Sleep Bytes & Blog

Will My Obstructive Sleep Apnea Ever Go Away? Hey Sleep Warriors! Will Obstructive Sleep Apnea, or OSA, ever go away? Many patients ask me this question. My style has always been to be upfront with people, so I want to do the same for you.  The short answer: probably not, but it depends, so stick with me.  Obstructive Sleep Apnea is a chronic condition where an individual experiences brief and repeated interruptions in breathing during sleep, due to the relaxation of throat muscles. It tends to get worse with age as the tissue in the back of our throats gets a little “looser”. It also gets worse with increased weight.  Now, thankfully, we have effective treatments for OSA, such as CPAP and oral appliances. These therapies work by keeping the airways open, reducing or eliminating the occurrences of apnea events during sleep. While CPAP and other therapies are excellent for managing symptoms, such as improving daytime sleepiness and overall sleep quality, it's important to note that they don't necessarily address the underlying cause of OSA. It's like using glasses for vision correction; it aids the condition but doesn’t cure it So, for most people, sleep apnea does not go away. But, like most things in medicine, there are exceptions.  #1 - Weight loss! Excess weight, particularly around the neck, can contribute to airway obstruction. Therefore, losing a significant amount of weight may eliminate your OSA. However, here’s the catch – it can be quite challenging to lose weight when dealing with untreated sleep apnea due to the impact on energy levels and metabolism.  Addressing your sleep apnea with treatment can help improve your energy levels and overall well-being, potentially making it easier to engage in healthy behaviors and weight loss activities. So I recommend getting started on treatment – use it as a springboard to increase energy and motivation – and then after you have lost a significant amount of weight (usually at least 10-20% of your body weight or to a BMI below 30), retest with a diagnostic sleep study.  The second situation in which sleep apnea may go away is surgery. For some people, nasal or oral surgery can improve airflow and open the airway. One such surgery is a tonsillectomy for people who have enlarged tonsils. If you remove what’s in the way, your sleep apnea is likely to improve. An important point is that it can be difficult to know if your sleep apnea has resolved if you don’t do another sleep study. Even if you “feel” like your sleep apnea has improved or gone away, it is important to retest, as untreated sleep apnea can lead to a number of negative effects on your overall health, especially if you had moderate to severe sleep apnea.  Living with Obstructive Sleep Apnea means adapting to a new normal. Maintaining the continuous flow of oxygen to your brain is critical. It not only prevents the immediate symptoms of sleep apnea but also reduces the risk of long-term health issues, such as heart disease and stroke. It's crucial to work on your mindset, to embrace the treatments available, and to understand that by treating your sleep apnea, you are enabling your best life through quality sleep.  So, in conclusion, Obstructive Sleep Apnea is a chronic condition that may not ‘go away’ in the conventional sense. However, with the right treatment, lifestyle changes, and mindset, you can lead a joyful, productive, and healthy life. Thanks for being here. I’ll see you next week!

Be Prepared: Pain Pills & Your CPAP Narcotics or opiates - which I will refer to as just “narcotics”- are commonly prescribed for pain relief. These include medications like oxycodone, Vicodin, Norco, and Percocet, in addition to straight-up morphine, Dilaudid, Fentanyl, and MS Contin, and to a lesser degree, Tramadol. Narcotics are common in the treatment of post-operative pain; however, they are known to slow down breathing - something called “respiratory depression” - even at appropriate doses. The presence of obstructive sleep apnea (OSA) increases the risk of opioid-induced respiratory depression. This can lead to an increase in obstructive events by increasing sedation and cause a different type of event - central sleep apnea - and what your CPAP machine reads as "clear airway" events. The potential result? An unexpected spike in your morning AHI (Apnea-Hypopnea Index) numbers. And just as a refresher, with treated sleep apnea, we aim for an AHI of 5 or below. Your CPAP numbers can help to monitor the effect of your pain medication on your sleep apnea and the effectiveness of your CPAP in treating sleep apnea. If you use an oral appliance, you can monitor for worsening sleep apnea with a Snore App or certain sleep trackers that have the ability to (imperfectly) measure oxygen levels. Three Tips for Optimal Sleep Health while taking narcotic pain medication: Open Communication: Always discuss with your doctor if you believe the narcotics might be affecting your sleep. If you've been noticing an unusual rise in your morning AHI after starting on pain medication, it's essential to inform your provider, as adjustments in your machine settings may help. Use the lowest dose of narcotic needed to treat your pain, and discuss alternatives for nighttime pain relief with your doctor. Medications like Tylenol, non-steroidal anti-inflammatory medications such as naproxen or ibuprofen, or nerve pain medications like gabapentin can all help decrease pain during sleep. So talk with your provider about which ones may be options for you. Avoid long daytime naps. After a procedure, it might be tempting to sleep during the day. But remember, short, 20-minute naps are more beneficial and can help maintain a healthy sleep cycle. Avoiding long daytime naps (meaning longer than about 45 minutes) will increase your sleep drive at night and make uninterrupted sleep more likely. So set an alarm and keep those naps short. Thanks for being here. I’ll see you next week!

