Treatment Options

Dr Alex Bartle of Sleep Well Clinic NZ talks about the treatment options for Sleep Apnoea


Dr Alex Bartle talks about care of your CPAP and replacing parts


 

Dental options Dental Treatment for Snoring and OSA - a 2007 pdf with options that may be suitable for mild sleep apnoea

 

 

 

 

 


Weinmann Notes

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Reproduced in the SAANZ website with the express permission of Weinmann. 
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What Treatment Choices are There?

The goal of sleep apnoea therapy is to eliminate nightly respiratory arrest and to restore healthy sleep structure.

General Measures
These measures help you to eliminate the preventable risks associated with sleep related
respiratory disorders or at least to reduce them considerably. They are:

  • Weight reduction
  • Observance of good sleep habits
  • Reduced consumption of alcohol and nicotine
  • Discontinuation of medicine that diminishes respiratory functions during sleep (eg sedatives
    or sleeping pills)
  • Avoidance of coffee / tea / cola in the evening

Position Therapy
You should prevent yourself from turning over onto your back during the night since that position increases the risk of sleep related respiratory disorder. You can wear a backpack filled with newspapers or sew a tennis ball into your pyjamas.

- Respiratory ArrestTherapy Devices
In the treatment of obstructive sleep apnoea, the use of nasal positive pressure devices (CPAP, auto-CPAP, Bi-Level) have proven to be the most successful by far. These devices prevent the airways from closing by providing a so-called ‘splint’ of individually determined air pressure that keeps airways open.

In CPAP therapy (Continuous Positive Airway Pressure), the patient is supplied with air set at a pressure determined for each individual patient at the sleep lab and set on the device.

Some patients with obstructive sleep apnoea require a greatly varied pressure. In this case, an auto-CPAP device or an intelligent CPAP device can be of help. They always see when an obstruction is building up and react in time to prevent the airways from closing.

Another patient group requires permanently high pressure to hold open the airways through the night.

For some patients, the high pressure makes exhalation increasingly difficult. Fortunately, Bi-Level devices can help by greatly reducing the pressure during exhalation.

Depending on the type of device (‘S’ or ‘ST), Bi-Level devices are also used for assisted or controlled ventilation, for example, in cases of Adipose-Hypoventilation Syndrome or central respiratory regulation disorders.

Exhalation Systems
During therapy, the exhaled CO2-laden air has to be discharged properly. This is handled by the exhalation system, which is an opening, slits or pores through which the air can be expelled. Obviously, the patient will find therapy more comfortable if the noise level of the outgoing air is low.

Headgear
The mask is held in position by appropriate headgear. Caps and straps are now available in many forms and colours to suit all possible head shapes and tastes.

Humidifiers
Some patients have sensitive mucous membranes that dry out quickly. They also need a humidifier, which puts humidity into the air and prevents the airways from drying out. Heated humidifiers that warm the air with water are especially efficient because they provide a higher humidity level than devices without heating elements. The appropriate humidifier should be selected on a case-by-case basis.

Dental Splint / Orthesis
A small number of OSA patients benefit from dental splints or orthesis appliances. They are normally positioned to push the lower jaw forward.

Medicinal Therapy
Only a few patients with a slight case of sleep apnoea can be considered for theophylline treatment.

Surgical Therapy
Some patients with sleep apnoea syndrome can be helped with oral or facial surgery, which stabilizes and enlarges the pharyngeal area. Since the success rate is very low, this method of treating OSAS is hardly ever used.

Masks - How does the air flow get into the airways?
The air is brought from the device via a hose system to the patient’s mask, which is held firmly in place by headgear. The mask is a central component of treatment. It sits directly on the patient’s face and determines the degree of movement permitted during sleep. A mask with a ball-and-socket joint allows the patient to move any way he likes during the night.

Patients Tell of Their Experiences:

Michael K:
“When I first saw the device combination that was supposed to be with me night after night, I was not exactly happy. But as soon as I’d spent one trial night with my CPAP device, I felt fresher and more rested the next morning than I had in years. Now I use it every night, even on holiday because otherwise I’d get nothing out of my break.”

Richard R:
“In the beginning, I had problems with dried out mucous membranes. Then my doctor prescribed a heated humidifier for me. After that, everything was much better.”

Richard P:
“At first I was worried that my family wouldn’t accept my therapy. It’s not easy to overlook the equipment. But my wife and children are so happy that their lively husband and father is back again.”

For decades Weinmann has been developing, producing and marketing medical devices for markets around the world. In cooperation with our partners Weinmann design economic health systems for diagnosis and therapy in Sleep Medicine, Home Mechanical Ventilation, Oxygen Medicine and Emergency Medicine.

 

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