ALLERGY, RESPIRATORY
'Safe' Ozone Levels May Not Be for Some
Folic Acid Might Offer Allergy Relief
Combating Myths About Seasonal Allergies
ALTERNATIVE MEDICINE
Tai Chi: An Ideal Exercise for Many People with Diabetes
Needling Away Your Headaches With Acupuncture
Acupuncture May Trigger Natural Painkiller
ANIMAL CARE
Separation Anxiety, Canine-Style
'Comfort Dogs' Come to Emotional Rescue
Animals Respond to Acupuncture's Healing Touch
BONES & JOINTS
Gene Therapy May Ease Rheumatoid Arthritis
Human Ancestors Put Best Foot Forward 1.5M Years Ago
Vitamin C Protects Some Elderly Men From Bone Loss
CANCER
Steady Weight Gain Boosts Late-Life Breast Cancer Risk
Family History Key Player in Brain Cancer Risk
Study Cites Gains in Gall Bladder Cancer Treatment
CAREGIVING
Birthmark or Blood Vessel Problem?
Diabetes Epidemic Now Poses Challenges for Nursing Homes
Study Links Pesticides to Birth Defects
CIRCULATORY SYSTEM
Exercise Extends Life of Kidney Patients
Health Tip: Are You Anemic?
Bye, Bye Back Fat?
COSMETIC
What to Do If You Have Unsightly Veins
Health Tip: After Liposuction
Science May Banish Bad Hair Days
DENTAL, ORAL
Gum Disease Treatment Doesn't Cut Preterm Birth Risk
Toothbrushing May Stave Off Heart Woes
Health Tip: At Risk for Gingivitis
DIABETES
Brown Rice Bests White for Diabetes Prevention
Formula Puts Doctor, Patient Glucose Readings on Same Page
Treatment for Type 2 Diabetes Updated
DIET, NUTRITION
Cinnamon Breaks Up Brain Plaques, May Hold Key to Fighting Alzheimer’s
Natural Oils Help Lower Body Fat For Some
Six Healthy-Sounding Foods That Really Aren't
DISABILITIES
Review Finds Marijuana May Help MS Patients
Could Your Cell Phone Help Shield You From Alzheimer's?
ENVIRONMENTAL HEALTH
Climate Change Could Sting Allergy, Asthma Sufferers
Chemicals in Carpets, Non-Stick Pans Tied to Thyroid Disease
FDA Faulted for Stance on Chemical in Plastics
EYE CARE, VISION
Stem Cells Repair Damaged Corneas in Mice
Time Teaches Brain to Recognize Objects
Clues Found to Brain Mechanism Behind Migraines
FITNESS
Mom and Baby Alike May Benefit From Exercise
MRSA Infections Can Bug Fitness Buffs
Exercise 30 Minutes a Day? Who Knew!
GASTROINTESTINAL PROBLEMS
Soothing Imagery May Help Rid Some Kids of Stomach Pain
Peppermint Oil, Fiber Can Fight Irritable Bowel
Olive Oil May Protect Against Bowel Disease
GENERAL HEALTH
Want to Stop Cancer? You Can, Experts Say
8 Drugs Doctors Would Never Take
What you need to know about swine flu.
HEAD & NECK
Many Children Will Outgrow Headaches
Ski Helmets Encouraged for All
Zen May Thicken Brain, Thwart Pain
HEALTH & TECHNOLOGY
Imaging Sheds Light on How Acupuncture Works
'Cell Phone Elbow' -- A New Ill for the Wired Age
E-Mailing Your Way to Healthier Habits
HEARING
Summer Sounds Can Lead to Hearing Loss
Noise Hurts Men's Hearing More, Study Shows
HEART & CARDIOVASCULAR
Obese People Seem to Do Better With Heart Disease
Cocoa in Chocolate May Be Good for the Heart
After a Stroke, Light Exercise Gets Hands, Arms Working Again
INFECTIOUS DISEASE
Swine Flu Loves a Crowd
Hand Washing 10 Times a Day May Help Keep Flu Away
Chinese 'Devil Dung' Plant Could Be a Swine Flu Fighter
INFERTILITY
Obesity May Affect Fertility in Young Womene
KID'S HEALTH
Even Young Kids Can Learn CPR
Daily Exercise at School Yields Rewards
Play Creatively as a Kid, Be a Healthier Adult
MEN'S HEALTH
Whole Grains, Bran May Fight Hypertension in Men
The Dark Side of Vegetarianism
Soy Linked to Low Sperm Count
MENTAL HEALTH
Most Depressed Teens Don't Get Treatment
Living Alone Increases Odds of Developing Dementia
Estrogen May Help Men's Hearts
PAIN
Tai Chi May Help Ease Fibromyalgia
Are We Exercising Pain Away? Not So Much.
Alleviating Rheumatoid Arthritis
PHYSICAL THERAPY
PREGNANCY
Acupuncture May Relieve Acid Indigestation In Pregnancy
Woman in America Are Delaying Motherhood, Study Says
Placebo Acupuncture Tied to Higher IVF Pregnancies
SENIORS
Older People at Greater Risk of Swine Flu Death
Want Better Health in the New Year, Add Exercise to Your Day
15-Point Test Gauges Alzheimer's Risk
SEXUAL HEALTH
SLEEP DISORDERS
Exercising Throat Muscles May Relieve Sleep Apnea
Better Sleep, Grades Seem to Go Up
Pay Attention to Signs That Say You're Too Fatigued to Drive
WOMEN'S HEALTH
Natural Therapies for Menopause
Lifting Weights Can Ease Arm Swelling in Breast Cancer Survivors
Vitamin D Deficiency Puts 40% of U.S. Infants and Toddlers At Risk
Add your Article

