Best Sleep Apnea Treatments.com

I have to admit, the idea that you could treat sleep apnea with nose plugs was very interesting. Ventus Medical’s Provent is a totally different type of sleep apnea treatment using adhesive plugs that works by making breathing out slightly more difficult through your nose. When you inhale, your breathing is normal, but as you exhale, a slight bit of resistance is created, creating a gentle amount of positive pressure downstream in the throat, preventing the tongue and soft palate from collapsing.

The scientific explanation is a little complicated (even for me), but the gist of it is that at the end of exhalation, that’s when your throat muscles are most prone to collapse. So by slightly increasing the pressure, a stent-like effect is created, just like with CPAP.

Their study involved 28 people who used the device over 3 nights in the lab. On average, the AHI dropped about 50% (19.1 to 8.2) and after 30 days at home, it stayed low at 10.6. Other studies have also shown an average drop of about 50%. As expected, patents with severe sleep apnea didn’t respond as well. You can find out more about the results at the companies’ website.

Another study showed that 94% of patients continued using the device for a significant number of hours on a regular nightly basis.

Without a doubt, Provent does work to various degrees in various people. But just like every other new sleep apnea treatment option, it’s not a “magic bullet” that cures sleep apnea for 100% of patients. Looking at the numbers, It seems like it’s no better than other minimally invasive options (except that it’s not invasive).

Practically speaking, I’ve had limited experience using this device in a handful of patients with mixed results. Some patients like it and others can’t use it at all.

It’s not covered by insurance yet, and it’ll cost about $135 per month. They also have a rebate program for a 50% discount for the first few months. If you’re interested in trying out Provent, an examination is needed to make sure you’re a right candidate. A limited number of free samples are available for patents.

Habitual snoring and sleep apnea are two of the most common sleeping problems encountered by Americans today. People with sleep apnea often snore but not all snorers are suffering from apnea. Either way, they have one thing in common. The CPAP.
Continuous positive airway pressure (CPAP) is the most common mode of treatment for snoring and sleep apnea. This is also used to help neonates and critically ill patients who are suffering from respiratory failure. This is a more convenient alternative to tracheostomy, a surgical procedure done to apnea patients before the advent of CPAP.
A CPAP machine delivers air with a predetermined amount of pressure to your airway through a nasal mask keeping the airway open and free of obstructions while you sleep which allows sufficient amount of air to enter the lungs and preventing apnea episodes and constant wakefulness. A hose connects the mask to the blower or the machine that delivers the pressurized air.
Common features found in today’s CPAP machines, which are purchased separately and may not be covered by insurance, are: air humidifier, ramp (pressure adjuster), exhalation pressure relief (makes it easier for the user to breathe), and data logging (records pertinent data for later evaluation). These additional features help increase treatment compliance among patients. You can either rent or purchase a CPAP machine from a durable medical equipment (DME) company.
Other positive air pressure devices are the BiPAP and autoPAP. A bi-level positive airway pressure (BiPAP) provides two air pressure levels, one for inhalation and a lower pressure level for exhalation. That way, breathing out would be more comfortable than when using a CPAP without an exhalation pressure relief. An automatic positive airway pressure (AutoPAP) automatically regulates the amount of pressure on a breath-by-breath basis.
Choosing the right machine for you comes after you have been evaluated. Your medical history, current medications and your lifestyle will be thoroughly evaluated by your doctor. He will also have you go though an EENT examination and a polysomnography or sleep study to evaluate your apnea and to determine the appropriate CPAP pressure for you. If it is apparent that you need to be on CPAP treatment, choosing a mask with the right fit, the right machine and the optional features follows.
Since the main consequence of sleep apnea is sleep disruption, a CPAP machine is used mainly at home to help with the breathing problems at night. It is also important that you know the proper maintenance your machine requires. The company where you got it from always gives out a detailed instruction manual for a specific unit. It is important that you keep the machine and its parts clean, and always have them checked for wear and tear to ensure optimal functioning.
A CPAP machine is undoubtedly an effective treatment for snoring and sleep apnea, but we cannot always rely on machines to do the job for us. CPAP is not as effective as when coupled with significant lifestyle changes like regular exercise, weight loss, and alcohol and smoking cessation. A positive attitude and a responsible mind will help us achieve wellness in no time

Treating Sleep Apnea caused by Type 2 Diabetes with CPAP

Studies demonstrate approximately 40% of people with type 2 diabetes have sleep apnea.  People with diabetes often go undiagnosed for a long time and one study suggests that physicians should consider testing for the metabolic disease if they diagnose someone with sleep apnea.

