Got sleep apnea? Official treatment recommendations released Sept. 23 point to two complimentary approaches: Lose weight and undergo treatment with continuous positive airway pressure (CPAP).


Surgery, on the other hand, should not be considered as an initial treatment[1] , as evidence is limited on its effects, the recommendations say.


The recommendations, published in the journal Annals of Internal Medicine[2] and created by the American College of Physicians, are directed toward people with the most common kind of sleep apnea, which is called obstructive sleep apnea. It is a sleep disorder that causes a person to stop breathing[3] for short periods during sleep because of a collapsed or blocked airway. The other kind of sleep apnea, central sleep apnea[4] , is rarer than the obstructive type, and occurs when nerves and parts of the brain responsible for the regulation of breathing don't work properly.


"Obesity is a risk factor for obstructive sleep apnea[5] and the evidence indicates that intensive weight loss interventions help improve sleep study results and symptoms of OSA," Dr. Molly Cooke, M.D., FACP, the president of the American College of Physicians, said in a statement. "Plus, losing extra weight is associated with many other health benefits."


For people who don't experience a benefit from CPAP, or choose not to use CPAP, a mandibular advancement device[6] -- which is worn in the mouth and opens up the airway by moving the jaw -- could be a good alternative treatment option, according to the recommendations.


"The evidence shows that a mandibular advancement device can effectively improve sleep study results and sleepiness," Cooke said in the statement. "However, CPAP more effectively raised the minimum oxygen saturation compared to MAD."


Sleep apnea affects more than 18 million adults, and is a known risk factor for a host of other conditions including heart attack, diabetes, high blood pressure and daytime drowsiness. Overweight and obesity[7] are known to raise the likelihood of having sleep apnea, but people of any weight can experience it.



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  • Sleep Apnea Increases Risk Of Heart Attack


    The sleep disorder has a number of poor effects on the heart. "It's as if somebody's choking you, so your heart rate goes up, your blood pressure goes up," Charles Czeisler, M.D., the Baldino Professor of Sleep Medicine at Harvard Medical School told <em>Health</em> magazine. "Over time, even your daytime blood pressure is higher." Sleep apnea may be responsible for a third of all cases of <a href="http://www.huffingtonpost.com/2012/03/14/sleep-health_n_1310353.html">high blood pressure</a> in Americans, he told the magazine. A 2007 study showed just how serious these cardiovascular effects of sleep apnea are. The research found that people with sleep apnea were <a href="http://www.sciencedaily.com/releases/2007/05/070520183533.htm">30 percent more likely to have a heart attack</a> or die of any cause over a four to five year period.




  • Sleep Apnea May Increase Depression Risk


    The under diagnosed sleep condition takes a <a href="http://www.huffingtonpost.com/2012/03/30/sleep-apnea-depression-risk_n_1391707.html">serious toll on the mood</a>, according to March research from the CDC. In fact, men with sleep apnea were more than twice as likely and women more than five times as likely to feel hopeless, lose interest in their regular activites and display other signs of clinical depression, Health.com reported. Snoring did not seem to be associated with depression. Luckily, the very same <a href="http://www.huffingtonpost.com/2012/06/15/sleep-apnea-treatment-depression-cpap_n_1597703.html">treatment for sleep apnea may also ease depression</a>, according to Cleveland Clinic research.




  • Sleep Apnea May Be A Risk Factor For Diabetes


    There is a growing body of research supporting a link between the presence of sleep apnea and <a href="http://www.huffingtonpost.com/2012/05/24/sleep-apnea-diabetes-type-2-_n_1539933.html">metabolic disorders like diabetes</a>, HuffPost reported in May. Both moderate and severe obstructive sleep apnea were found to be predictors of the disease. A previous study found that people with sleep apnea had more than <a href="http://news.yale.edu/2007/05/24/sleep-apnea-increases-risk-heart-attack-and-diabetes">double the risk of developing diabetes</a>.




  • Sleep Apnea May Increase Cancer Risk


    Not only do people with sleep apnea have a <a href="http://well.blogs.nytimes.com/2012/05/20/sleep-apnea-tied-to-increased-cancer-risk/">higher risk of developing cancer</a>, but they also have a higher risk of dying from the disease, the <em>New York Times</em> reported. Two studies in May examined this link. One found people with sleep apnea had a 65 percent higher change of developing any kind of cancer. The second found that disordered breathing contributed to a five-times higher rate of dying from the disease.




  • Sleep Apnea May Sap Your Libido


    Excessive sleepiness is certainly enough to kill the mood, but research suggests that sleep apnea in particular has an effect on sexual function in both men and women. It may <a href="http://well.blogs.nytimes.com/2011/10/10/really-the-claim-sleep-apnea-causes-sexual-problems/">drive down sex hormones</a> like testosterone in a way that can extinguish the flame for women and cause erectile dysfunction in men, according to the <em>New York Times</em>. And while the typical treatment -- a CPAP machine -- is not exactly an aphrodisiac, Dr. Michael J. Breus writes, it can help not only with sleep apnea, but <a href="http://www.huffingtonpost.com/dr-michael-j-breus/sleep-apnea_b_1661687.html">with the sexual side effects as well</a>.




  • Sleep Apnea May Increase Stroke Risk


    Researchers have long studied the link between the sleep disorder and the risk of stroke, but a small recent study found that 51 of 56 stroke patients evaluated -- or <a href="http://www.huffingtonpost.com/dr-michael-j-breus/sleep-apnea_b_1342311.html">91 percent of patients</a> -- had sleep apnea, Dr. Michael J. Breus wrote for HuffPost. More research is still needed to determine just what role disrupted breathing plays in this elevated risk.




  • Sleep Apnea Increases Accident Risk


    It's not rocket science -- excessive sleepiness during the day leads to sleepier drivers who are at a higher risk of crashing. But a 2008 study found that people with sleep apnea have double the risk of being in a car accident and are <a href="http://www.sciencedaily.com/releases/2008/02/080218214401.htm">three to five times more likely to be in a serious crash</a>. The study was the first to examine the severity of car crashes among people with sleep apnea, and found that even mild disordered breathing was linked to increased risk.




  • Sleep Apnea Is Linked To Pregnancy Complications


    Granted, Perry doesn't have to worry about this particular concern. While sleep apnea is often perceived as a problem predominately for men, <a href="http://www.huffingtonpost.com/2012/08/16/sleep-apnea-in-women-may-_n_1779127.html">women are not immune</a>. And, in fact, sleep apnea presents unique complications for women. A recent study found that women with sleep apnea were more likely to develop high blood pressure during their pregnancies, to require a C-section birth and their babies were more <a href="http://www.huffingtonpost.com/2012/09/21/sleep-apnea-in-pregnancy-_n_1903534.html">likely to be admitted to the neonatal intensive care unit</a>.




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