Most people have all heard that loud snoring person who makes weird sounds in the middle of the night, sometimes gasping for air and choking. Yet, somehow they seem to sleep through the night. These gasping spells are caused by the flaccid tongue dropping into the airway and blocking air entry into the lungs. This causes oxygen levels to drop in the lung and subsequently the blood stream. The blood pressure in the lungs and body rise in order to grab more oxygen but none is readily available. When the brain begins to sense low oxygen levels, it stimulates the person to wake up, adjust their tongue, and breathe. Although these people appear to sleep through the night, they are always tired and can usually nap at the drop of a hat. They are always fatigued and sleepy because they are not getting to the deep stages of sleep required to feel rested. This syndrome is called Obstructive Sleep Apnea (or OSA), and it is gaining momentum in the medical community. It is being unveiled as a “silent killer” similar to high blood pressure. Many people have symptoms of fatigue, low energy, and poor focus. Most people blame it on age or stress, so they drink more coffee and eat more sugar to stimulate alertness. This is the snowball effect. A fatigued person usually does not have energy to exercise, and they typically eat sugar to stimulate energy levels; thus, they end up gaining weight which actually worsens sleep apnea. As if this syndrome was not bad enough already, it is actually associated with early death, early heart attacks, early strokes, high blood pressure, etc. All of those problems stem from chronic, frequent dipping of oxygen levels. Some people’s oxygen levels go as low as 60% (normal is 100%) before they wake up!
The treatment for Obstructive Sleep Apnea is usually a machine called a CPAP or Continuous Positive Airway Pressure. It basically creates an air pillow in the throat which “splints” the airway open and holds the tongue up. Therefore, the oxygen levels are always maintained because the airway is never blocked. Now, the person can actually get to the deeper stages of sleep. Many people cannot tolerate the CPAP machine because the mask is uncomfortable. The mask covers both the mouth and nose although there are masks that only cover the nose. Moreover, some people feel that the machine “forces” air into their mouth and lungs which leads to discomfort and inability to fall asleep. They are still fatigued due to restless nights. Because of these issues with CPAP machines, the medical community has been seeking new devices that can get people to sleep more comfortably while treating sleep apnea.
One of the newest devices is an implantable device that stimulates the nerves in the tongue to prevent collapse and airway obstruction. This device is implanted beneath the skin of the chest which is similar to a pacemaker. There are 2 leads, or wires, that stretch out from the device. One lead is a sensor planted in the lungs that senses when the person begins to breathe. The other lead is a stimulator that leads to the hypoglossal nerve which stimulates the tongue to contract / flex. By sensing the breath and contracting the tongue, the tongue will not fall into the airway and cause obstruction. Thus, this will treat obstructive sleep apnea. A novel idea, and it is brand new to medicine. We will see in the near future if this takes off.
As always, we at Austin Family Medicine Associates are staying at the cutting edge of medicine.
#SleepApnea #OSA #CPAP