Sleep Apnea

Sleep apnea is common and should be suspected if someone is sleepy during the day, complains about the quality of their sleep, snores, and is overweight. Many times a member of the household is kept awake and annoyed by the loud snoring and reports periods of no breathing or silence. This should not be ignored and be taken seriously. When a person has those periods of shallow or no breathing their Oxygen level becomes dangerously low which also affects the heart. If a person suspects that they may have sleep apnea they should contact his / her health care professional.  Diagnosing sleep apnea is painless and requires a sleep study. The test is non invasive and relatively simple.

Monitoring Sleep Patterns

The person will be monitored while sleeping to see if breathing is significantly less or stops during sleeping. The Oxygen saturation is monitored using a non invasive device called a pulse oximeter. The heart rate is also monitored.

Treating Sleep Apnea with CPAP

The good news is that if one is diagnosed with sleep apnea the treatment is simple and effective. Usually treatment includes a weight loss program if one is overweight coupled with a device known as a CPAP Machine.  CPAP stands for continuous positive airway pressure. The device will prevent the apnea, keep the Oxygen level up, stabilize glucose levels, stop the snoring, stop the fatigue during the day and allow the person and family members to have a restful sleep.

Bibliography

Einhorn,D. Medscape: Endocrine Practice, Prevelence Of Sleep Apnea in a Population of Adults with Type 2 Diabetes Mellitus, http://www.medscape.com/article/564208_print. retrieved 8/6/2009

Dawson, Loving, Journal of Clinical Sleep Medicine, CPAP Therapy of Obstructive sleep Apnea in (Patients with Type 2 Diabetes) Control During Sleep.( 12/15/2008) vol 4, No. 6 P.583.

Landers, Susan J. Landers, American Medical News, Close tie between diabetes and sleep apnea, June 23/30, 2008. www.ama-ssn.org/amednews/2008/06/23/hlsb0623.htm

Mendoza, D.,The Sleep apnea-Diabetes Connection,Jan 31, 2007. www.healthcentral.com/diabetes/c/17/3423sleep-connection/pf/

The Birth of the CPAP Supply Industry

The leading cause of death in the hospital is infection usually caused by staff, patients, and visitors not washing their hands. Respiratory supplies were changed every forty-eight hours to help prevent respiratory infections. When I got into home health I recognized that patients were not changing their CPAP supplies. I discovered that a lot of patients did not know that most insurance companies would pay for these new supplies. They were very thankful; some of them had never received a new CPAP mask or supplies. Thus the Supply Program was born! My hope in this article is that you will find out how to recognize symptoms associated with Sleep Apnea, learn some new terms, and discover the proper treatment to help you sleep better.

Sleep Apnea Diagnosis

Sleep Apnea can be best defined as someone who stops breathing while sleeping. According to the American Sleep Apnea Association this affects more than twelve  million Americans alone! There are three types of Sleep Apnea: Central, Mixed, and Obstructive Sleep Apnea (OSA). The most common form of Sleep Apnea is OSA, which is caused by an obstruction or collapse of the airway. For example, the tongue, palate, orepiglottis can obstruct the airway. Central Sleep Apnea is caused when the brain fails to tell the muscles to breathe. Mixed Sleep Apnea is a mixture of both Central and Obstructive Sleep Apnea. Untreated Sleep Apnea can cause Congestive Heart Failure, Diabetes, High Blood Pressure, Headaches, WeightGain, and Motor Vehicle Accidents. Since most people are not familiar with the symptoms of Sleep Apnea it is most often overlooked and undiagnosed.