New Options Offered for Sleep Apnea

By Steven Reinberg
HealthDay Reporter

MONDAY, May 18 (HealthDay News) -- Two new treatments -- one surgical and the other an appliance that adjusts the jaw -- might help people with sleep apnea, which has proven tough to treat.

In sleep apnea, the upper airway becomes blocked, and people stop breathing during sleep, usually in 10- to 20-second bouts that can occur 30 or more times an hour. The problem is usually treated with a device that increases air pressure in the throat, keeping the airway open. Called continuous positive airway pressure, or CPAP, the therapy involves wearing a mask attached to a machine.

Though effective, many people find it uncomfortable.

"Whilst continuous positive airway pressure is the gold standard treatment, it does not adequately serve all patients, with some that fail to tolerate treatment and others that simply refuse treatment," said Dr. Neville Patrick Shine, of St. Johns Hospital in Edinburgh, Scotland, and the lead author of a study that tested a surgical treatment for sleep apnea.

The surgery, called transpalatal advancement pharyngoplasty, enlarges the space behind the roof of the mouth.

When the obstruction is significant, "the choice may lie between surgery or no treatment, with the potential attendant cardiovascular and neurocognitive sequelae of sleep apnea," Shine said. "So in this cohort, transpalatal advancement surgery offers a reasonable treatment option."

For the study, Shine and his colleague Dr. Richard Hamilton Lewis, from the Royal Perth Hospital in Perth, Australia, reviewed the medical records of 60 people who had this surgery to treat sleep apnea.

The researchers looked for reductions in sleep disturbances and increases in the amount of oxygen in the individual's blood. With these criteria, the surgery was deemed successful in 38 people. Sleep apnea was cured in 21 people.

"One of the limitations of the procedure is the inability to accurately predict the positive responders to surgery from preoperative characteristics, and all patients undergoing this surgery must be made aware of this fact," Shine said.

"Although this surgery is not a magic bullet treatment for sleep apnea, it does have a role in those patients who have failed conservative treatment, have putative retropalatal disease and are willing to undergo surgery with no absolute guarantee of success," he said.

