Dr. Safwan Badr, M.D.
Professor and Chief, Critical Care and Sleep Medicine
DMC Detroit Receiving Hospital (DRH)
DMC Harper University Hospital (HUH)
(part 2 of a two-part series)
Last week my colleague, Dr. James Rowley, wrote in this space about the most common sleep disorder, obstructive sleep apnea (OSA). This week, I’ll write about the ways we have to treat this serious condition.
The treatment recommended for your sleep apnea will depend on the reason for and the severity of the disorder. If your OSA is from being overweight, weight loss may cause the apnea to go away completely. Other things you can do are avoid alcohol for at least four hours before going to bed. If you sleep on your back, use a pillow or some other strategy to force yourself to sleep on your side. Some people sew a tennis ball into their pajama bottoms to remind them not to turn on their back.
Continuous Positive Airway Pressure (CPAP) is a common device ordered to treat most conditions of OSA. CPAP is delivered by a compressor that blows air (with or without oxygen) into a mask that is worn snugly over the nose and/or mouth during sleep. The flow of air acts like a splint to keep the upper airway from collapsing. This helps prevent obstruction and the apnea from occurring. The air pressure is adjusted to a setting that best corrects the apnea. Often a person will notice much less snoring when wearing a CPAP device.
There are devices and surgeries which can be done to treat OSA, for patients who are unable to use the CPAP machine. Some oral devices (worn in the mouth during sleep) may keep your airway open. Most of them work by either bringing the jaw forward or keeping the tongue from blocking the throat. Oral devices are most likely to help a person who has mild sleep apnea and is not overweight. They are usually custom-made and fitted under the supervision of a specialized dentist or oral surgeon who works with these problems.
The role of surgery in the treatment of sleep apnea is less clear, given the number of possible surgical interventions. Generally speaking, surgery is less effective than CPAP and is usually reserved for patients who cannot use CPAP. Surgery can also facilitate the use of nasal CPAP by clearing out nasal narrowing or removing severely enlarged tonsils.
For more information or to schedule an appointment, call the staff at the Detroit Receiving Hospital Sleep Disorders Center (313) 745-4525.
Dr. Safwan Badr is a leading national expert in sleep disorders who is board certified in internal medicine, pulmonary medicine, critical care medicine and sleep medicine. Dr. Badr graduated from Damascus University Medical School in Syria and completed his internship and residency in internal medicine at Cook County Hospital, Chicago. Following two fellowships at the University of Wisconsin, Dr. Badr was named to the school’s faculty. Since 1996 he has served as the director of the WSU Sleep Program, and in a variety of teaching and administrative positions at the school, including chief, division of pulmonary, allergy, critical care and sleep medicine; professor of physiology; professor of biomedical engineering; and director of the ACGME Sleep Fellowship Program. Dr. Badr has been the principal investigator on 19 grant-funded research efforts and seven clinical trials. He holds four patents for biomedical devices.