Obstructive sleep apnea affects around 20 million Americans and can lead to hypertension, heart attack, stroke, depression, muscle pain, fibromyalgia, morning headaches, and excessive daytime sleepiness.

Sunday, February 6, 2011

GOOD NEWS - BAD NEWS ABOUT SLEEP APNEA

The good news about sleep apnea is that it easily diagnosed and treated.

The bad news is that sleep apnea can cause Hypertension and an estimated 50-70% of people with sleep apnea have hypertension, or high blood pressure. This increases the risk for heart attack, stroke, and other health problems.

The Good news is that sleep apnea is easily and effectively treated with CPAP.

The bad news about sleep apnea is that 60% of patients diagnosed with sleep apnea cannot tolerate CPAP. When sleep apnea is not treated it can lead to Coronary Heart Disease. Sleep apnea can lead to activation of the sympathetic nervous system which is responsible for the “fight-or-flight” response. Sleep apnea also is responsible for problems with the lining of blood vessels, inflammation, and problems with metabolic regulation.

The good news is that oral appliances are a comfortable alternative to CPAP.

The bad news is that your doctor probably never told you that oral appliances are considered a first line treatment for mild to moderate sleep apnea. Because patients are unaware of this effective and comfortable alternative to CPAP they are at increased risk for Stroke, Chronic Heart Failure and Sudden Death.

The association between stroke and sleep apnea according to considerable research is as convincing as the association between smoking and stroke. During apneic episodes the blood vessels of the brain dilate when the oxygen levels fall. Patients with sleep apnea are more susceptible to clots that may lead to stroke. Research has shown that the number of strokes in patients with untreated sleep apnea are staggering and that 40-60% of people experiencing strokes have been found to have obstructive sleep apnea. In addition to stoke sleep apnea leads to chronic heart failure and numerous serious cosequences from this condition as well as a staggering risk of dying in their sleep. Half of patients with sleep apnea die between midnight and 6 AM compared to only 21% of patients without sleep apnea.

The good news is that weight loss can improve sleep apnea.

The bad news is that it is almost impossible for patients with untreated sleep apnea to lose weight because of metabolic changes associated with their sleep apnea.

The good news is that oral appliances are effective for treating sleep apnea and that the vast majority of patients prefer them to CPAP. Patients who treat their sleep apnea with oral appliances usually have more energy and find it easier to exercise and to lose weight.

The bad news is that patients who treat their sleep apnea with oral appliances need to save more for retirement.

The good new is the reason they need to save more is because they live longer.

The bad news about sleep apnea is that patients with untreated sleep apnea have a six-fold increase in motor vehicle accidents and slower reaction times than drivers who are legally drunk.

The good news is effective treatment with CPAP or a comfortable oral appliance reduces that risk to to normal. Also good news is that recent studies have shown that when properly titrated oral appliances can be as effective as CPAP for a majority of patients with severe sleep apnea.

The bad news is that snoring and associated sleep apnea can lead to marital difficulties, separate bedrooms, reduced sex drive and even impotence. According to a study at Mayo Clinic spouse of snorers lose up to 15% of their sleep. According to anecdotal evidence I have seen this pisses them off.

The good news is that there are oral appliances with volume controls for the spouse to turn off the snoring and eliminate sleep apnea. The bad news is your spouse will live longer, no thats the good news.

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posted by Dr Shapira at 9:51 PM