Dr. Jose W. Ruiz, an assistant professor of otolaryngology at the University of Miami Miller School of Medicine, noted that the surgery is only one of the surgical procedures used to treat sleep apnea.

"Most sleep apnea surgeries have success rates that range from 50 percent up to 70 percent," Ruiz said. "Most of it comes down to selecting the correct patient for the surgery and doing the right surgery. We haven't found the best surgery to do for everyone. That's why we are coming out with new techniques every year."

The ideal candidate for surgery is someone who has tried CPAP therapy but cannot tolerate it, Ruiz said. The success rate of CPAP therapy is very high, more than 90 percent, he noted.

"The problem is that only about 50 percent of the people tolerate it," Ruiz said. "So even though it works really well, most people don't use it." In fact, he said, some people have had surgery to make CPAP therapy more tolerable.

Another new study, though, offers a different alternative to surgery. Its findings are published in the May issue of Archives of Otolaryngology, Head & Neck Surgery, as is Shine's study.

The alternative tested in the study was an appliance called a mandibular advancement device, designed to prevent the airway obstruction of sleep apnea. It does this by moving the lower jaw forward.

A research team led by Dr. Chul Hee Lee, from Seoul National University Bundang Hospital and Seoul National University College of Medicine, evaluated 50 people with sleep apnea who used the device. Based on reductions in shallow or stopped breathing, the device worked in 37 of the participants, including a mix of people with mild, moderate and severe sleep apnea, the researchers found.

"The mandibular advancement device is a simple, non-invasive, easy-to-manufacture and easy-to-use device and showed good treatment outcome in nocturnal respiratory function and sleep quality in Korean patients with obstructive sleep apnea," including those with a severe condition, the researchers wrote. They described it as a "good alternative option" for anyone with obstructive sleep apnea.

However, Dr. Shirin Shafazand, an assistant professor of medicine in the Division of Pulmonary and Critical Care Medicine at the University of Miami Miller School of Medicine, said that devices such as the one tested in the Korean study, are really for people with mild sleep apnea and should be prescribed only after people have undergone sleep studies to determine the severity of their condition.

"It wasn't a surprise that there is improvement," Shafazand said. "But the numbers are too small to know whether people with severe sleep apnea will truly benefit long-term with this device."

She noted that the severity of the condition was reduced in those with severe sleep apnea, but the best result still reduced it only to the level of moderate sleep apnea.

There are a number of devices available that do the same thing, Shafazand said. But, she added, over-the-counter devices don't really work very well.

"The oral appliances that we recommend are to patients who have the sleep studies, so we know their level of severity," Shafazand said. "If their sleep apnea is mild, and they don't want to use continuous positive airway pressure therapy or can't tolerate it, we refer them to a dentist that fits them properly."

However, given the available options, Shafazand said she prefers to start most people on CPAP therapy.

"I always advise patients to try continuous positive airway pressure therapy, especially if it's moderate to severe," Shafazand said. "It's my first-line agent. If they absolutely can't do continuous positive airway pressure therapy, then oral appliances and surgery are alternatives -- but they are not perfect alternatives."

More information

The U.S. National Heart, Lung, and Blood Institute has more on sleep apnea.



SOURCES: Neville Patrick Shine, F.R.C.S., St. Johns Hospital, Edinburgh, Scotland; Shirin Shafazand, M.D., assistant professor, medicine, Division of Pulmonary and Critical Care Medicine, University of Miami Miller School of Medicine, Miami; Jose W. Ruiz, M.D., assistant professor, otolaryngology, University of Miami Miller School of Medicine, Miami; May 2009, Archives of Otolaryngology, Head & Neck Surgery

Last Updated: May 18, 2009

Copyright © 2009 ScoutNews, LLC. All rights reserved.

More articles at www.eholistic.com