Sleep Apnea: Increasing Awareness & Treating the Most Complex Cases

As many as 80 percent of people with sleep apnea don’t know they have it or are currently untreated. Left untreated, sleep apnea can be dangerous and life-threatening. Sudden drops in blood oxygen levels that occur during sleep apnea episodes increase blood pressure and put strain on the cardiovascular system of sleep apnea patients. According to the New England Journal of Medicine, untreated obstructive sleep apnea also greatly increases the risk of stroke. In addition to the health risks of untreated sleep apnea, patients experience a decrease in quality of life, including daytime fatigue, an increased risk of car accidents, headaches upon waking up, a short attention span, as well as depression and memory loss.

A complete list of Warning Signs and Symptoms include:

Frequent cessation of breathing during sleep. Sleep partner may notice repeated silences.

Choking or gasping to get air into the lungs

Loud snoring

Sudden awakenings to restart breathing

Waking up in a sweat during the night

Feeling unrefreshed in the morning after a night’s sleep

Headaches, sore throat of dry mouth after waking up

Daytime sleepiness, including falling asleep at inappropriate times

Lethargy

Rapid weight gain

Memory loss and learning difficulties

Short attention span

Poor judgment

Depression

Personality changes.

The most common form of sleep apnea is obstructive sleep apnea (OSA) caused by a breathing obstruction that stops the air flow in the nose and mouth. In some cases, clients diagnosed with OSA and treated with a CPAP or bilevel device may find that their symptoms still occur, and when they revisit their physician or sleep lab, they discover that they have one of the less common forms of sleep apnea: central sleep apnea or mixed sleep apnea.

Central sleep apnea (CSA) is when the brain signal that instructs the body to breathe is delayed. A central nervous system disorder, CSA can be caused by a disease or injury involving the brain stem, such as stroke, a brain tumor, a viral brain infection or a chronic respiratory disease.

Mixed sleep apnea is a combination of both obstructive sleep apnea and central sleep apnea.

Complex sleep apnea typically consists of predominantly obstructive apneas, which convert to central apneas when treated with a CPAP or bilevel device.

According to Mick Farrell, vice president of marketing, Americas, ResMed Corp. (www.resmed.com), complex sleep apnea is often characterized by:

The persistence or emergence of central apneas or hypopneas upon exposure to CPAP or bilevel when obstructive events have disappeared

Predominately obstructive or mixed apneas during the diagnostic sleep study, occurring at least five times per hour.

With use of a CPAP or bilevel device, a pattern of central apneas and hypopneas that meet the Centers for Medicare & Medicaid Services’ (CMS’s) definition of CSA.

Patients with complex sleep apnea cannot be adequately treated with CPAP or bilevel devices. The clinical consequences are residual symptoms including fatigue, sleepiness, depressed mood and intolerance to current therapy. Patients with CSA may not be able to tolerate conventional CPAP or bilevel therapy both during lab titration and at home. Neither CPAP nor bilevel therapy seems to alleviate sleep disorders.

ResMed has introduced the VPAP Adapt SV, the first FDA-cleared device designed to treat complex sleep apnea, mixed apnea and periodic breathing. VPAP Adapt SV uses adaptive servo-ventilation to adapt to a patient’s ventilatory needs on a breath-by-breath basis, ensuring optimal therapy.

ResMed has introduced its VPAP Adapt SV to sleep labs for patients who are considered “the worst” in terms of their sleep apnea diagnosis and who are experiencing a normalization in their breathing after receiving treatment from the VPAP.

Since the health consequences of untreated sleep apnea are dire, ResMed is working with public relations firms to iincrease the national awareness of sleep apnea and get people into sleep labs. ResMed is also working to educate physicians to look at sleep patterns and how it affects overall health.