Testing for Sleep Apnea with the Edgeworth Sleep Test

A Sleep Test is the most common tool used to diagnose Sleep Apnea. During the sleep  test usually half the night will be spent diagnosing whether the patient does have Sleep Apnea. The second portion of the test will be spent using CPAP equipment to document any improvement and measure its effectiveness. The most common test for symptoms is the Epworth Sleepiness Scale. This is not a diagnosis but simply a guideline to indicateto your physician that you may have Sleep Apnea and may require a sleep study. If you suspect that you or a loved one may suffer from Sleep Apnea try answering the following questions:

How likely are you to doze off or fall asleep in the situations described below, in contrast to feeling just tired? This refers to your usual way of life in recent times. Even if you haven’t done some of these things recently try to work out how they would have affected you. Use the following scale to choose the most appropriate number for each situation:0 = would never doze1 = Slight chance of dozing2 = Moderate chance of dozing3 = High chance of dozingSituation Chance of dozingSitting and readingWatching TV Sitting, inactive in a public place (e.g. a theatre or a meeting)As a passenger in a car for an hour without a breakLying down to rest in the afternoon when circumstances permitSitting and talking to someoneSitting quietly after a lunch without alcoholIn a car, while stopped for a few minutes in the trafficTotal_____________________________________________________________________________________________________________________Score:0-10 NORMAL RANGE10-12 BORDERLINE12-24 ABNORMAL

Treatment With CPAP Equipment

CPAP (Continuous Positive Airway Pressure) is the most common treatment for patients who have been diagnosed for Sleep Apnea. The amount of pressure being delivered with a CPAP machine is usually determined by your sleep study and varies for each person. This equipment is only available through an order written by your physician. The biggest problem associated with CPAP is the patient’s inability to tolerate air pressure, the type of cpap mask used, or poor cpap mask fitting. Over a period of time many patients do get used to the pressure from CPAP with practice. I have found that an excellent way to alleviate the discomfort especially during this learning phase is to use the “ramp” feature. The patient can use this feature anytime they are having difficulty tolerating the pressure from CPAP. The “ramp” feature reduces the pressure dramatically and within 30-45 minutes the pressure slowly builds up until optimal pressure has been reached again. The patient will usually fall asleep during this period and not notice the increased air pressure.BiLevel or BiPAP (Bilevel Positive Airway Pressure) is designed for patients who have a high pressure prescribed or who have trouble tolerating the pressure associated with CPAP. BiPap has two pressures. Inspiratory (inhalation) and Expiratory (exhalation) The Expiratory pressure is dramatically reduced so the patient can tolerate BiPAP. Although this equipment is much more expensive than CPAP most insurance companies will pay for it with the proper documentation.In conclusion, there are many types of equipment and supplies to treat Sleep Apnea. Selecting the right equipment to handle your personal pressure settings along with a comfortable mask and the right filters and cushions can be quite confusing. Therefore, it is important that you select a company that can not only provide you with quality CPAP machines and CPAP supplies but also with personal service customized for your particular needs. The very best durable medical equipment companies are awarded the Gold Seal of Approval by the Joint Commission so that is also something to look for when selecting a company. Lastly, select a company that specializes in Sleep Apnea equipment and service for your best chance at achieving your goal to sleep better now!About The Author:Lloyd Mote is a licensed Respiratory Therapist with over twenty years of experience. He is also the Chief Executive Officer and founder of Americare Respiratory Services, Inc., which has been awarded the Gold Seal of Approval from the Joint Commission.

Snoring is an indicator that your airway is not completely open. The sound of a snore is made when the air you breathe in has difficulty pushing past this obstructed area.

For most people who snore, the medical consequences are not severe. But for an estimated 5 out of 100 individuals, it is a sign of obstructive sleep apnea.

In addition to snoring, some other symptoms are excessive daytime sleepiness, restless sleep, high blood pressure, being overweight and waking up gasping for breath. Even if you don’t have high blood pressure during the day, you could have it when you first wake up due to the lack of oxygen you get when you do not breathe properly. If you awaken with headaches, this is a good indicator that your blood pressure is high due to respiratory disturbances during your sleep.

