Ask Dr. Park: Top 10 Questions About Sleep Apnea

This month, I’ll be answering the top 10 questions I get asked about obstructive sleep apnea. Of course, I’ll also leave plenty of time for me to answer your other questions at the end of the program.

1. What’s the difference between snoring and apnea, and where is each coming from?

2. What’s the best CPAP – mask combination?

3. Is snoring itself harmful or do you need to have sleep apnea to have adverse health effects?

4. How effective are mouthpieces for sleep apnea?

5. How can the source of airway blockages be determined?

6. What’s the best operative solution after UPPP fails and what is it’s success rate?

7. Does sleep apnea cause permanent brain damage?

8. Can CPAP convert OSA into UARS?

9. Do you have any suggestions for what to do for patients who just cannot sleep in a sleep lab?

10. What’s the best sleep apnea treatment?


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11 thoughts on “Ask Dr. Park: Top 10 Questions About Sleep Apnea

  1. Dear Dr. Park,
    I was disgnosed with Sleep Apnea in 2006 and have used a Resmed CPAP with humidifer since. I see gravity as squishing me, as I have Osteogenesis Imperfecta (severe fracturing before the age of 18 years).

    I have been on Bio-Identical Hormones now for 13 years and I am not beaking any bones.

    I hang upside down and created myself a slant board but still I feel tired and diminished retrival of information from my hard-drive brain. I am 61 years old, love life and teach at the college level.

    Would anything out there in the world of action help me outside of my Resmed device?
    Semper Fidelis,
    Christinah

  2. Does Sleep Apnea directly contribute to serotonin deficits in the brain ?

    In reference to Cristinah, STAY AWAY FROM BIO-IDENTICAL HORMONES.

    Consider homeopathic hormone rejuvenation by Dr. Theresa Dale, N.D., Ph.D of http://www.wellnesscenter.net

    Regards,

    Jay

  3. I have an 8-year-old son who was diagnosed with sleep apnea 5 years ago, his results so extreme the doctor wanted the study repeated as the doc thought the equipment malfunctioned. Two tests later, one at a different hospital, the results remain the same.

    No adnoids to remove, no solutions at all. No desats, so docs have no reason to try CPAP..but I have requested a trial run. My son falls asleep in school and at dinner mid-bite.

    Scores:
    109 total arousals due to everything with a sleep efficiency of 75%. central apneas were not causing the majority of the arousals and they were not due to periodic limb movements.

    Where do I go from here? Any advice is greatly appreciated. Docs want try blood pressure medicine. I’m against it.

  4. Margaret,

    What was his AHI? Assuming it’s high, it’s a good idea to at least try CPAP. If he can’t tolerate CPAP, there are a number of orthodontic jaw expansion options that can significantly enlarge his jaws, and hence his airway. Without examining him, I can’t say for sure, but typically children with these issues have jaw underdevelopment and dental crowding. I’m going to have some of these technologies being featured during my upcoming Expert Interviews in the next few months.

  5. AHI score is 2.2

    Just got back from the densit who says his jaw looks ok–didn’t recommend any dental device. She did suggest fluoride inserts every night before CPAP to minimize decay/dryness in mouth. But, we haven’t gone the CPAP route yet so we’ll see.

    Am pretty confused at this point.

    Thanks you for your time and advice. Will buy your book–I’m wondering if an appointment with you would be a good idea? How do we help our son sleep?

  6. Margaret,

    Your confusion is understandable. What are your sleep doctors saying about your son’s condition? If he’s a side or stomach sleeper, it’s likely he has a sleep-breathing problem, but the length of obstructions aren’t long enough to be called apneas. You can literally stop breathing and arouse 10 to 20 times per hours and not have official sleep apnea. Most regular dentists aren’t aware of these issues.

    If you or his father snores heavily, even more reasons to suspect a sleep-breathing problem with your son. I can’t say for sure this is what’s happening without examining him, but this is a typical situation. In the meantime, make sure that he’s not eating anything within 3 hours of bedtime.

  7. Docs pretty much gave up when I said I wasn’t interested in medications–they want to try blood pressure meds.

    He is a side sleeper, then back.

    Sometimes I snore, but it is rare. Same w/his dad.

    We are revisiting the CPAP idea in April. Would a CPAP help with a sleep-breathing problem? Do you think it is worth a try?

    In your book, do you discuss sleep-breathng issues (vs. apnea)? And the eating 3 hours before bedtime, do you discuss this too? (wondering how this helps.)

    I think we may come for a meeting/check up. It is worth getting help with this.

    Thank you again for all your input here.

  8. Have you heard of this procedure?

    A recent basic research advance of potential clinical implication relates to the application of modern three dimensional medical imaging techniques to the study of pathogenesis of sleep apnea. Magnetic resonance imaging (MRI) and ultrafast X-ray computed tomography (CT) of the upper airways, combined with computer graphics and reconstructions, have begun to provide exquisite details of the geometry of the upper airway. These approaches now permit identification of the precise anatomical sites of collapse or areas of abnormal compliance to determine if the problem is in a specific area or is a more generalized multifocal abnormality.

  9. In my opinion, MRIs, Cone-beam CT, and other new imaging modalities look really nice, and can be useful in pre- and post-procedure imaging, but I haven’t found it any more helpful than a good ENT exam and upper airway awake endoscopy. There are three major disadvantages to imaging studies: cost, radiation (CTs), and lack of scanning in the supine position, where the upper airway anatomy changes dramatically. Imaging also gives you static pictures, whereas with endoscopy, you’re seeing the airway live and real-time, at all levels of the upper airway (from the nostrils to the tongue base). You can see these dramatic changes relatively easily with a simple 30 second endoscopy with the patient sitting up and lying flat. Even sleep endoscopy hasn’t been helpful for most cases—the results are similar to what you’d see with the patient lying down.

  10. CPAP can be helpful sometimes even if you don’t officially have an OSA diagnosis. The reason why you shouldn’t eat late is that additional stomach juices will be suctioned up into his throat every time he stops breathing and this can wake him up much more frequently. Although there are certainly reasons other than a sleep-breathing disorder that can explain his condition, you have to exhaust this possibility before moving on to these other options. A simple endoscopy procedure that takes about 1 minute should give us a good answer. It can be done relatively easily in an 8 year old.