By Dr. Jordan Stern, MD
About the author: Jordan Stern, MD, Founder and CEO of BlueSleep, is a Head and Neck surgeon, a subspecialty of Ear, Nose and Throat (ENT or Otolaryngology), who has treated over 10,000 Sleep Apnea patients and published multiple studies on the diagnosis and treatment of Sleep Apnea. He is also the author of The New York Times bestselling book, Dropping Acid, about reducing acid reflux through a better diet.
“You have Sleep Apnea.”
The road to getting diagnosed and treated for a sleep problem generally starts with a Google Search for “Sleep Apnea” or “Snoring”. The process to fixing these problems is getting shorter thanks to telemedicine, home sleep tests, and better therapies. Patients have more choices than ever for treatment: mandibular oral advancement devices (MAD); CPAP; Inspire Surgery; and medications (coming soon!). BlueSleep’s process is to ensure patients get the right treatment, depending on the severity of treatment; sleep history; lifestyle; and age.
After reviewing patients’ sleep history and results from a home sleep test, BlueSleep providers may diagnose patients with mild, moderate, or severe sleep apnea. The patient’s first reaction is relief, knowing there’s a clinical reason for their snoring and daytime sleepiness. They’re also surprised to learn that Sleep Apnea is closely associated with life-threatening diseases such as hypertension, heart disease, and diabetes.
The second reaction is a wave of emotions including fear about how the treatment may change their normal sleeping patterns. What are the aesthetic, comfort, and maintenance issues? Some worry about claustrophobia. Others fear surgery. But, a majority of patients welcome a treatment option and are relieved that their health insurance covers most of the cost.
“We recommend you have a CPAP.”
Fifty percent of BlueSleep patients are prescribed CPAP, a machine that uses positive airway pressure to improve the flow of air to your lungs. Most of these patients have tested positive for severe apnea, meaning their AHI is greater than 30 (meaning 30 respiratory episodes per hour of sleep ). And, some have teeth problems or dentures which preclude an oral device. BlueSleep doesn’t recommend Inspire Surgery unless patients have tried another treatment first. Furthermore, health insurance doesn’t cover surgery unless patients have tried non-invasive treatments. Surgery is also expensive and requires a 2-3 hour operation under general anesthesia.
Most CPAP patients rely on BlueSleep providers to educate them about Sleep Apnea and CPAP while others have friends and family members to help them. In addition to explaining the mechanics of the CPAP, BlueSleep recommends that patients pay attention to their sleep hygiene–healthy habits, behaviors and environmental factors that can be adjusted to help them have a good night's sleep. Obesity and OSA are directly linked, so weight loss helps reduce the severity of sleep apnea and its comorbidities. In fact, treating sleep apnea facilitates weight loss.
Benefits and Challenges of using CPAP Therapy
Most doctors focus on the dangers of Sleep Apnea and the benefits of CPAP therapy during initial discussions, but the reality is that CPAP has a 50% failure or non-compliance rate. The other 50% tolerate their machines and some swear by them–better sleep; more daytime energy; and happier bed partners.
Those who fail CPAP generally fall off in the first 90 days. Why? Claustrophobia; mask fit; noise; discomfort; cleaning; paying for supplies with insurance; and aesthetics. If patients don’t use their CPAP for at least four hours for 70% of nights then insurance requires patients to return the machine. Unfortunately, many patients fall back into their old, unhealthy patterns. Knowing these barriers to use, BlueSleep improves compliance by ensuring a specific approach and monitoring, recommending the best machines and using a virtual mask fitting tool called SleepGlad to ensure an optimal fit from the start.
Sleep Better, Live Longer
With 54 million Americans suffering from Sleep Apnea and only 20% seeking diagnosis and treatment, educating the public and primary care about Sleep Apnea is priority number one. The risks of untreated Sleep Apnea are clearly documented and especially dangerous for those who are obese.
Improving access to treatment is also important. BlueSleep offers same-day, no-wait appointments and ships home sleep tests within 24 hours. The time from appointment to diagnosis is under two weeks.
Patients want better support. From education to mask fitting to problem solving, patients want answers about their problems and treatments. Healthcare must be more patient centric and embrace the latest technologies–from scheduling to mask fitting to online support, all coming from board certified sleep experts.
Finally, patients want more choices to stop their snoring and Sleep Apnea. CPAP is the leading treatment, but not always the best choice if 50% fail. Many prefer the ease and aesthetics of an oral appliance. We’ve rated the best oral appliances based on comfort, maintenance, durability, and efficacy. BlueSleep is a medical provider, not a lab or manufacturer, so we get you the best and most affordable treatment to solve your problem so you can lead a happy, healthy life.
References
Journal of Clinical Sleep Medicine
Although treatment of obstructive sleep apnea (OSA) with positive airway pressure (PAP) therapy is effective, adherence is often poor. Understanding the patient perspective is needed to inform adherence-promoting interventions. This qualitative study assessed the experiences, preferences, facilitators, and barriers surrounding PAP therapy for the management of OSA in patients from adolescence to older adulthood.
The unique perspectives of patients regarding PAP therapy should be taken into consideration when developing interventions to increase PAP adherence and improve clinical care. Based on identified themes, opportunities for intervention may exist at all stages of care, from diagnosis to treatment initiation. Involving partners, parents, and other caregivers in PAP therapy may be beneficial for optimizing adherence.
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