After being evaluated by a sleep specialist, if you are found to have sleep apnea, the best treatment for you is a sleep apnea machine, also known as a continuous positive airway pressure (CPAP) machine. This is simply a device that sits on your bedside table and delivers air pressure to you via a mask over your nose and mouth.

A CPAP machine will hold your airway open and allow you to breathe like you should. Using a sleep apnea machine will ensure that your oxygen levels stay where they should while you sleep. It will also help you to achieve a restful nights sleep so that you feel refreshed the next day.

There are serious consequences of leaving sleep apnea untreated. A CPAP machine is the optimum choice to maintain your health and overall well being.

Sleep Apnea is part of the spectrum of what is called “Sleep Disordered Breathing” or “SDB.” The condition Sleep Apnea is commonly broken into three main categories. The three main categories of Sleep Apnea are as follows:

Obstructive Sleep Apnea (OSA)

Central Sleep Apnea (CSA)

Mixed Sleep Apnea (MSA)

The three main categories, or types, of Sleep Apnea will be discussed in more detail below. Sleep Apnea is commonly and effectively treated with CPAP therapy (Continuous Positive Airway Pressure). Keep in mind that this is not a comprehensive treatment on the subject of Sleep Apnea. For more information please reference the citations at the end of the article or speak with your doctor.

Obstructive Sleep Apnea (OSA)With Obstructive Sleep Apnea, the soft tissue of the upper airway collapses during the night and slows air intake, eventually eliminating air intake altogether. When oxygen intake is reduced or eliminated and blood oxygen levels fall significantly, the brain sends an emergency signal to wake up and resume a normal breathing pattern. This process can happen as many as a few hundred times a night for some people with severe OSA. The use of a CPAP machine either drastically reduces these “apneic” events or eliminates them altogether. This results in the restoration of a normal breathing pattern and the CPAP user is able to achieve deep, REM(3) sleep, allowing the body to do routine maintenance and restore many healthful functions in the body.Central Sleep Apnea (CSA)Central Sleep Apnea is similar to OSA in its final effect on the sufferer, however, the mechanism of oxygen reduction is different. The principal mechanism of oxygen reduction in CSA is due to a failure of the brain to send a proper breathing “signal” to the muscles that control the breathing process. This type of Sleep Apnea is more rare than OSA and according to the Mayo Clinic accounts “for less than 5 percent of sleep apneas.”(4) Even though CSA is different in function than OSA, the outcome for the sufferer is the same–reduced oxygen intake through out the night, failure to reach deep sleep cycles and general fatigue throughout the day. Fortunately, in most cases, CSA can be treated with the same equipment that is used for those that suffer with OSA. Most CPAP, BiPAP and APAP machines have sophisticated circuitry which allows for the detection of different types of apneas, allowing the machine to adjust to the needs of the user throughout the night.Mixed Sleep Apnea (or Complex Apnea)According to the National Institutes of Health, Mixed Sleep Apnea is defined as a combination of both Obstructive Sleep Apnea and Central Sleep Apnea. The technical explanation for Mixed Sleep Apnea according to the NIH is as follows: “intervals of ten seconds or longer during which there was a complete cessation of airflow accompanied by an absence of respiratory effort in the early part of the apneic episode and a resumption of respiratory effort in the latter part.” Basically, this means that a CSA-related apneic event occurs, followed by an OSA-related apneic event. Interestingly, according to the study by the NIH, the sequence of events is always from CSA to OSA and never in reverse. In other words, the brain fails to send a signal to breath, resulting in an apneic event, followed by a collapse of the airway that further impedes oxygen flow. This makes sense, as it would not seem vary likely that an airway collapse related to an OSA-type event would cause the brain to misfire a breathing signal, however, a misfire by the brain would include the muscles involved in breathing and may lead to a loss of good muscle tone in the upper airway.

