23.05.2014
Symptoms may be present for years, even decades without identification, during which time the sufferer may become conditioned to the daytime sleepiness and fatigue associated with significant levels of sleep deprivation. For example, the hormone adiponectin is decreased in concentration in the serum in patients with sleep apnea. The availability of an effective treatment stimulated an aggressive search for affected individuals and led to the establishment of hundreds of specialized clinics dedicated to the diagnosis and treatment of sleep disorders. However, chronic, severe obstructive sleep apnea requires treatment to prevent sleep deprivation and other medical complications, including death. A bed partner may lose an hour or more of sleep each night from sleeping next to a person with sleep apnea.
Drastic problems can result from the oxygen deprivation of sleep apnea, including premature death.
The real difficulty in obstructive sleep apnea is identifying the level of obstruction in the pharynx during sleep.


An oral appliance is a custom made mouthpiece that shifts the jaw forward to help keep the pharynx open during sleep. Along with the apnea episodes, the person afflicted with sleep apnea may have additional trouble sleeping caused by side effects of the condition, including a frequent need to get up and urinate during the night, and excessive nighttime sweating. Oral appliance therapy is usually successful in patients with mild to moderate obstructive sleep apnea. People with CSA seldom snore, which makes it even harder to diagnose as they do not fit the "normal" profile of a sleep apnea sufferer.
The exact mechanism of the loss of central respiratory drive during sleep in obstructive sleep apnea is unknown. In obstructive sleep apnea, breathing is interrupted by a physical block to airflow despite contraction of the hemi- diaphragms.
That a tracheotomy can effectively treat even severe obstructive sleep apnea implies that the anatomic site or sites of obstruction of the airway during sleep are above or superior to the level of the trachea.


However, while the causes of the breathing cessation are different in central sleep apnea and obstructive sleep apnea, the symptoms and results are much the same.
In mixed sleep apnea, there is a transition from central to obstructive features during the apneic events themselves.
An adhesive flange can alternatively be used to retain the nasal-pharyngeal tube in place during sleep so that it does not back out of its desired position.



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