Getting a solid night’s sleep on a regular basis is essential for a long and healthy life. Both the quality and overall duration of sleep are equally important. Unfortunately, with the hectic work schedules and a stressful lifestyle of today, millions of Americans are unable to get uninterrupted sleep at night.
One of the underlying causes of not sleeping well in many cases is a condition called sleep apnea. There are an estimated 18 million patients who suffer from this disorder in the United States alone. In this guide, we will explore the various causes and symptoms of this condition, and the dangers of leaving it untreated. We will also discuss various treatment options, including physical therapy for sleep apnea.
What Is Sleep Apnea?
Sleep apnea is a disorder that prevents you from breathing air normally while you are asleep. Patients are unable to maintain a regular breathing cycle when sleeping – instead, they will repeatedly stop breathing.
When this happens, the blood oxygen level will drop and the brain kicks into a state of alertness or survival mode. As a reflex action, the brain will wake the patient up for a brief instant to kickstart breathing.
After this reflex action, the brain again tries to return to the sleep cycle. The patient does not register this reflex as it happens in an incredibly short span of time. With that said, it’s still severe enough to disrupt a normal sleep cycle. It’s not uncommon for patients to wake up at least 30 times per hour in their sleep, all through the night.
Different Forms of Sleep Apnea
The most common form of sleep apnea is called obstructive sleep apnea (OSA), and it can be caused by many factors:
- Enlarged tonsils or adenoids in children
- Old age and obesity in adults
- Men have a higher risk than women
- Physical defects in the airways
- Nasal congestion and sinus infections
- Alcohols, drugs, and other sedatives
- Spending a long time sitting or driving
Central sleep apnea is another form of the disorder. It’s quite rare and caused by irregular brain function. Since the vast majority of patients suffer from OSA, this article will focus on the treatment of OSA.
The severity of your sleep apnea is calculated based on how many interruptions you have in one hour of sleep. This is called the apnea/hypopnea index (AHI). There are three main categories:
- Mild: Between 5 and 15 AHI, or up to 120 interruptions in 8 hours. Treatment may be unnecessary in mild forms of obstructive sleep apnea syndrome.
- Moderate: Between 15 and 29 AHI, or between 120 and 239 sleep interruptions in 8 hours. You may need some treatment for this type of obstructive sleep apnea
- Severe: Above 30 AHI, or more than 239 interruptions each night. Treatment is essential in severe cases, as you may be at increased risk of suffering from heart attack, stroke, diabetes, and other life-threatening illnesses.
The Symptoms and Causes of Sleep Apnea
In its severe forms, the condition can have a wide array of symptoms, including loud snoring at night, extreme fatigue and drowsiness during daytime, memory loss, insomnia, night sweats, and bedwetting (in children).
How Is Severe Obstructive Sleep Apnea Treated?
Obstructive sleep apnea is quite common in the United States – an average of 14% of men and 5% of women suffer from OSA, with a higher risk among African Americans, Asians, and Hispanics.
The most common treatment for severe OSA is continuous positive airway pressure (CPAP). You have to wear a mask attached to a machine every night before you go to bed with this treatment.
A CPAP machine will pump air constantly into your mouth and nostrils, almost entirely removing the risk of interrupted breathing. However, the machine and the mask are not popular among patients.
Wearing the mask can impact your ability to sleep, especially if you are claustrophobic. The straps and mask can also cause contact irritation on your face with extended use. Moreover, carrying an electric-powered machine around is not very practical in many situations.
The main problem with CPAP is that it is not a cure – it is a maintenance therapy that you have to continue your entire life. This is why many patients explore alternatives to CPAP machines, which can include:
- Oral appliances custom made at a dentist’s office that adjust the lower jaw position to improve breath frequency.
- Corrective surgeries and steroids for apnea caused by nasal obstruction.
- Removal of tonsils and adenoids (in children).
- Other surgical options, often as a last resort for patients with severe OSA who cannot use CPAP.
Is Physical Therapy Effective for Obstructive Sleep Apnea?
The head and neck region is made up of a complex system of over 28 bones, 20+ neck muscles, and three distinct joints, as well as a network of passages, the sinuses, in the nose, face, and throat.
Structural weaknesses or deformities in any of these regions can lead to obstruction of the upper airway and sleep-disordered breathing. Even though there is no approved treatment that solely relies on physical therapy in the current clinical guideline, studies indicate that it can provide at least some relief.
At the National Cheng Kung University Hospital in Taiwan in 2017, 15 people with moderate to severe OSA were given physical therapy for 12 weeks. Physical therapy involved a series of massages and simple exercises to strengthen the upper airway muscles. The following areas were targeted in the therapy:
- Tongue, soft palate, and sinus
- Throat and neck
- Jaw and cheek
The participants were also required to do other general exercises, stretching, and aerobics every day to reduce body weight. After 12 weeks, the results indicated that the severity of OSA was reduced from an average of 46 interruptions per hour to 32. The patients experienced higher levels of oxygen in their blood as well.
Certified physical therapists can help reduce the severity of OSA, especially when they work alongside an ENT doctor or other specialists in respiratory medicine. Physical therapy can help in the following ways:
- Improve your jaw and neck alignment.
- Reduce any dysfunction in the soft and hard palate.
- Treat any misalignment in the spine or surrounding muscles.
- Offer advice on pillow placement and sleep positioning.
The key takeaway here is that physical therapy can be a valuable tool in improving your sleep and reducing snoring/OSA. However, for positive outcome measures, it has to be combined with other forms of medical treatments from specialist ENT doctors. Physical therapy cannot cure OSA on its own.
Choose Dr. Mandel’s MIPS Treatment for a Lasting Solution to Sleep Apnea
Dr. Lee Mandel has over two decades of experience in treating snoring and other sinonasal/sleep disorders using minimally invasive procedures. A double board-certified otolaryngologist and specialist in facial reconstructive surgery, Dr. Mandel has pioneered an innovative and proven procedure called minimally invasive palatal stiffening (MIPS) to successfully treat sleep apnea.
To learn more about the MIPS procedure and how it can help you gain freedom from OSA so you don’t have to rely on CPAP machines for the rest of your life, book a consultation today at the Florida Sinus & Snoring Specialists. Call now at 954-983-1211.