- Now how do you treat it? Oh, there's a few things. Obviously weight loss because sixty,
seventy percent of the patients are overweight or obese, so weight loss is
important. Exercise is important. In fact aerobic exercise - twelve weeks in a study.
A little muscle exercise, aerobic exercise decreases decrease the apnea
severity by twenty five percent. And also good habits of sleep. Avoiding certain
things like alcohol before going to bed. Alcohol very specifically relaxes the
throat muscles, what we call the pharyngeal dilators and you will snore.
If you don't have apnea or snore, and you drink and go to sleep you'll snore
that night. And if you snore but don't apnea, you drink you'll have apnea
that night. If you have apnea it'll be more severe.
It just goes that way, so avoid drinking alcohol before going to bed. Now here's the
dreaded CPAP, continuous positive airway pressure. But it is the best therapy we
have so far. There's all kinds of other things you may have some questions about,
Inspire or some other things out there right now, but this remains in the gold
standard that we have. It it is effective 100% of the time if you're able and willing
to use it. Rarely do we have to do something else and that has to do with
people who are extremely big. Otherwise it's quite effective but cumbersome. It
splints the throat open that's all it does. It's not a ventilator. It doesn't give you
oxygen, it just keeps your throat open and you do the rest. There's other
treatment options, and this is called a mandibular repositioning device or MRD,
or a mandibular advancement device, or a jaw advancing advice. Whatever you're
gonna call it. It goes on your teeth and pulls your jaw forward. You have to have
good teeth. It's good for people have mild, maybe moderate apnea, and young good
teeth. Otherwise it'll knock your teeth out. And it has problems with TMJ issues.
It is definitely a second to sleep apnea, to CPAP, but probably a distant second.
Some people use it extensively. But when we take them to the lab and see how
effective it is, it is not that effective. At least at the VA hospital it is not very
very good, because of the population we have. And there's other other therapies. I
mentioned the Inspire therapy. It's actually surgery, it's a pacemaker you put
in. Goes in, a wire goes to your tongue, a
wire goes to your ribs. There's this little barbed piece of plastic you put
in your throat that's basically for snoring, doesn't work very well.
This one you stick a needle in the back of your tongue and you cook it with
microwaves and then as it heals it decreases in volume, becomes stiff
because that's the part of the tongue that blocks you. Again for snoring
doesn't do much for a sleep apnea. And this one, you put these little plugs in your nose.
It's a one-way valve. When you inhale it's, open when you exhale is partially closed.
So it's a back pressure. I haven't made it be able to work in anybody that I've
tried it. And some people say it works but I tell you my patients just just
cannot even be awake with that thing on. And it turns out that the exercising the
tongue is important. And I don't mean talking all right, I don't mean talking. I
mean exercising the tongue decreases the apnea severity if you do it correctly up
to 50 percent. So 20 minutes a day of the didgeridoo keeps the sleep doctor
away. And so this gentleman is a middle-aged adult male he probably needs
it, he probably has asleep apnea. Nicole Kidman probably does not have sleep apnea.
This guy definitely needs it. And by the way when you play this thing you don't have
to dress the part. You just use it like that and you'll just be fine. But I'd be
surprised. I do have a patient, maybe four, that are using this and one is very cute
because he lost weight. And I thought yeah he actually cured his sleep apnea and he
lost weight and using the didgeridoo. And so repeat the study knows apnea, but now
the wife is upset because he's making noise all day long. And so he goes he
goes on vacation with the wife and he forgets the blessest didgeridoo. Two weeks
later he starts snoring. The wife said when we get home you better start that
thing again. So it may work.