Sleep apnea isn’t something that you can just treat on your own—it requires proper evaluation and treatment from board certified sleep apnea doctors in Portland and Astoria, OR, who can determine not just the severity of your sleep disorder but also help you determine the treatment that is right for you.
That's why our sleep medicine team including Dr. Radhika Breaden and Dr. Jennifer Kim are here to provide you with the care you need to understand and manage your sleep apnea.
Symptoms of sleep apnea include
- Pauses in breathing throughout the night
- Gasping sounds while sleep
- Daytime fatigue
- Trouble concentration
- Mental fog
- Increased irritability
- Depressive or anxiety symptoms
- Insomnia or restless sleeping
- Morning headaches
- Waking up during the night to urinate
- Acid reflux/heartburn during the night
- Tooth grinding
Not all patients with sleep apnea have all or most of these symptoms. The symptoms can also vary in severity based on age. For example, in a child, sleep apnea may manifest as issues of attention or hyperactivity. For women, symptoms may include insomnia alone without any other observed symptoms.
In order to determine whether sleep apnea is present, we may consider either home sleep testing or in-laboratory sleep testing (at our clinic). There are pros and cons to both types of testing, which we will review with you at the time of your initial consultation.
Once you’ve undergone a sleep study, the next step is to create a treatment plan for you. This treatment plan will be based on how severe your sleep apnea is as well as other factors, including changes in severity based on position, stage of sleep and other medical conditions you may have. At your follow up appointment, we will review all treatment options including PAP (positive airway pressure), oral appliance therapy, surgery, Inspire neurostimulator therapy, Provent therapy and positional therapy.
Many patients can also benefit from lifestyle modifications that can help reduce symptoms. Certain lifestyle modifications that our sleep specialists in Portland and Astoria, OR, may recommend include,
- Losing excess weight or maintaining a healthy weight
- Quitting smoking
- Avoiding or limiting alcohol, caffeine, and sedatives
While lifestyle changes can reduce the severity and frequency of your symptoms, you may also require additional treatment, depending on the severity of your sleep apnea.
One common treatment option is CPAP therapy, in which the patient wears a mask interface over their nose and/or mouth. The mask is attached to a machine that generates a gentle air pressure to apply just the amount of pressure needed to keep the airways open and to prevent airflow obstruction.
Many patients may also benefit from getting oral appliance therapy. Using a custom-made device that fits over the upper and lower teeth, oral appliance therapy repositions the jaws to prevent the collapse of tissues in the back of the throat.
Surgical options including the UPPP (uvulopalatalpharyngoplasty) in which the uvula and part of the palate are removed, as well as the MMA (maxillomandibular advancement) in which both the upper and lower jaw are advanced forward to provide more airway space. These surgeries are performed by ENT (Ear, Nose and Throat) surgeons.
A newer option for treatment is the Inspire neurostimulator therapy, in which an implantable device has electrodes which stimulate the airway muscles to provider structure and tone during the night. Inspire surgery is used in patients who have moderate or severe obstructive sleep apnea with a BMI (body mass index) of 32 or less.
Other options including positional belts and collars as well as Provent therapy, which are nasal expiratory pressure stickers for the nasal passages that are used predominantly when camping or travelling internationally.
Pacific Sleep Program has two offices to ensure that patients living in Portland and Astoria, OR, get the comprehensive sleep care that they need. If you suspect that you might be dealing with sleep apnea, we recommend that you schedule a sleep medicine consultation with our clinic.
We know that sleep and weight are closely related. A significant amount of metabolic regulation, including the regulation of insulin (which regulates our blood sugar), leptin (which regulates our body weight and set point) and ghrelin (which regulates our appetite and sense of feeling full) occurs during sleep.
We also know that when our weight goes up, it will increase our risk of certain sleep disorders, such as obstructive sleep apnea. As we gain weight, the fat pads by our neck and along our chest wall and abdomen get bigger, which makes it even harder to open the airway and to breathe.
We know that when sleep is affected, including when we do not get enough sleep or when our sleep is poor quality, our weight goes up. We also know that when our weight goes up, it affects our sleep. It is a vicious cycle.
