of patients with mild sleep apnea.
• Young children (under age 3) with sleep apnea have more respiratory problems when they sleep on their back, indicates a 2006 study.
• Simple lifestyle techniques (pillows, tennis balls) that force people to sleep on their side can help reduce sleep apnea episodes.

Mouth Guards and Tongue Splints

CPAP is the best treatment for sleep apnea, but many patients find it uncomfortable and have trouble sticking to the therapy. As an alternative, some patients with mild-to-moderate sleep apnea use mouth guards or tongue splints. A 2006 review suggests that these dental devices help reduce apnea episodes in half of all treated patients. The researchers also found that, for many patients, oral devices work as well as surgery.

Pillar Implant Surgery

A relatively new surgical procedure, the pillar palatal implant, works well for treatment of mild-to-moderate sleep apnea and snoring, according to several 2006 studies. The 10-minute procedure is performed in a doctor’s office under general anesthesia and is much less invasive than uvulopalatopharyngoplasty (UPPP), the standard surgical treatment for sleep apnea.

• Review Date: 7/19/2006
• Reviewed By: Harvey Simon, M.D., Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital

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