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Treatment and Therapy

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CPAP Titration Study

Maybe you begin to wonder why your doctor asks you to undergo CPAP Titration study after either having the Home Sleep Study or polysomnography to confirm sleep apnea.

Titration is the process of determining the optimal pressure setting for the patient.   Meanwhile, CPAP titration study is a test done in a sleep center wherein you will be attached to a machine that will determine the amount of pressure needed for you to have normal breathing while asleep.  Air pressure setting varies from patient to patient.  It may also change for you if certain factors change (i.e. weight change)

During the procedure, you will be asked to wear a mask and the sleep technician will do the adjustments on the CPAP air pressure that best help you whenever you are having sleep apnea. You may also be asked to sleep on your back, sides and even on the stomach during the study.

Some PSG studies are purely for CPAP titration (usually after a first study where OSA is diagnosed). Some PSG studies are “Split Studies”, where titration happens in the second half.

 

Oral Appliance Therapy (Jaw Advancing Device)

Are you looking for more convenient ways to manage your sleep apnea? The Oral Appliance Therapy may be the answer. Otherwise known as Jaw Advancing Device (JAD), this therapy may be an effective way for you in your fight against sleep apnea.

JAD is similar to the mouth guards used by the sports athletes. This works by moving your jaw forward, thus increasing the size of your airway which prevents snoring and pauses in your breathing. Your sleep specialist may first recommend that you undergo a sleep study before you will be prescribed to use this device. Once the prescription has been released, your sleep doctor will refer you to a dentist for fitting.

 

Surgery For Sleep Apnea

I have difficulty wearing my CPAP device, this may be your answer when your sleep doctor asks you the reason for not religiously using CPAP for your sleep apnea. However, if your sleep apnea is severe and you cannot tolerate CPAP use, your sleep specialist may recommend that you undergo surgery.

There are several types of surgery for sleep apnea and your doctor will first have a detailed examination of your airway to determine which surgery will you undergo. An Oral Surgeon will perform the surgery which may focus on the following areas of your air passage: soft palate and uvula, tonsils and adenoids, tongue, and upper and lower jaw.

However, surgery does not guarantee a cure for your condition and that is why a follow up visit with your sleep doctor, after your operation, is very important.

 

Melatonin

Melatonin is a hormone produced by pineal gland of our brain. It plays an important role in the control of our sleep and wakefulness. Normally, there is an increasing amount of melatonin produced at nighttime to signal our body to sleep and melatonin drops early in the morning to signal our waking hours.

The production of this hormone is affected by factors such as light (exposure to natural sunlight), season (winter may change the timing of its production) and, age (older people secrete less melatonin than normal). This hormone is usually used to treat people who are suffering from Circadian Rhythm Disorders like delayed sleep phase disorder, jetlag, shift work and insomnia.

 

Cognitive-Behavioral Therapy

Cognitive-behavioral Therapy (CBT) is a type of treatment that helps us change the way we think and behave. This therapy is used in treating sleep disorders without the use of pills and machines. This therapy is commonly used to treat chronic insomnia. Sleep habits are also the cornerstone of CBT which can help you address the thoughts and behaviors that prevent you from sleeping well. It also includes techniques for stress reduction, relaxation and sleep schedule management.

In CBT, your sleep doctor will help you identify triggering factors that may have contributed to your sleep problems. Here are some CBT methods:

  • Stimulus Control Therapy – this helps you remove the factors that conditions your mind from sleeping.
  • Sleep Hygiene – this is a method in which your habits are corrected to promote sleep.
  • Sleep Restriction – this method reduces the time you spend in bed sleeping.
  • Relaxation Training – this method helps you calm your mind and body.

Usually, the most effective method maybe a combination of these therapies.

 

Sleep Medications

If you are searching for solution to your sleep problems like having trouble sleeping and staying asleep or taking too much sleep, you may have bumped into sleep medications which target specific areas of the brain.

Medications such as sleeping pills may help you fall and stay asleep in cases of insomnia while stimulants (amphetamines) may help you with daytime sleepiness like narcolepsy. These are usually prescribed if your sleep problem is severe. Medications are usually used for a short time and work best in combination with good sleeping habits.

 

Bright Light Therapy

Trouble falling asleep and staying asleep maybe your reasons for not being able to give your best performance at work. You may also have looked for options to treat this problem by browsing the internet but to no avail. Well, good news, Bright Light Therapy or simply Light Therapy maybe the answer to your problem.

Light therapy is performed by exposing you to a bright light source in order to stimulate your body clock. It is thought that the light emitted through this therapy mimics the sunlight and can reset your internal body clock. It can also help boost your energy and mood. To choose the best therapy for your sleep problem, a consultation with a sleep specialist can be helpful.

 

Sources:

  • American Academy of Sleep Medicine. (2018). Sleep Education. Essentials in Sleep. http://sleepeducation.org/essentials-in-sleep/cpap
  • Henry G. Raroque, MD. (2014). Lecture notes on OSA and CPAP Compliance. The Dallas School of Neuroscience and Sleep Medicine, Texas.
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