At Pacific Sleep Program, we understand this
A recent study, which was presented at the Endocrine Society (ENDO) 2019 Annual Scientific Sessions in New Orleans, LA, found that OSA patients undergoing CPAP treatment lost an average of 5.7 pounds more in 16 weeks than OSA patients who did not receive CPAP therapy.
Also per several studies, when people do not get enough sleep, either due to chronic sleep deprivation, insomnia or circadian rhythm disorders, they are more likely to gain weight.
Contact us at Pacific Sleep Program at our Portland or Astoria location to learn more about how we can help you with your sleep and how this may help you in your journey toward a healthy weight.
Many people think of insomnia as one specific problem with one treatment. However, just as any type of pain can represent different causes in different people, insomnia has different causes in different people.
First of all, insomnia is often a symptom of some other disorder. Insomnia is defined as any one of 4 basic symptoms – difficulty falling asleep, waking up during the night and having difficulty getting back to sleep, early morning awakening insomnia and nonrestorative sleep insomnia. People can experience more than one of these symptoms.
Insomnia can occur for many reasons. It is often due to another undiagnosed sleep disorder, such as a circadian rhythm disorder (sleeping on a different clock, such as shift work or being on call or circadian rhythm delayed sleep phase, being a natural night owl), sleep apnea/sleep disordered breathing, periodic limb movement disorder but can also be due to mood disorders (it can herald the onset of depression or anxiety disorder or a substance abuse disorder) or be a residual effect of a previous episode of a mood disorder. It can be due to medications or pain issues as well. Unlike other fields of medicine, patients with sleep disorders often have more than one underlying sleep disorder, and all of them need to be treated.
In order to clearly understand insomnia, we need to take a very thorough history of the predisposing factors (“Why me?”) such as genetic insomnia tendency or mood disorders, the precipitating factors (“What got it started?”) such as abuse issues leading to hypervigilance, transitions including parenthood, stressors, shift work in the past, etc., and the perpetuating factors (“Why is insomnia STILL happening?”).
Our goal during our consultation is to isolate all of the possible perpetuating factors and put together a plan to diagnose and treat these factors. This may involve further testing or other treatment protocols that we approach and apply in a systematic manner.
Once the above has been addressed, many patients have a conditioned insomnia, in which the brain has been conditioned to have awakenings or arousals. The brain then needs to be retrained on how to sleep again because the coping mechanisms that people adopt for insomnia usually worsen the insomnia – for example, sleeping late because they “did not get a wink all night”, getting up to do relaxing activities or work during the night, “because since I can’t sleep, I might as well do something”, etc.
Many patients ask about using sleeping pills. There are no medical studies that show that the use of long term sleeping pills are either recommended or helpful in insomnia except in certain rare cases, such as after severe traumatic brain injury or other similar conditions. However, sleeping pills may be considered for brief periods if indicated due to particular stressors. The chronic use of sleeping pills is associated with multiple risks, including dementia and fall risks. Some sleeping pills can also be addictive and can cause a rebound insomnia, which can cause a more severe insomnia if the pills are discontinued.
More importantly, sleeping pills do not actually cure insomnia. A person can take sleeping pills for decades, and at the end of it, they will still have insomnia. The pills have only masked the insomnia. Masking the insomnia problem with pills is not the same as curing the insomnia. Proper treatment of insomnia requires thorough consultation and treatment of all perpetuating causes as well as more detailed treatments such as Cognitive Behavioral Therapy for Insomnia (CBTI).
Insomnia treatment can be challenging. A nice introduction to insomnia treatment that we sometimes recommend is a book called "Say Goodnight to Insomnia" which outlines some of the strategies that are used in Cognitive Behavioral Therapy for Insomnia.
For a thorough evaluation for your sleep problems, we recommend that you contact us at our Portland or Astoria location and schedule a consultation.
How the doctors in Portland and Astoria, Oregon can help with sleep problems
If you are having trouble sleeping, feel groggy during the day, or are having trouble concentrating, you could be one of 35 million Americans who have a sleep disorder. Sleep medicine is right for you if you are having a tough time sleeping. The doctors at Pacific Sleep Program can help you sleep better. They have two convenient office locations in Astoria, and Portland, Oregon to serve you.
