As we mentioned before, more than 18 million Americans are believed to suffer from obstructive sleep apnea (OSA), a disorder in which breathing is interrupted during sleep.
OSA can lead to insomnia and irregular sleep patterns, teeth grinding (bruxism), chronic allergies, earaches, acid reflux and hypertension. And it’s more than just a nuisance. It can be life-threatening. After all, when the upper airway is blocked, oxygen can’t get to the brain! This, in turn, affects other parts of your body – both organs and muscles (and your heart is one big muscle). It has been linked with conditions such as heart attack and stroke.
Clearly, doing nothing about it is NOT a great option.
One of the most common treatments for it is the use of a CPAP machine, where CPAP stands for “continuous positive airway pressure.” It consists of three parts: a mask to cover your mouth and nose, a tube to connect the mask to the machine, and a machine which creates air to blow into the patient’s airway.
Suffice it to say, CPAP has its drawbacks, which contribute to notoriously low compliance rates with the therapy. Some patients complain that the machine is cumbersome or makes them feel claustrophobic. Some complain of stuffy noses, dry mouth and skin irritation.
And a new case report, published in the journal Bipolar Disorders, suggests that it may trigger manic symptoms in those diagnosed with that condition. The extreme euphoria associated with bipolar disorders – the total opposite of the extreme depression on the other end of the pole – brings behavioral changes, such as talking too fast and erratically, shopping excessively and uncontrollably and acting impulsively. It’s not hard to see how this could easily mess with one’s ability to perform basic day-to-day tasks.
While more research on this potential side effect of CPAP, the authors of the case report caution that
Clinicians need to monitor patients with bipolar disorder closely for worsening of manic symptoms when they are started on CPAP for underlying OSA.
Of course, there are alternatives for dealing with OSA. In fact, new guidelines from the American College of Physicians indicate that weight loss should be the first treatment where obstructive sleep apnea is suspected.
“Not everyone with sleep apnea is overweight, but most patients are,” [Dr. Molly] Cooke says. Losing weight gets rid of fat that blocks the windpipe. It would “not only fix your sleep trouble, it would help your cholesterol, it would help your knees, your clothes would fit better and you would be a happier person,” she says.
Patients who still have symptoms at that point might need to go to a sleep clinic and do an overnight test for apnea.
For people who are diagnosed by a sleep clinic, the No. 2 treatment of choice is CPAP, or continuous positive airway pressure.
At least when it comes to conventional medicine. Many consider oral appliance therapy (OAT) to be the frontline treatment at least for mild to moderate OSA – or for those who cannot use CPAP for whatever reason. (At least one study has shown that it may be “effective in controlling…more severe forms of OSA.) These custom-fit devices “reposition the lower jaw, tongue, soft palate, and uvula,” and strengthen the tongue, keeping it from falling back when relaxed, obstructing the airway.
Another alternative is myofunctional therapy, which involves exercises to retrain the muscles of the face and oral cavity, restoring them to proper function. Research continues to support the usefulness in dealing with sleep apnea and a host of other issues. Both the International Association of Orofacial Myology and the Academy of Orofacial Myofunctional Therapy provide online directories of therapists worldwide.
Image by Brandon, via Flickr