A good night’s sleep

Sleep Thief

Sleep apnea can mess up more than just a good night’s sleep.

An HSI member named Michaele wrote to ask for alternative treatments for obstructive sleep apnea (OSA). This disorder is characterized by prolonged, heavy snoring, but the accompanying health issues far surpass the annoyance that snoring causes.

The most common sleep apnea treatment is called nasal continuous positive airway pressure (CPAP) in which a device supplies a stream of air through a small plastic mask secured over the nose. This is usually effective, but it’s somewhat cumbersome and can be hard to get used to. And according to Michaele: “It has taken the romance out of my life.”

Two new studies show that Michaele may now have another effective treatment option that just might put Cupid back in business.

Don’t hold your breath

The word “apnea” literally means “without breath,” and that’s a good way to describe how almost 25 percent of all middle-aged men and 9 percent of women in America spend their nights. People with sleep apnea actually stop breathing during their sleep, sometimes as many as a hundred times per night, with each episode lasting a minute or longer. So part of the reason a person with sleep apnea feels fatigued during the day is because their body hasn’t been getting enough oxygen during sleeping hours.

But as serious as daytime fatigue can be (resulting in ineffectiveness at work and accidents on the road), research shows that sleep apnea can have far more serious consequences than just fatigue. A 2004 study found that men who suffer from OSA are five times more likely to develop cardiovascular disease, regardless of their age, body mass index, blood pressure or smoking habits.

One tragic story concerning a sleep apnea patient hit close to home. Two years ago, an HSI member named Marilyn wrote to tell us about a surgical procedure her husband underwent to address OSA. This surgery has been shown to curb snoring, but has produced poor results in taking care of sleep apnea. When the snoring stopped, Marilyn and her husband believed his OSA was under control, when in fact he was still having breathing problems during the night.

Marilyn writes: “The specialist never admitted to us that the surgery was only useful to stop the snoring – not the apnea. My husband died from an extremely enlarged heart because we didn’t know until too late that the surgery is now considered worthless.”

Patients & partners

In the years since Marilyn’s loss, a new minimally invasive surgery for sleep apnea has been developed with promising results so far.

The surgery is known as Pillar Procedure and it recently received FDA approval for mild to moderate OSA. With this method, three short polyester strands are implanted in the soft palate on the roof of the mouth. The strands are intended to give additional structure to the soft palate and open the airway.

Last month, researchers from a Massachusetts clinic presented their Pillar Procedure research at the annual meeting of the American Academy of Otolaryngology. Twenty-five OSA patients and their bed partners completed pre-procedure questionnaires to identify severity of snoring, daytime sleepiness and other measures of the condition.

At one month and again at three months after the procedure, patients reported no changes in speech, swallowing or pain. On average, snoring volume was cut in half. Three out of four OSA patients reported satisfaction with the procedure, and 90 percent of the bed partners said they would recommend it. Within the 90-day follow up, three implants partially extruded but didn’t cause complications. No bleeding or infection was reported.

In a similar trial of 53 OSA patients conducted in five clinical centers across the U.S., the Pillar Procedure produced the same rate of success: about 75 percent.

Although FDA officials have given this procedure their stamp of approval, it remains to be seen if in the long run it’s significantly more effective than the surgery Marilyn’s husband had. And according to one report, the cost (around $1,700) may not yet be covered by insurance companies.

You can find more information about the Pillar Procedure at the web site for Restore Medical, Inc. (restoremedical.com).

Sources:
“Pillar Procedure Safe, Effective for Snoring, and Bed Partner Recommended” Newswise, 9/20/05, newswise.com
“Implant Treats Obstructive Sleep Apnea” Ivanhoe Newswire, 9/26/05, ivanhoe.com