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What is
sleep apnea
and CPAP?

The most obvious symptom of Sleep Apnea is loud snoring.
Estimated 80% of sleep apnea sufferers are unaware that they suffer from OSA, and therefore are untreated(1).

Why do we snore?

It is a matter of poor “plumbing”. Our anatomical make-up or obstacles in the throat can inhibit the flow of air and make a noise.

It is a matter of poor “plumbing”. Our anatomical make-up or obstacles in the throat can inhibit the flow of air and make a noise.

There is a clear hereditary aspect, and other factors such as obesity, smoking, drinking, certain drugs or just extreme tiredness can all contribute to snoring. Finally, we are more likely to snore if we sleep on our back.

Snoring may be a sign of sleep apnea, but only specialised doctors are qualified to draw any conclusions. CPAP treatment usually cures snoring.

What is Sleep Apnea?

Sleep Apnea is one of the most common kinds of sleep disorders. People suffering from Sleep Apnea would stop breathing during sleep. Such events can happen hundreds of times during sleep and each may last for a few seconds to a few minutes(2). This causes lowering of oxygen saturation in blood, frequent awakenings and poor sleep quality.

There are 3 types of sleep apnea:

Obstructive Sleep Apnea (OSA):

During normal breathing, the airway is clear and open, allowing air to flow freely in and out of the lungs. OSA is the most common type of sleep apnea. It occurs when tissues in the throat collapse and block the air flow in and out of the lungs during sleep.

Central Sleep Apnea (CSA):
CSA is resulted as the central nerve system fails to give proper breathing signals to drive the respiratory efforts.

Mixed Sleep Apnea (MSA)
MSA is a combination of OSA & CSA.

 

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Symptoms and Causes

If you have more than one of the below symptoms, you should consult with a physician immediately.

The main symptoms of sleep apnea are :

  • Snoring, interrupted by pauses in breathing
  • Loss of energy, fatigue
  • Morning headache
  • Excessive daytime sleepiness
  • Loss of concentration, slow in response
  • Irritability
  • Forgetfulness
  • Sexual dysfunction

What risks do I have for going untreated?

Clinical studies indicate that sleep apnea causes oxygen de-saturation.  Prolonged deficiency in oxygen can cause damage to the normal function of many organs and increase the risk of developing the followings:

  • Heart failure(3): If OSA is left untreated, the risk of having a heart attack is doubled. 70% of patients admitted to hospital for coronary artery disease were found to have sleep apnea.
  • Hypertension(3):If you have OSA, you are more likely to have high blood pressure. Bear in mind that 30% of hypertensive people have OSA and 50% of people suffering from OSA have hypertension.
  • Stroke(4): OSA is connected with an increased risk of stroke in middle-aged and older adults, especially men.
  • Heart disease(5) : 2 times more likely to have a fatal cardiovascular event and 3 times more likely to have a non-fatal cardiovascular event.
  • Type 2 diabetes(6) : medical research has confirmed the link between sleep apnea and type 2 diabetes. 40% of people with OSA have type 2 diabetes.
  • Fatigue-related vehicle accidents(7) : 6 times more likely to have a car accident.

Therapeutic Options

The most common options are: CPAP(Continuous Positive Airway Pressure) and BiPAP (Bi-level Positive Airway Pressure) which are devices which deliver pressure to nasal cavity by a mask to prevent the upper airway from collapsing.

  • Continuous Positive Airway Pressure (CPAP)

If the sleep specialist recommends you to use CPAP, you may be required to do a CPAP titration in order to find the optimal pressure. CPAP is a device which delivers pressure to nasal cavity by a mask to prevent the upper airway from collapsing. It is the most effective and common way of OSA treatment which is suitable for mild to severe sleep apnea patient.

  • Bi-Level Positive Airway Pressure (BiPAP)

BiPAP is a bi-level positive airway pressure system that delivers two different positive pressure levels. It keeps the upper airway from collapsing by putting higher pressurized air during inspiration and helps users exhale by putting lower pressurized air. You may be required to do a titration in order to find the optimal pressure for inspiration and expiration (i.e. IPAP/EPAP).
 

  • Other options

1) Oral appliance: only suits for mild OSA. Surgery: An invasive way treatment but it may not be suitable for everyone, and it is not the first therapeutic choice.

2) Surgery: An invasive way treatment but it may not be suitable for everyone, and it is not the first therapeutic choice.

3) Modification of the life style: such as do more exercise and reduce weight for obese person, sleep laterally, stop using sleeping tablets or sedatives, and avoid taking alcoholic drinking in the evening.

 

Customer Story

CPAP User Sharing

Mr Au , 59 vears old

Read more

Three years ago I was diagnosed with severe sleep apnea.
When I woke up, but also during the day, I felt tired and drained of energy. On the recommendation of my doctor, I started to.use a CPAP machine. 
The technique does require some getting used to, but it brings considerable relief. It makes waking up much easier and sleep much more restful. The machine also stops you snoring, which is a great advantage for your partner! 
It also made me realise that losing significant weight reduces snoring and sleep apnea. I did that too! 

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Reference:

(1) Obstructive Sleep Apnea – A guide for GP’s – British Lung Foundation (NHS).
(2) Rules for Scoring Respirator Events in Sleep: Update of the 2007 ASSM Manual for Scoring of Sleep and Associated Events - Journal of Clinical Sleep Medicine, Vol. 8, No. 5, 2012.
(3) Patient information series – Seep Mini series #4, Obstructive sleep apnea and heart disease, American Thoraic society. ​
(4) Logan et al. High prevalence of unrecognized sleep apnoea in drug-resistant hypertension. J. Hypertension. 2001.

(5) Marin, J.M., Carrizo, S.J., Vicente, E., & Agusti, A.G. (2005). Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study The Lance, 365(9464), 1046-53.
(6) Einhorn et al. Prevalence of sleep apnea in a Population of Adults With Type 2 Diabetes Mellitus. Endocr. Pract. 2007; 13(4): 355- 362.
(7) Teran-Santos J., Jimenez-Gomez A., &Cordero-Guevara. J. (1999). The association between sleep apnea and the risk of traffic accidents. N Engl J Med., 340 (11), 881-3.