(1)http://www.webmd.com/sleep-disorders/sleep-apnea/sleep-apnea(2)http://www.sleepapnea.org/info/index.html(3)http://www.webmd.com/sleep-disorders/guide/sleep-101(4)http://www.mayoclinic.com/health/central-sleep-apnea/DS00995

Have you been diagnosed with sleep apnea? Your doctor could prescribe one of two types of sleep apnea machines for your sleeping disorder, a CPAP or BiPap machine. Which one do you believe is the best? The CPAP has been a lifesaver, literally. Keeping airways open so those who have sleep apnea can sleep without the dangers of not breathing.The Differences Between the CPAP and the BiPAPThe CPAP machine is designed to increase the pressure when you inhale to keep the airways in the nose, throat and mouth from closing while you are sleeping. This has been a great help to many people who suffer from sleep apnea and may stop breathing several times a night.On the other hand, the BiPAP machine may help as well. Using the same setup as a CPAP with tubing, masks and a machine, the BiPAP uses a different setting. The CPAP uses one pressure and the BiPAP uses two. These two pressures are called inhalation pressure (IPAP) and the exhalation pressure (EPAP).Where the CPAP works as the person using it inhales, the BiPAP provides more breathing assistance. They have been prescribed for patients who have congestive heart failure and other serious diseases affecting the heart and lungs. People with nerve and muscle problems may also benefit from the BiPAP machine rather than the CPAP machine.The BiPAP is preset with two settings. The pressure when inhaling and exhaling is monitored. When the person sleeping does not breathe for a certain mount of time, the BiPAP increases pressure and forces them to take a breath. There are higher level CPAP machines that do this as well. These machines need a BPM (breathes per minute) setting that is targeted to your particular breathing needs.Both machines are designed to make sure the users breathe a set number of times per minute. One of the main benefits of the BiPAP machine is the pressure is decreased as the person breathes out. This keeps them from having to work as hard at breathing and the person is able to have a more restful sleep.The BiPAP machine is not large or noisy. They are designed to make the least amount of noise possible so you can sleep. The inclusion of a humidifier may be included with the BiPAP making it a higher end machine than the CPAP.The main difference between these two machines will be the needs of the patient. The one that will help each individual with the specific breathing problems they have will be based on doctor’s examinations and recommendations. A sleep test will be conducted to allow the doctor to see exactly what settings are needed on the type of machine required.The CPAP machine will be used for mild sleep apnea. Make no mistake, this can be a dangerous condition. It just depends on the levels of sleep apnea to govern the needed machine. Both machines are quite beneficial and are crucial to keeping sleepers breathing when they have problems.In conclusion, remember, the sleep apnea machines are not designed to be used as ventilators. They do not breathe for you. They merely make sure you take the number of breaths per minute that your doctor believes is right for you. After doing tests to determine what the correct number may be, the doctor will advise you as to which machine he thinks you need.

Some patients with sleep apnea do remarkably well, despite all the hurdles and obstacles that arise. Then there are others that procrastinate, or refuse to take any action at all. I’ve noticed 7 commonalities amongst the ones that do succeed in the end:

1. They take responsibility for their own health, and not rely on doctors alone. They surround themselves with a team of medical professionals, constantly reading and learning, asking questions, and staying up to date on the latest in new sleep apnea treatments and research. They are willing to make major changes their lives, daily habits and diets to achieve set goals.

There are some people who are unwilling to make any changes, such as with eating late or going out 2-3 times per week and drinking alcohol. These are the same type of people who say they don’t have time to read an important book to help them along. These are the people who want only a quick fix. They are unwilling to commit to a life change.

2. They are willing to pay extra. Unfortunately, insurance will typically cover only the bare essentials for sleep apnea treatment. Most durable medical goods vendors will give a basic model, and typically won’t cover any additional add-ons or extras or a more full-featured CPAP machine. Depending solely on insurance to cover for everything will lessen your chances for achieving success. Sometimes, you have to pay for a new mask, or a dental device. Yes, you should maximize your insurance benefits, but you should also not hesitate to go outside of medical insurance to invest in your health.