Sleep Apnea and Follow-up Sleep Studies: What You Need to Know Hey Sleep Warriors! Today, we're diving into a topic that has garnered quite a few questions over the years: “How often should you undergo a sleep study after being diagnosed with sleep apnea?"  Imagine this: you've been diagnosed with sleep apnea, you've got your treatment in place, and you're now comfortably breathing easy at night. This may go on for years. Then, the big question becomes, when should you go back for another sleep study?  Here's the deal. Once you're diagnosed and are comfortable with your treatment, repeating a sleep study is, more often than not, not medically required. That's right! Because sleep apnea is a chronic condition, once you get the diagnosis, you don't need to keep going back to prove you still have it.   In fact, I've had some patients who have been on sleep apnea therapy for decades without ever setting foot back in a sleep lab.  Your CPAP machine, however, like all equipment, has a lifespan. You'll need to replace your CPAP roughly every 7 to 10 years. But—and this is key—just because you're replacing your machine doesn't mean you need to revisit the sleep lab. If you're feeling refreshed every morning and the data from your machine looks consistent and positive, then it's an affirmation that everything's on track. Now, as with everything in the medical realm, there are exceptions.  Significant Weight Loss: We're talking major transformation. If you've lost a lot of weight, there's a chance your sleep apnea could resolve, or at least, decrease in severity. Going back to the sleep lab to determine the NEW severity and/or having a repeat CPAP titration study to determine new pressure settings, may be beneficial. However, even after weight loss, there are ways to avoid returning to the sleep lab, so talk with your provider to see what is right for you. Changes in your machine numbers. This is a crucial one. If the data from your machine starts showing concerning patterns like a hike in your AHI (Apnea-Hypopnea Index), your provider may want to make some minor adjustments to your settings. If this doesn’t resolve the issue, you may need to return to the lab so your provider can get a better view of what's going on. Be sure and let your provider know of any new medications or weight gain – both of which can impact your sleep apnea. Changing medical equipment providers. Let’s say you move across the country - you’ll most likely need to switch your medical equipment provider - which is the company that supplies your masks, filters, and hoses. The new company will need to have a copy of your original sleep study to “prove” that you indeed have sleep apnea and they can bill your insurance company for supplies. If you no longer have access to this study and can’t get a copy, you may need to get a new sleep study. A pro-tip is that your old equipment company likely has a copy and they can often forward this to you or the new equipment company. Now, even with the old sleep study, there are some insurances out there that will just insist on a new diagnostic test. Unfortunately, this means that you will need to spend the night without your CPAP - so talk to your provider about preparing and don’t plan on any significant driving the next day!  Now, a golden nugget of advice here. The world of sleep studies has evolved. Today, most diagnostic sleep studies are actually conducted at home. Yep, in the comfort of your pajamas and favorite bedtime stories! But here's where you need to tread with caution. If you've had past sleep studies done in a lab, those numbers might differ from the ones done at home. It's not an apples-to-apples comparison, so always remember to consider the context when interpreting any updated results.  Sleep is crucial, friends. It's our body's natural way of recharging, healing, and rejuvenating. And if you've battled sleep apnea and found your therapeutic sweet spot, great job, keep up the good work.  Thanks for being here. I’ll see you next week.