Recognizing Common Sleep Conditions
Sleep Disordered Breathing (SDB)
The term sleep-disordered breathing encompasses a variety of sleeping disorders that include, but are not limited to, obstructive sleep apnea (OSA), central sleep apnea (CSA), complex/mixed sleep apnea, and Cheyne-Stokes respiration.
Obstructive Sleep Apnea Overview
Obstructive sleep apnea is the most common disorder and is characterized by a cessation of breathing during sleep. It is caused by the collapse of the soft palate at the back of the throat, which causes an obstruction of the airway that can cause the patient to wake many times during the night. It is estimated that over 4 million Americans suffer from OSA, with the majority of these patients remaining undiagnosed.
1. Reduced Hospitalization in Patients on CPAP Treatment.
2. Utilization of Health Care Services in Patients With Severe OSA
Central Sleep Apnea
Although not as common as OSA, central sleep apnea is when the brain forgets to tell the muscles that control the respiratory system to breathe. Unlike people who suffer from OSA, the airway remains open and unobstructed, but the patient is unable to initiate breathing.
Complex/Mixed Sleep Apnea
It is characterized by both obstructive and central sleep apnea. Often, people who have been misdiagnosed with OSA find that CPAP treatment can actually make their condition worse. For this reason, it is important to find a lab that is truly committed to accurate, quality sleep diagnostic services (such as Fountain Valley Regional Sleep Center).
Cheyne-Stokes Respiration
This is a condition often seen in critically ill patients and patients on long-term opiate use to help control chronic pain. The condition is characterized by alternating periods of shallow and deep breathing. A new treatment option for these patients is found in noninvasive servo ventilation (auto-bi-level).
Difficulty Tolerating Mask/Interface
1. Have DME or the sleep center check to make sure you have the correct mask size.
2. Make sure the mask/interface is positioned correctly.
3. Loosen the mask/interface slightly (make sure there are no areas that leak).
4. Make sure you are replacing the mask every 6 months to keep it in good working order.
5. Consult with DME to see if a different mask/interface may be required.
6. Make sure you are cleaning your mask on a regular basis to keep it in good working order.
Therapy Makes You Feel Claustrophobic
1. Practice using the device in the daytime to get used to breathing while on the device.
2. Consult DME or the sleep center to see if the new nasal pill hybrid mask is appropriate.
3. Consult DME or Sleep Center to see if using a nasal mask with a chin strap is an option if you are currently using a standard full face mask.
Problems W/Cpap Pressure
1. Use the CPAP ramp feature.
2. Practice using CPAP while awake to get used to breathing on CPAP.
3. Consult with DME or the sleep center to see if Bi-level or Auto-PAP is the appropriate therapy for you (physician prescription is required).
4. Consult with DME or the sleep center to see if lowering pressure by 1 or 2 cmH20 is appropriate for you (physician prescription is required).
5. Make sure you are using a heated humidifier to optimize comfort.
Problem Falling Asleep W/Cpap or Other Device
1. Delay going to bed until extremely tired.
2. Make sure you are using good sleep hygiene.
3. Consult with your physician about temporarily using sleep medicine.
Therapy Causing Nasal Irritation
1. Make sure you are using heated humidification.
2. Make sure the humidifier is set at the appropriate level to optimize comfort.
3. Use nasal saline spray before starting therapy.
4. Make sure you are properly cleaning the humidifier water chamber.
5. Use nasal corticosteroid spray (consult DME, sleep center, and physician).
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