You or your bed partner may be a snorer or gasper or perhaps you do not feel that you get refreshing sleep. Your bed partner may be stressed watching your every breath while you stop breathing at night. Many people with sleep related disorders are inefficient during the day, falling asleep easily or constantly feeling tired. Many of our patients are depressed and moody and have trouble with weight gain. Unfortunately, for many who have been diagnosed with sleep apnea you are given one choice … A CPAP machine.
Sleep Studies/Home Studies
If you have signs or symptoms of sleep apnea, we may request a home or lab sleep study. Common signs include:
- stopped breathing at night
- unrefreshing sleep
- daytime tiredness and fatigue
- weight gain
- mouth breathing
- history of high blood pressure or heart and lung disease.
It is important to understand that most people who have sleep apnea snore, but most people who snore do not have sleep apnea. We will not assume that you have sleep apnea based on the presence of snoring alone.
What Is A Sleep Study…
If we suspect that you may have sleep apnea, you may be scheduled for a sleep test called a polysomnography (PSG). A PSG may be performed at a sleep center or at home depending on the severity of your symptoms. During these overnight tests, you are measured for apneas (pauses in your breathing), oxygen levels, snoring, as well as a number of other events. You may be asked to go for a second night sleep study so that you may be given a breathing or CPAP machine to determine how much pressure is required to overcome your collapse. Although this test may be inconvenient, the data from these studies is essential in determining the severity of your sleep apnea as well as determining your treatment plan. Insurance companies may also require sleep studies in order for you to be covered for your treatment.
If you have already received a sleep study please obtain the study or have it faxed to the office prior to your visit, if possible.
We Will Explain Your Study To You…
On your return visit, Dr. Pasha will discuss the results with you and allow you to have a perspective on the severity of your sleep apnea. Dr. Pasha has found that many patients do not understand their sleep study and may have been told that they have sleep apnea when in fact they might be better characterized as having an upper airway disorder or a primary snoring disorder. Dr. Pasha will give you a score called a Respiratory Distress Index or Apnea/Hyponea Index. This number is one measure of the severity of your sleep apnea. A score of >5-10 is considered abnormal. Scores greater than 16 are more severe. If your score is greater than 41 you are at a higher risk of medical disease such as high blood pressure or heart or lung disease.
5 Ways to Treat Snoring & Sleep Apnea
There are five ways to address your snoring and sleep apnea.
Observation. Observation may be an option if the snoring does not bother you or anyone else. An advantage to addressing your snoring early is that typically, as you advance in age, the laxity or sagginess of the back of your throat increases which worsens your snoring and often leads to sleep apnea.
Behavior Modification. This includes losing weight, avoiding sedatives and alcohol at night, sleeping on your side, and developing better sleeps habits. All sleep apneic patients must try to reach their ideal weight. Weight loss is difficult when you have sleep apnea because you are tired and your metabolism is slowed. Addressing your sleep apnea typically results in weight loss. Alcohol and sedatives, including sleeping pills, are prohibited if you have significant sleep apnea to avoid suppressing your rescue gasp that allows you to catch your breath at night. If you are sedated, your oxygen may reach dangerously low levels, causing a heart attack or sudden death.
Breathing Machines: These machines are more commonly known as a Continuous or Constant Positive Air Pressure (CPAP) machine. This apparatus prevents airway collapse by forcing air through your nose and mouth. The amount of pressure required to keep you from becoming apneic is determined by a sleep study. CPAP machines have a high rate of success for those who use them. CPAP machines can be cumbersome, inconvenient, and may not be tolerated because of claustrophobia. Dr. Pasha prefers to use the “smart” machines that come with a card so that he may read data to see how you are doing with the machine at night. If you choose to use a CPAP machine, Dr. Pasha will help you stay compliant with your machine by monitoring your usage, adjusting your pressures, and adjusting your masks. Dr. Pasha may also perform minor procedures in the office or in the operating room so that you can better tolerate the machine or lower your pressures. Many times, sleep centers place everyone on CPAP machines without alternatives. CPAP machines do not address the underlying cause of the collapse of the airway at night.
In-office Procedures or Surgery. Dr. Pasha has performed well over 1,600 procedures for sleep apnea/snoring and considers it an art. After a detailed physical examination, Dr. Pasha may offer a long-term procedure specific for you. Philosophically, our center focuses on the least invasive technique with the most effective outcome. For some this may mean a 20-minute procedure that can be performed in the office under local anesthesia. For others it may require a more advanced surgical technique. Since, Dr. Pasha specializes in all the most common available modalities, he can offer a variety of choices based on your specific circumstance. Dr. Pasha also commonly evaluates those who had a prior failed procedure and specializes in revision techniques.
Dental or Oral Appliances. These devices have variable success but may be recommended for selected patients especially for those of you who have mild sleep apnea or are more concerned with snoring.
Dr. Pasha recognizes that there are many inappropriate techniques offered to patients that snore or have sleep apnea. It can be very confusing to patients which technique is best suited for them. Some clinics specialize in only in-office, minimally invasive techniques. Others may push for dental appliance or CPAP machines. Because of their limited options and financial incentive there is an increased chance of inappropriate recommendations. The Pasha Snoring and Sinus Center was designed to present logical, proven-effective multiple solutions that are specific for your situation.
Pasha Snoring & Sinus Center Difference
Dr. Pasha is Specialty Certified in Sleep Medicine and Ear, Nose, and Throat Head and Neck Surgery, giving him a unique expertise that allows him to identify the source of your snoring and then offer a myriad of choices including more permanent solutions rather than just a CPAP machine.
Our Center Investigates The Cause … then Provides Real Solutions.
Our clinic is not a “one trick pony.” We offer an entire array of possible solutions. In the Greater Houston area Dr. Pasha has become a pioneer for numerous techniques; from in-office solutions such as the Pillar Procedure™ to more advanced surgical techniques for severe sleep apnea even utilizing the Da Vinci Robot. Dr. Pasha has also developed his own combination of techniques to address the back of the throat and some that are unique to his clinic. Dr. Pasha also provides other traditional modalities: from dental appliances to the latest breathing machines, including CPAP and Bi-PAP devices. Most of our procedures are covered by insurance.