So, how do you know if sleep medicine is right for you? Sleep medicine can help if you suffer from:
Acute or chronic insomnia, which is difficulty falling asleep or staying asleep; if insomnia goes untreated, it can lead to fatigue, difficulty concentrating, and mood swings.
Snoring, which can be a sign of sleep apnea; if sleep apnea goes untreated it can lead to an increased risk of stroke, heart disease, and other serious medical conditions.
Narcolepsy, which is a form of epilepsy involving episodes of suddenly falling asleep; untreated narcolepsy can result in difficulties at work, operating a vehicle, and other day-to-day activities.
You can try some simple techniques at home to help you get to sleep including creating a restful atmosphere in your bedroom, with no television, computer screens, phones, or other screens to look at. If you have tried conservative measures and still have trouble falling asleep, you need to seek out the services of a sleep medicine doctor.
The doctors at Pacific Sleep Program do sleep testing to evaluate your sleep patterns and determine the sleep disorder you might be suffering from. They offer sleep study appointments on most nights during the week. Your sleep study will be comfortable and easy because you can sleep on a Select Comfort Sleep Number bed, enjoy WI-FI access, and satellite TV services.
These are just a few of the many conditions sleep medicine doctors can treat. 95% of people who suffer from a sleep disorder go undiagnosed, and you don’t want to be one of them. Find out if sleep medicine is right for you by calling the sleep medicine doctors at Pacific Sleep Program, with offices in Astoria, and Portland, Oregon. Call today!
CPAP—you've heard of it, and now that you have been diagnosed with Obstructive Sleep Apnea (OSA), this bedside machine is going to be your nightly companion. At Pacific Sleep Program in both Portland and Astoria, our team of 4 sleep physicians and their support staff answer many questions regarding the hows and whys of CPAP and how it can reduce the harmful health effects of OSA. Here are some of the most frequently asked questions and their answers regarding this helpful sleep therapy.
FAQs regarding CPAP
1. Just what is CPAP?
CPAP means Continuous Positive Airway Pressure. Prescribed by a board-certified sleep physician Pacific Sleep Program, a CPAP machine counters the harmful health effects of Obstructive Sleep Apnea. A CPAP machine delivers a steady stream of air through a mask into the wearer's airway, keeping it open and the patient both breathing and sleeping well.
2. What does a CPAP machine look like?
There are many CPAP styles, including variations on the machine itself and on the facial mask. Your sleep physician in either Portland or Astoria will help you determine what CPAP machine is right for your sleep disorder.
3. How do I know I need CPAP?
Only a sleep physician can tell you if you have a sleep disorder such as OSA and if CPAP is the right therapy. At Pacific Sleep Program, our professional team has the experience, expertise, and sleep study capabilities to determine why you don't sleep well, snore loudly, wake up multiple times a night, and feel fatigued during the day. Our state-of-the-art facility provides in-house and at-home sleep studies which yield data helpful in pinpointing your particular issue
4. Is CPAP hard to get used to?
Any CPAP machine requires a period of adjustment. Some people feel a bit claustrophobic because of the mask, or others may need time to find their best sleep positions as they use their machine on a nightly basis. Your doctor will work with you to ensure maximum benefit from your CPAP machine.
5. Will CPAP stop my problem snoring?
The American Sleep Apnea Association says that about 90 million American adults snore consistently. Fifty percent of these individuals actually have Obstructive Sleep Apnea. Fortunately, therapy with a CPAP machine reduces snoring considerably because the airway literally is propped open by the steady flow of air. Thus, the vibration of the uvula and other soft tissues at the back of the throat appreciably ceases, and so does noisy snoring.
6. How often should I use my machine?
To maximize its benefits, use your CPAP machine every time you sleep, whether if that is at night or if you take any naps. Consistent use helps sleep therapy patients adjust to their machines more quickly.
Find out more
CPAP machines have revolutionized sleep therapy over the past three decades. To learn more about OSA and other sleep issues, or if you have a question about your current CPAP apparatus, please call the Pacific Sleep Program. We have two offices: one in Portland (503) 228-4414 and one in Astoria (503) 325-3126.
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