Successful people also are willing to invest in gym memberships, yoga classes, books and information products that complement standard sleep apnea treatments.

3. They take action. The people that succeed typically have tried multiple different options and have failed more often than once. But because they are persistent and take massive action, eventually, they find something that works for them.

There are many patients research everything but can’t make up their mind. This is called paralysis by analysis.

4. They do everything possible to breathe well through the nose. Being able to breathe well through the nose, although not a cure for sleep apnea, helps every other form of treatment option. Whether it’s with CPAP, dental devices or surgery, not being able to breathe well through your nose will ultimately diminish the quality of your results. Through trial and error or by working with your doctor, you can usually figure out what’s causing your stuffy nose, and take care of it in one way or another.

Many successful CPAP patients get into the habit of irrigating their noses with nasal saline. There are various ways of getting saline into your nose, so you’ll have to try different options to see which one you like.

5. They set aside time for regular exercise or relaxation. Paradoxically, exercise is a great form of relaxation. When you take the time to exercise, you have to focus on your exercise activities, which forces you not to stress about work, life and other distracting things. Not to mention the cardiovascular benefits. The more advanced people discover that active forms of relaxation or meditation helps to calm the overstimulated stress part of the nervous system, or the sympathetic nervous system. They routinely practice yoga, meditation, tai chi, which are all disciplines where proper breathing techniques are stressed.

6. They join a community of other sleep apnea patients. There’s a saying in business, “Teamwork makes the dream work.” Surrounding yourself with other successful people’s perspectives will help you to grow, learn. There are live groups such as AWAKE, or various internet forums and support groups.

7. They accept sleep apnea rather than fight it. At a certain point, all these habits will be a regular part of your life. If you’re constantly resisting it and fighting it, always looking for a “cure,” you’re in for a long and frustrating battle. Unless you undergo a tracheotomy, you’ll never be cured. Your ultimate goal should be to reach a point where you’re able to function normally, gain satisfaction from the work that you do, and ultimately, to be able to enjoy life.

Finding the right surgeon for you can be a challenge in any situation, but finding the right sleep apnea surgeon can be even more challenging since there are so many different procedures and there are no standard operations. I’m asked quite often by people in other states or other countries who they should go see to treat their sleep apnea condition, and over the years, I’ve come up with the following 10 thoughts and tips. These are suggestions that I would offer to a friend or relative in a remote state if they asked for my advice.

In most cases, an ENT surgeon will be the most appropriate person to see, as they are most qualified to perform surgical procedures of the upper airway. By definition, ENTs (otolaryngologists) are trained in plastic and reconstructive surgery of the soft tissues of the head and neck region. They are the specialists that other doctors call to manage complications of the upper airway. However, there are situations where oro-maxillo-facial surgeons and general plastic surgeons may also play a role.

1. Did you exhaust every other possible option for sleep apnea? Did you try CPAP? How much effort did you put into making sure you gave CPAP a chance to work? Did you consider dental appliances? A good surgeon doesn’t rush into surgery without trying conservative options first.

2. Can you breathe through your nose? Having a stuffy nose can definitely prevent you from benefitting from either CPAP or dental devices. Often, after optimizing nasal breathing via medical or surgical means, people are able to use CPAP or dental devices more effectively.

3. Make sure the surgeon is confident to a reasonable degree where your obstruction is happening. Performing major surgery to “see what happens” is not a reason to do surgery. There are three major areas: the nose, the soft palate and the tongue. The surgeon must be comfortable operating in all three areas. How thoroughly do they examine your upper airway? Do they look with the fiberoptic camera with you sitting up and lying flat? Do they look for movement of the space behind the tongue by having you thrust your lower jaw forward?

4. Can they give you their success rates and complication rates? What is their definition of success? What are their long-term success rates? Compare this with current success rates for uvulopalatopharyngoplasty (UPPP), which has published success rates around 40%. Multilevel surgery approaches around 75 to 80%.

