* Courtesy of Fisher & Paykel Healthcare

Many of us take a good night's sleep for granted. We sleep peacefully through the night, blissfully unaware that up to 9%¹ of the adult population struggle to sleep with a frightening and potentially life threatening disorder known as Obstructive Sleep Apnea (OSA). Up to 80% of these people are undiagnosed. Worse still many of these people are completely unaware of their condition – oblivious to the reason for their tiredness and lesser quality of life. This link is designed to help people who have been diagnosed with OSA and their families understand more about the condition and the means by which it is treated.

Normal

During normal sleep most of our muscles are in a relaxed state; however, the muscles that control the airway maintain some muscle tone in order to hold the airway open for us to breathe.

Snoring

In some instances the airway muscles relax too much causing the airway to narrow slightly. Partial collapse will often result in snoring. Snoring is the noise generated by the soft/floppy parts of the throat vibrating as air passes through during breathing. During snoring the airway has narrowed slightly but this does not severely reduce the airflow while breathing.

Apneas, Hypopneas and OSA

Similarly in people with OSA the airway muscles relax too much, however the airway narrowing is more significant than in snoring and causes a slight or complete reduction in air-flow to the lungs, i.e. they will stop breathing! A partial airway collapse associated with a reduction in air-flow is called a "hypopnea". A complete airway collapse associated with complete cessation of airflow to the lungs is called an "apnea".

When the airway is blocked OSA sufferers will wake either partially or completely to breathe again, although they are most often unaware of this happening. This can occur up to several hundred times in a single night, resulting in strain on the heart, severe disruption to sleep and debilitating daytime sleepiness.

OSA not only disrupts your sleep but also has a profound impact on every aspect of your health. Untreated OSA has been linked to:

• High Blood Pressure²
• Serious cardiovascular disease including congestive heart failure and stroke²
• Couples sleeping apart³
• Poor work productivity^4-5
• Increased risk of vehicle accident⁶

(The terms hypopnea and apnea are derived from the Greek words "HYPO", meaning below normal, "A", meaning absence or lack of, and "PNEA", meaning to breathe. (literally "below normal breath" and "absence of breath")).

Below are the symptoms of OSA. If you or your bed partner experience most of these, you may suffer from OSA and should consult your physician for further advice.

• Loud Snoring
• Witnessed apneas/choking sensation when sleeping
• Excessive daytime sleepiness
• Partner reports Breathing Pauses
• Morning headaches
• Restless Sleep
• Depression
• Poor concentration
• Loss of memory
• Sexual dysfunction

If you have very MILD OSA your doctor might suggest one or more of the following:

• Weight reduction
• Reducing alcohol intake
• Stop using sleeping tablets
• Stop smoking – this irritates the nasal lining
• Reduce nasal stuffiness with nasal sprays
• Consider surgical options/visit an ENT
• A personally fitted oral appliance to move the lower jaw forward at night (mandibular advancement splint)

Taking some of these actions might help reduce the severity of OSA for mild sufferers. However if you have MODERATE to SEVERE obstructive sleep apnea these steps will have little to no affect on treating the condition. For these people, the most efficient and widely accepted treatment is CPAP, or continuous positive airway pressure.

CPAP and how it works

Continuous positive airway pressure (CPAP) is the simplest and most effective treatment available for OSA. CPAP consists of a snugly fitted mask that seals the nose, the mouth or both nose and mouth. This mask is connected to an electronically driven pump that delivers a flow of air through a length of tubing. Supplying a flow of air to the upper airway in this manner creates a positive airway pressure. This positive pressure provides a splint in the airway to prevent it from collapsing during sleep. CPAP treatment is used only when sleeping and needs to be used EVERY time someone with OSA sleeps. The user will experience almost immediate relief of symptoms with this form of treatment. However it is a treatment and not a cure, if the treatment is stopped the airway will continue to collapse.

CPAPs are portable, lightweight and can be used at home or while on vacation. The pressure range for most CPAP machines is 4-20cmH20 and the pressure that you require will be determined in the sleep lab during a sleep study.

Introducing the F&P ICON^TM

The F&P ICON^TM has been designed from the outside-in to answer the CPAP user's call for a compact, stylish CPAP that blends seamlessly into any bedroom environment. As well as being stylish on the outside the F&P ICON^TM is smart on the inside, so you can feel at ease knowing you are being taken care of by a range of the world's leading comfort-enhancing technologies for treating OSA. The F&P ICON^TM also has a range of useful features that compliment your CPAP therapy as well as everyday life, such as an alarm clock and customizable AlarmTunes^TM.

Choosing the Right Mask

Selecting a mask by delivery category is likely to provide a more natural transition to therapy. The first thing to establish is how you naturally breathe (through the mouth, nose or both). Secondly, ascertain whether you are sensitive to enclosed spaces. If so, a mask that provides a free field of vision, such as a direct nasal or oral mask, may suit you best.

EsonTM Nasal	SimplusTM Full Face
PilairoTM Nasal Pillows	OracleTM Oral

FAQs

^{1.Al Lawati NM et al. Prog Cardiovasc Dis 2009; 51(4): 285-93. 2.Budhiraja R et al. Respir Care 2010; 55(10): 1322-32. 3.Billman SJ and ware JC. Sleep Med 2002; 3(1): 55-9. 4.Nena E et al. J Occup Environ Med 2010; 52(6): 622-5. 5.Alghanim N et al. Lung 2008; 186(1): 7-12. 6.Tregear S et al. Sleep 2010; 33(10): 1373-80.}