Sleep apnea is a complex disease, but its treatment is relatively straightforward. Most cases are the instructive type, and some are the central type. Sleep apnea testing can be done at home, and there are even easier methods of diagnosing this condition.
Diagnosing Sleep Apnea
It’s always best to see a Sleep Physician when figuring out what type of sleep apnea a patient has (central versus obstructive.)
Insomnia, fatigue, restless leg symptoms, and heavy snoring are signs and symptoms that might indicate potential sleep apnea.
If nothing else, the STOP-BANG questionnaire is quite useful in determining if someone needs any sleep apnea intervention.
Patient Referrals
Whenever possible, we try to lower the barriers in healthcare for our patients at Digital Nomad Health.
We work with Empower Sleep to streamline the process, from sleep apnea testing to treatment, cost discussion, and follow-up.
They will have patients do 7-10 nights of testing to determine the need for interventions. Empower Sleep will maintain all communication and schedule any necessary further testing.
Alternative Home Diagnostic Options
Another device that can be purchased for home use is the WatchPAT at-home sleep apnea test. For around $200, the device includes a one-time interpretation of the sleep data.
This compact device is accurate enough to diagnose not only OSA but also CSA (central sleep apnea).
We recommend that our patients not rely on a single night test for accurate diagnosis. We take our patients through the proper protocol to ensure the test is accurate.
Treatment Options for OSA
1. PAP Devices
A positive airway pressure device (PAP) ensures that the airway receives adequate air, preventing it from collapsing during inhalation or exhalation.
CPAP devices are the most common ways to manage OSA, and many are automated - referred to as APAP - meaning no adjustment is needed since the device can self-adjust.
2. Mandibular Devices
Dental devices push the lower jaw forward and allow more airflow.
Physicians use iNAP to move the position of the tongue in the mouth. This can work incredibly well for some, while others find it ineffective.
3. Implantable Devices
Inspire is an implantable device - similar to a pacemaker for the tongue and relays information based on the movement of the chest wall.
When in Doubt
In our practice, we had an unfortunate case of a patient who had undiagnosed sleep apnea, which caused severe high blood pressure, leading to a major vascular event.
Testing is always the best option, but when you can’t test, start with the questionnaire above or perform a simple home test with consumer-grade devices.
The cost of such devices may be prohibitive, but financing is often available, and the alternative to living with undiagnosed sleep apnea is quite concerning.
Is Your Treatment Working?
It is a great idea to repeat your home sleep study after starting a new intervention. If your mandibular device is working, you should have fewer episodes of awakening, hypopnea, apnea, or hypoxia at night.