There are bulky machines and small devices, but there's no cure-all.
By Amanda Leigh Mascarelli, Special to the Los Angeles Times
February 28, 2011
As Americans' waistlines continue to grow, so does the number of people who aren't getting a good night's sleep.About 2% of women and at least 4% of men suffer from obstructive sleep apnea, a condition in which the airway collapses and blocks breathing for 30 seconds or even up to a minute or two. The brain senses that it isn't receiving enough oxygen and sends a signal to the person to wake up. The awakenings are brief enough that people usually are not aware of them, but sleep is disrupted continually throughout the night, leading to daytime fatigue and drowsiness. (...)
Some people have mild enough symptoms that the condition can be alleviated with minor changes, such as sleeping on one's side rather than on the back.
But for those with more stubborn cases, the most common treatment is continuous positive airway pressure, or CPAP. There are many versions, though they all include a mask hooked up to a machine that blows air into the airway, acting like a virtual splint to help keep it open. Some masks cover the nose and mouth, while others cover the nose only or use tubes to blow air directly into the nostrils.
When used properly, CPAP is extremely effective. A study last month in the journal Sleep found that after three weeks of CPAP treatment, patients with severe symptoms saw marked improvements in daytime sleepiness and fatigue.
But not everyone wants to wear a mask to bed. "It's not very pretty, it's not very sexy and it can be uncomfortable at first," Ancoli-Israel says.
One new alternative is Provent, a much smaller device that emulates CPAP but uses the pressure created by a person's own breathing to maintain airflow. It consists of two circular stickers, each with a miniature valve in the middle. They cover the nostrils during the night — similar to a pair of Band-Aids — and are thrown away in the morning. A forthcoming study from the journal Sleep found that patients who used Provent consistently had significantly fewer apnea events and less daytime sleepiness.
Dental mouthpieces are another option for treating mild to moderate sleep apnea, especially for patients who are only modestly overweight. The devices are similar to retainers — they push the lower jaw forward, bringing the tongue forward as well and widening the airway as a result, Epstein says.
But for those with more stubborn cases, the most common treatment is continuous positive airway pressure, or CPAP. There are many versions, though they all include a mask hooked up to a machine that blows air into the airway, acting like a virtual splint to help keep it open. Some masks cover the nose and mouth, while others cover the nose only or use tubes to blow air directly into the nostrils.
When used properly, CPAP is extremely effective. A study last month in the journal Sleep found that after three weeks of CPAP treatment, patients with severe symptoms saw marked improvements in daytime sleepiness and fatigue.
But not everyone wants to wear a mask to bed. "It's not very pretty, it's not very sexy and it can be uncomfortable at first," Ancoli-Israel says.
One new alternative is Provent, a much smaller device that emulates CPAP but uses the pressure created by a person's own breathing to maintain airflow. It consists of two circular stickers, each with a miniature valve in the middle. They cover the nostrils during the night — similar to a pair of Band-Aids — and are thrown away in the morning. A forthcoming study from the journal Sleep found that patients who used Provent consistently had significantly fewer apnea events and less daytime sleepiness.
Dental mouthpieces are another option for treating mild to moderate sleep apnea, especially for patients who are only modestly overweight. The devices are similar to retainers — they push the lower jaw forward, bringing the tongue forward as well and widening the airway as a result, Epstein says.
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