Dr Côté » Sleep Apnea: CPAP and Hybrid Therapy

Sleep Apnea: CPAP and Hybrid Therapy

You could suffer from sleep apnea if you snore loudly or if you feel tired the day after a long night’s sleep. Sleep apnea syndrome (or Obstructive Sleep Apnea, OSA) refers to brief and frequent breathing interruptions during sleep caused by the obstruction of the upper airway.

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Your Health : Our Objective

When breathing is partially blocked, snoring occurs with an unpleasant sound, which may indicate a health problem. It is estimated that nearly 10% of the population are affected by sleep apnea, and 85% don’t know it because they are not diagnosed.

In recent years, much research has been conducted to assess the various options for treating sleep apnea. Today, Continuous Positive Airway Pressure or CPAP is now recommended as the standard treatment for sleep apnea syndrome.

Who Suffers from Sleep Apnea?

1 in 4 Adults (26%)

Reported experiencing symptoms and risk factors.

3 out of 4 Canadians (75%)

Who report having sleep apnea are aged 45 and older.

Men

The prevalence of sleep apnea among men is nearly twice that of women.

Men Aged 50 and Older

73% of adults at high risk for obstructive sleep apnea are men, and 76% are over the age of 50.

Higher Risk

Men, seniors, individuals with obesity, smokers, and those who consume alcohol or take anxiolytics are at greater risk.

What is a CPAP Treatment?

For moderate to severe sleep apnea, the doctor will recommend an intensive nightly treatment with a CPAP machine. A mask is installed and supported by straps on the head. A tube connects the mask to the CPAP device that controls the snoring and apnea by constant air pushed into the mask that keeps the airways open at all stages of breathing.

Most Common Warning Signs

Waking up suddenly and feeling like you’re gasping or choking
Breathing stops during sleep as observed by spouse
Frequent round trips to the bathroom during the night
Loud or prominant snoring sound
Excessive sweating during sleep
Non-restorative sleep and decrease energy level
Morning headache and memory loss
Excessive daytime fatigue and drowsiness
Lack of concentration, or impaired judgment
Irritability, mood swings and nervousness
Decreased libido or erectile dysfunction
Depression or anxiety notable
Hypertension (high blood pressure)
Decreased alertness at the wheel.

A Treatment, But Not a Cure

Because apnea has no cure, this treatment will not heal the patient but will improve his quality of sleep. Upon ceasing to use the CPAP device, OSA patients will go back to snoring.

3 types of devices can regulate breathing of an apneic. To read more, go to our CPAP device page.

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Solutions

Sleeping With a Mask?

At first, learning to sleep with a mask on the face is not easy at all. One must resolve discomfort and minor adjustment issues of the mask or nasal obstruction. Only after this period, one starts to feel the treatment benefits.

Unfortunately, with a lack of quick results, many people abandon the CPAP. For a sustained improvement, you have be patient and use the device for the whole night, for 4 to 6 weeks. For maximum comfort, go ahead and try newer more efficient models that appear on the market.

Oral Appliances as an Alternative

For mild to moderate apnea, your doctor may prescribe an oral appliance for the advancement of the jaw or OAM. This is an adjustable double bite mouthpiece, tailored to the impressions of your upper and lower dentition by a dental laboratory as prescribed by a dentist.

Worn through the night, the mouthpiece holds the lower jaw and tongue forward, which has the effect of maintaining the upper airway open.

The use of OAM requires regular monitoring to prevent teeth movement and mandibular dysfunction, and to measure effectiveness of treatment, once the mouthpiece has been adjusted. Most patients will have no impact on their teeth.

OAM are also ideal when the person suffering from apnea cannot bring along a CPAP when traveling or going to work, or when it’s impossible to get used to wearing a CPAP.

NOT FOR ALL APNEIC

This oral appliance is available in fixed or adjustable model. The adjustable model has had a greater success than the fixed model. However, it is not suitable for all patients, does not offer as good results as the CPAP device and can cause jaw, teeth or gum problems. When it works well, some prefer it to CPAP.

WARNING! ORTHOTIC INTERNET SHOPPING

Watch this video where Dentist David Côté warns about the use of mandibular orthotics purchased on the web without a prescription and the tragic case of a Gatineau resident who suffered dire consequences from it (in French): http://bit.ly/1q2dAoa

Hybrid Therapy: OAM and CPAP

Unlike most CPAP masks, Dallas Airway Management’s TAP-PAP Nasal Pillow gives sleep apnea patients a great sleep experience. It requires no chin or head straps and represents a huge advantage for CPAP users. The system allows oral orthotic TAP-PAP to be used in conjunction with a CPAP compressor.

Air leaks are minimized because of the more stable adjustment of the mask on the face. This innovation allows many CPAP users having left their device to consider resuming therapy. The vast majority of patients tolerated the TAP and CPAP combination.

TAP® PAP NASAL PILLOW FEATURES

It is very stable regardless of the sleeping position
Head straps are optional, no marks to the face or nose in the morning
The nasal pillows fit comfortably without causing pressure sores on the nostrils
TAP-PAP is very easy to breathe, due to the design of the air pathway between the CPAP and your nose
The mouthpiece makes TAP-PAP the easiest mask to fit without needing frequent adjustments
It is one of the quietest masks on the market at 25.7 dBA.

ADVANTAGES OF HYBRID THERAPY

With the mask attached to the mouthpiece and not the straps, it cannot move during the night. There is less air leakage and the absence of straps provides improved comfort for the patient. Maintaining the mouth closed in advanced position, the orthosis allows compressor pressure reduction (29% on average) and reduces leaks through the mouth, which eliminates the use of a chin strap.

TAP ORTHOSIS IS EFFICIENT USED ALONE

When patients can’t bring a compressor along with them, the TAP orthosis can be used alone which can bring partial correction of apnea and reduced snoring. In Europe and North America, TAP-PAP is by far the device that arouses most research interest.

Dr. Côté Installs These Prostheses

Dr. David Côté has received special sleep medicine training to diagnose and adjust mandibular appliances and CPAP for sleep apnea patients. He delivers an essential and functional orofacial diagnosis to evaluate the indication of advanced orthotic mandibular and/or CPAP.

For more information on different types of devices to relieve sleep apnea, let Dentist Côté, who has a lot of experience with oral appliance therapy for the treatment of sleep disordered breathing, determine the type of device that suits you best. And sleep like a baby again!

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