Can they honestly give you their complication rates? If they have no complications whatsoever, I’d be suspicious. Are they prepared to handle anything that may arise? Ask what his or her last complication was and how it was managed. It may seem counterintuitive, but if they don’t have any experience managing complications, you don’t want to be the first one.

5. Do they have a plan in case the surgery doesn’t work as planned? If the post-op sleep study shows less than a significant drop in the AHI score, what are your options? This should be discussed before your initial surgery. Do you stop there, or do you go back and do more (if there’s an obvious area to address), or do you go back to CPAP? Is a referral to an oro-maxillofacial surgeon an option?

6. Don’t focus too much on volume of cases. What’s important is how well it’s done and the appropriate location of the procedure, rather than total number of cases performed. Thousands of UPPPs alone are performed every year by surgeons with only a 40% success rate. If this is the only operation that’s offered, without a plan to address the tongue either simultaneously or at a later point, then your chances of success is no better than 40%.

7. Do they use the Friedman staging system? This is a simple screening tool where by looking at the size of your tonsils and your tongue position, you can predict whether or not a UPPP alone can have an 80% chance of success. Most people will fall into the “unfavorable” category, but if you meet the “favorable” criteria, a UPPP alone may be a good option, as long as you understand that there’s still about a 20% chance of failure.

8. How comfortable are they performing tongue base procedures? Do they have experience with multiple procedures or are they very good at just one? Are they able to perform any of the minimally invasive tongue base procedures in addition to the standard techniques?

9. How well do they work with your sleep doctor and/or dentist to coordinate your care? Is he or she willing to combine multiple treatment options if necessary? Sometimes dental devices or surgery can make CPAP more tolerable by lowering the necessary pressure.

10. Do you trust your surgeon? You must be comfortable and have a good rapport before you undergo any invasive procedure. Get second or third opinions. No matter how technically skilled the surgeon is, if there’s no bedside manner or if the staff is rude, it will eventually show in the quality of your care. As with any doctor, the focus must be on you as a whole person, rather than an isolated surgical procedure.

As you can see there’s no one best solution for treating sleep apnea. There are general recommended guidelines and conservative options must be tried before surgery, but even with surgery, many different paths can be taken, since every patient is different with individual needs. If you’re considering surgery, find someone that you’re comfortable with, and develop a good relationship with that surgeon.

For many years the first line of defense for children with sleep apnea and other forms of sleep-disordered breathing has been to remove both their tonsils and adenoids in a procedure known as an adenoidtonsilectomy and follow-up studies normally carried out about six weeks and three months after surgery generally show positive results. However, it has now been suggested that in many cases, if follow-up studies were again conducted one year after surgery, the results would be very different.Initial studies indicate that two groups of children in particular are showing a relapse or worsening of their original condition a year out from an adenoidtonsilectomy and one of these groups is children who have gained weight rapidly during the period. However, some poor outcomes have also been reported in children who do not gain weight rapidly and this is leading to a conclusion that sleep-disordered breathing may in fact be a chronic condition.Data at this point is somewhat limited (the study upon which this conclusion is based involved only 40 children) and certainly more studies will need to be carried out before any firm conclusions can be drawn. Nevertheless, the implication at this stage is that the traditional surgical route for children with sleep apnea perhaps needs to be re-thought.Well, before you start rushing out and looking for alternatives perhaps we should look a little more closely at just what has been found here.In the vast majority of cases the children whose condition worsened a year out from surgery had also gained weight very rapidly during this period of time and, in fact, were described almost in passing as being ‘obese’. So, is the problem perhaps not the result of an ineffective form of treatment but simply of obesity, which we already know is a major contributory factor in cases of sleep-disordered breathing?Obesity is now at epidemic proportions but has only recently started spreading like wildfire through our children and is not only leading to increased cases of sleep apnea, but is also being seen in an increasing number of children with diabetes, heart conditions and various other disorders.We live in an age when we are rightly thankful for advances in medicine but the race to come up with the latest medical breakthrough also often leads to the publication of studies and the expression of opinions without adequate evidence to back up their conclusions. This may well be the case here and so perhaps a cautious approach should be advised until we have more evidence to support some firm conclusions.