FAQ’s

Sleep apnea is a disorder in which a person stops breathing during the night, perhaps hundreds of times , usually for periods of 10 seconds or longer. In most cases the person is unaware of it, although sometimes they awaken and gasp for breath. It is usually accompanied by snoring. People who have sleep apnea may not even be aware of the condition, but it inevitably causes daytime sleepiness. Furthermore, sleep apnea can lead to life threatening consequences and serious health conditions as listed below:

• Heart attacks
• Strokes
• High blood pressure
• Heart failure
• Increased risk of a motor vehicle or work related accident

Patients with obesity, family with a history of snoring, men, older patients, and patients with the following physicial characteristics are at a higher risk for sleep apnea:

• Narrow upper jaw
• Receding chin
• Overbite
• Larger tongues
• Longer and stiffer soft palates

Other predisposing factors include:

• Alcohol users
• Users of sedative drugs
• Hypothyroidism
• Smokers

People with sleep apnea usually do not remember waking up during the night. Indications of sleep apnea may be such vague symptoms as the following:

• Excessive daytime sleepiness
• Morning headaches
• Snoring -- bed partners may report loud and interrupted snoring
• Weight gain
• Limited attention

• Memory loss
• Poor judgement
• Personality changes
• Lethargy
• Erectile dysfunction

If you suspect you have sleep apnea, talk to your doctor. Your doctor then may refer you for a sleep study. The sleep study is done by using a special recorder to monitor, breathing, oxygen levels, sleep levels and heart rate. By examining the recorded signals, it can be determined if you have sleep apnea , and if needed you will then be refered for treatment. Sleep studies can be done at home or in a laboratory setting.  Generally, laboratory or hospital studies are reserved for those with more complicated symptoms or those who do not respond to treatment as would be expected.  In-lab testing is more expensive and has an extended wait list in Nova Scotia. Sleeping at home in your own bed provides a more natural environment for the at-home sleep test.  Fortunately, at home sleep studies are very reliable sources of information about the quality of sleep you are having.

The first line of therapy and positive solution in treating sleep apnea is with the use of CPAP therapy. In some cases, options may depend on the cause for sleep apnea, so it is always important to discuss with your doctor.

Patients suffering from sleep apnea are given a breathing mask to wear at night that is connected to a machine that provides Continuous Positive Airway Pressure (CPAP). It is this continuous flow of air that creates enough pressure to overcome the obstruction and maintain an open airway. CPAP is considered the most effective nonsurgical treatment for the alleviation of snoring and obstructive sleep apnea.

This is definitely a "frequently asked question", especially as it pertains to trips or holidays. The answer is this: yes. Why? You have to stop thinking of sleep apnea like a night-time disorder that is only affecting your spouse or bedmate, and start thinking of it as a disease that affects YOU. Obstructive sleep apnea is as bad for you in severe levels as having uncontrolled high blood pressure. It is worse, in fact, because sleep apnea also contributes to increased work related accidents, driving accidents, increased risk of diabetes, increased risk of pulmonary and cadiac complications and increased risk of stroke. Here is another reason. If you have been using your CPAP every night (good for you!!) and then decide to take a week off CPAP for a cruise you might be taking, it is like all of a sudden going without a good night's sleep for the next seven days. You will come home feeling worse. And you will probably have kept your bedmate up with your snoring. Is that fair? Think of it this way. If you have sleep apnea, and you are told it has a particular severity (mild, moderate or severe), compare it to having high blood pressure. If you were taking a cruise, and you have moderate high blood pressure, would you bring your blood pressure medication, or would you leave it at home on your night table so you could have more freedom and fun? It is the same thing.

Not all people that snore have sleep apnea. It is only when snoring is interupted with episodes of complete obstruction and breathing stops for 10 seconds or longer that snoring becomes fatal. The interrupted breathing pattern leads to the decrease in oxygen blood levels and in turn increases the work on the heart to provide oxygen to the body.

Weight loss does not prevent sleep apnea however it will reduce the severity of it Obesity is a contributing factor of sleep apnea. It is the excess accumulation of body fat that may cause the alteration and function of the upper airway and cause the airway to narrow and close. Studies have shown that a 10% change in weight can reduce the apnea-hypopnea index by up to 25%. That can often reduce the severity of sleep apnea from severe to moderate. However, it is important to maintain that weight afterwards.

One of the side effects with the use of CPAP is upper airway dryness, ie: nasal congestion, nose bleeds, sore tongue and sore throat. When we breathe, our nose naturally humidifies and warms the air. With CPAP, the increase in airflow can cause changes to the tissues in the inside of the nose and reduce natural humidification. With the use of a heated humidifier these nasal side effects can be reduced.

Increased condensation is a sign that the humidifier temperature is set too high, so by turning the temperture down this should prevent further accumulation. If by reducing the temperature you awake with a dry mouth but have prevented the accumulation of water in the tubing, go back to increasing the temperature and put an insulated cover over the hose. Other reasons for water accumulation can be pressure settings, mask style, hose position ( on top or under the covers), drafts and room temperture. When the room temperature is cooler than the heated CPAP air, rainout can occur.

There is good news and bad news for this question: There are a number of procedures that will help correct the degree of upper airway collapse that causes obstructive sleep apnea. However, if you have severe sleep apnea that requires a CPAP device, chances are that surgery will reduce some the CPAP pressures and make it more comfortable to wear. Some surgeries, such as maxillary-mandibular advancement surgery (MMA) will correct sleep apnea, if your facial skeleton is appropriate for this procedure. It can be curative, even for severe sleep apnea. Most upper airway procedures in adults, such as palate reduction, turbinate reduction, tonsillectomy, adenoidectomy, septal reconstruction will improve the airway and help reduce CPAP pressures as there would be less resistance. In children, tonsillectomy and / or adenoidectomy are USUALLY curative. However, the child should still be watched afterwards to make sure and followed by their doctor to ensure the sleep apnea is resolved. Tracheostomy is curative but is usually reserved for severe sleep apnea with severe heart disease and cannot tolerate CPAP therapy.