New Guidelines Validate CPAP As The Standard Treatment For Sleep Apnea

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New Guidelines Validate CPAP As The Standard Treatment For Sleep Apnea

http://www.medicalnewstoday.com/medicalnews.php?newsid=38673

New practice parameters published by the American Academy of Sleep

Medicine in the March 1 issue of the journal Sleep validate

continuous positive airway pressure, CPAP, as the standard of care

for treating adults with moderate to severe obstructive sleep apnea,

OSA.

" CPAP is the most effective therapy we have for treating patients

with sleep apnea, a disorder that can contribute to the development

of hypertension and heart disease, " said Lawrence J. Epstein, M.D.,

president of the American Academy of Sleep Medicine. " It is

immediately effective, relatively noninvasive and usually well

tolerated. "

Millions Suffer from OSA

OSA afflicts an estimated 15 million to 20 million Americans, the

majority of whom remain undiagnosed and untreated. Men are twice as

likely as women to develop sleep apnea, with excessive weight being

the primary risk factor. OSA is much more common in women as they

enter menopause.

CPAP Normalizes Breathing during Sleep

CPAP delivers pressurized airflow to sleep apnea patients who wear a

mask that covers the nose as they sleep. The steady flow of air from

the CPAP machine keeps the airway open and prevents the pauses in

breathing that characterize OSA. These pauses in breathing can occur

a few times an hour or even hundreds of times per night, resulting in

severely disrupted sleep, excessive daytime sleepiness, and an

increased risk of high blood pressure, stroke, and other forms of

cardiovascular disease.

CPAP Provides Additional Benefits

The practice parameters indicate that in addition to preventing

pauses in breathing and restoring oxygen levels, CPAP improves self-

reported sleepiness in patients with OSA and may also improve their

overall quality of life.

" Patients often express dramatic improvements in how they feel, often

after the first night, " said Dr. Epstein. " They are more alert, have

more energy and are able to perform at higher levels for longer

periods of time. "

The parameters, which were based on an accompanying review of the

evidence found in the scientific literature, suggest that physicians

may choose to use CPAP as a part of their patient-care strategy to

lower blood pressure in hypertensive patients with OSA. CPAP is also

presented as a treatment option that clinicians may recommend for

patients with mild cases of OSA.

Involvement of a Sleep Specialist is Important for Treatment Success

According to the parameters, a trained sleep physician plays a

critical role in the initiation and maintenance of a patient's CPAP

treatment. Treatment with CPAP must be based on both a prior

diagnosis of OSA and a systematic process of titration that

determines the optimal level of air pressure for the individual

patient's needs. An overnight sleep study, or " polysomnogram, "

conducted in a sleep center or laboratory is essential for both of

these requirements.

In order to establish and maintain a long-term adherence to CPAP, the

parameters also recommend that trained health care providers conduct

follow-up of patients, especially during the first few weeks of

treatment. Patients should also schedule annual follow-up

appointments with a sleep specialist who can troubleshoot problems

and make any necessary adjustments to their air pressure level.

Warning Signs for OSA

The following list shows common factors and warning signs in the

development of OSA. Discuss these statements with your doctor or a

sleep specialist if any of them describe your health and your sleep:

- You are overweight with a body mass index (BMI) of 25 or more

- You are a man with a neck size of 17 inches or more

- You are a woman with a neck size of 16 inches or more

- You have high blood pressure

- You are a menopausal or postmenopausal woman

- You snore loudly and frequently

- You make choking or snorting sounds during sleep

- You stop breathing during sleep

- You normally feel tired even after a full night of sleep

- You fall asleep while driving or during periods of daytime

inactivity

- You have a family member who has sleep apnea

Sleep is the official journal of the Associated Professional Sleep

Societies LLC, a joint venture of the American Academy of Sleep

Medicine and the Sleep Research Society. Go online to

http://www.journalsleep.org or visit http://www.sleepeducation.com

for more information about sleep and sleep disorders.