Snoring is often a nuisance, especially for those who share a bed with a light sleeper. However, for some people, snoring may be a sign of a more serious health problem: sleep apnea. Once a little-known condition, there are now several treatments for sleep apnea, and more are being developed. But many patients remain unaware of apnea and don’t get the help they need.
The word “apnea” simply means a pause in breathing, and this can happen for a number of reasons, including crying. Sleep apnea is defined as repeated periods (10 seconds or more) of not breathing throughout the night – 5 to 100 times per hour. It comes in two main forms: central sleep apnea and obstructive sleep apnea (OSA). Obstructive sleep apnea occurs when the airway muscles physically block a person’s breathing, while central apnea is when the actual muscles used to breathe stop working, usually due to a lack of signals from the brain (a third type Complex forms have both types). Of the two, OSA is the more common, with an estimated 12% of U.S. adults having the condition, compared with less than 1% of adults with central sleep apnea.
While snoring may be the symptom most associated with sleep apnea, there is no guarantee that you will have it, as approximately 25 to 50 percent of people snore at least occasionally. Other symptoms include difficulty sleeping, waking up with a dry mouth, and feeling sleepy during the day. Over time, sleep apnea worsens our health and may increase the risk of other conditions, such as heart disease, diabetes, brain damage, and even premature death.
“The harm is twofold. One, when you pause to breathe, your oxygen levels drop, and low oxygen levels make the heart and brain less happy, and from there they can suffer damage from repeated reductions in oxygen. “Similarly, when we start breathing again, because we always start breathing again, our blood pressure and heart rate rise after each episode,” Douglas Kirsch, a spokesperson for the American Academy of Sleep Medicine, told Gizmodo by phone. Blood pressure rises repeatedly, night after night, over and over again, which can also lead to heart and brain problems,” he added.
once a mysterious disease
We have only recently begun to understand much about how common sleep apnea is. The condition was not officially named sleep apnea until 1965, although written reports of it may date back thousands of years (before sleep apnea was widely used, cases were sometimes referred to as “Pickwick syndrome”). Syndrome” – a reference to a character in a novel by Charles Dickens) The Pickwick Papers who exhibit many obvious symptoms). In the early decades after its discovery, the go-to treatments for sleep apnea were far from mild. Doctors often perform a tracheotomy, cutting a hole in the windpipe that opens at night and inserting a permanent tube so that air can still flow through (this procedure is still sometimes used, although only in the most severe cases) .
But in the early 1980s, doctors Eliot Philipson and Colin Sullivan invented the first continuous positive airway pressure (CPAP) machine, which was partly Inspiration came from Sullivan’s research on dogs with their own breathing problems. Oliver Sum-Ping, a sleep disorders clinician and researcher at Stanford University, said that to date, CPAP remains the gold standard for treatment of respiratory arrest, although it is sometimes misunderstood.
“There are some common misconceptions about CPAP, like that it’s specifically giving you oxygen, or that it’s breathing for you,” Sum-Ping told Gizmodo over the phone. “While there are some variations, basic CPAP uses air pressure just to help. Dilating the airway, a bit like blowing air into a balloon, helps separate the walls of the balloon.”
CPAP is very effective for sleep apnea, but it has its limitations. For example, although they become less cumbersome to wear over time, many people still have difficulty using them long-term or have health conditions that preclude their use. There are now other options, such as upper airway stimulation devices, which are implanted in the chest and neck and send an electrical current to the hypoglossal nerve to help control tongue movement.
During sleep, the device senses a person’s breathing and uses stimulation to prevent the tongue from blocking the airway. The only such device with explicit approval is the Inspire implant, which was approved by the U.S. Food and Drug Administration in 2014. While these devices are less disruptive to daily life, they are not suitable for everyone, Sum-Ping said. There are also dental devices that attempt to reposition the jaw or tongue, although these devices are not considered widely effective either. As we’ve covered before, lipstick may be the latest sleep health trend on TikTok, but there’s little evidence that it can be used to treat sleep apnea.
“With a CPAP machine, you can try it for almost anyone with sleep apnea. That’s not to say it’s for everyone, but it has broad applicability. For treatments like hypoglossal nerve stimulation, It’s more important to select patients carefully, and even then the results are often not as good as with CPAP,” Sum-Ping said. “But for patients who are unable to use CPAP for one reason or another, it may be a reasonable option.”
Medications to Treat Sleep Apnea
In the near future, we may see approved drugs specifically designed to treat apnea. In April, Eli Lilly announced early results from two Phase III trials testing its diabetes and obesity drug tezepatide in patients with obesity and obstructive sleep apnea. As other studies have shown, people taking tilsiparatide lost significantly more weight than placebo, up to 20% of their baseline weight. But they also tended to have significantly fewer apneas, with the frequency of apnea attacks reduced by up to two-thirds, or about 30 fewer per hour. The company has submitted an application to the FDA for expanded approval of tilsiparatide that would cover sleep apnea and could be available as soon as the end of this year.
While the approval could be critical, Kirsch noted that tilsiparatide and similar drugs are not a panacea for treating apnea. Obesity is one of the most common risk factors for this disease, but it is not the only risk factor. People who are not obese can also develop the disease. Since the drug’s effect on apnea appears to come primarily from its weight-loss effects, that means it won’t do much for many patients. Even in the clinical trial data, slightly less than half of the patients who took tezeparatide experienced a significant reduction in their apnea symptoms, enough to be considered resolved.
“I think it’s important to recognize that when weight becomes an issue, it’s part of good practice to try to help all patients with sleep apnea control their weight. But it may not be as common as other types of devices in everyone.” Alternative therapies,” Kirsch said. That said, there are other drugs in development that directly aim to address the mechanisms behind respiratory cessation, such as drugs designed to keep people’s airways open at night.
Unfortunately, no matter what medications or devices are used, many people experience no relief from their apnea due to a consistent lack of awareness. Studies estimate that up to 80% of sleep apnea cases go undiagnosed, a disparity that may be greater among more vulnerable populations, such as those living in poverty (people in low-income communities also appear less likely to start Treatment, even once) diagnosed).
Sum-Ping is encouraged by the development of technology, such as wearables and “near devices,” that can make it easier to screen for sleep apnea. Just in February of this year, the Samsung Galaxy Watch became the first such device in the United States to feature FDA-approved sleep apnea detection capabilities, which is accomplished by measuring blood oxygen levels. Kirsch noted that over time, it has become easier to formally diagnose apnea because of simpler tests.
“I see a lot of people who don’t want to go to a sleep doctor because they don’t want to have sleep tests in a lab. But now in some cases we can do those things at home. Or people don’t necessarily want to go to a sleep doctor because they don’t want to. Consider a CPAP machine. I tell them all the time, let’s figure out how serious your problem is before we worry about which treatment, because the severity of the problem sometimes changes how we think about treatment.
The future of sleep apnea treatment looks bright, but perhaps the most important goal is to make sure patients understand it first.
