York County Medicine Summer 2019 - 14

YO R K C O M E D S O C . O R G

FEATURE:

Sleep Apnea

by Michelle Cantwell, M.D.

I

t's aggravating for bed partners and the bane of pillow
punchers around the world. But snoring is not just a source of
irritation.

It can wreak havoc in snorers' daily lives, making them
struggle to stay awake at work and behind the wheel. And it
can be deadly, increasing their risk of stroke and heart rhythm
disturbances.
Snoring may be a sign of obstructive sleep apnea, a potentially
serious sleep problem that causes people to periodically stop
breathing while they are asleep. Obstructive sleep apnea is very
common, affecting up to 18 million people in the U.S. Of those,
as many of 80 percent may be undiagnosed and untreated.
Fortunately, it's getting much easier and more convenient
to be tested for sleep problems. And there are a variety of new
treatments, including mouthpieces and implantable devices, that
are now available.
"A good night's sleep is vital. Without it, you can wake
up already stressed before the day even begins," said Michelle
Cantwell, M.D., of WellSpan Pulmonary & Sleep Medicine.
"Today's treatments are more advanced and more comfortable
with testing now done in the comfort of a patient's own bed.
There are many options to treat obstructive sleep apnea that allow
people to get a good night's rest and live healthier lives."
Here are some of the newer advances in sleep apnea diagnosis
and treatment offered at WellSpan Pulmonary & Sleep Medicine:
* Home testing
Snorers used to have to routinely report to a sleep center and
be hooked up to a rather complex set of monitors during an
overnight test.
Many patients now can use the WatchPAT, an FDA-approved
home testing device. The WatchPAT includes a wrist sensor,
a finger sensor and a chest sensor, which measure body
movement, oxygen and heart rate. The device ships directly to
your home.

14

York County Medicine | SUMMER 2019

Luke Yankowy - Regional Manager of Sleep Services
for Wellspan Health
A physician examines the readings to determine if someone is
suffering from obstructive sleep apnea, to determine the best
course of treatment.
* AutoPAP machines
Patients with obstructive sleep apnea frequently use a machine
that delivers a treatment called CPAP, or continuous positive
airway pressure. This common treatment for obstructive sleep
apnea uses a hose and a mask/nosepiece to deliver a steady air
pressure that keeps the patient's airway open for breathing as
they sleep.
Patients must undergo monitoring to determine the correct
pressure that is needed to treat whatever their severity of
apnea is.
The autoPAP or APAP machine is a home regulating
device that is set to a range of pressures that continuously
calculates the patient's needed pressure, coming up with the
best pressure level and alleviating the need for an overnight
monitoring stay in a sleep lab.
* Oral appliances
Patients with mild to moderate or even very severe apnea can
benefit from an oral appliance.
Like a sports mouthguard, a custom-made, adjustable, acrylic
oral appliance temporarily repositions the patient's lower jaw
forward, to maintain an open airway during sleep.
Patients who require a very high air pressure on their CPAP
machine can use an oral appliance in conjunction with a
CPAP machine, so they require a lower and more comfortable
air pressure as they sleep.
* Inspire
Inspire is an implantable device that treats obstructive sleep
apnea. The device, implanted during an outpatient procedure,
has leads that are connected to the patient's diaphragm and
tongue. A patient uses a handheld remote to turn on the


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York County Medicine Summer 2019

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