CPAP IS THE #1 TREATMENT FOR OSA.

During your stay at the sleep lab, a mask may be placed over your face if you have sleep apnea. The mask fits over the nose, and constantly blows room air into the nasal passageway. The technician will raise the amount of airway pressure as needed to eliminate any obstruction in the airway. You will receive a mask and CPAP machine following your CPAP titration at the sleep lab. Some patients feel better immediately, but it may take up to two weeks of nightly use before you notice an increase in your energy level. There are times when CPAP therapy is not enough. In these cases patients need to use oxygen and CPAP together to keep blood oxygen saturations at a desirable level.

An alternative to wearing the CPAP mask is having surgery. If the cause of OSA is a narrow airway, different surgeries can be performed to widen the airway. This removes the obstruction that causes OSA. Your doctor will refer you to a specialist (ENT) to determine if surgery is right for you. After surgery, patients typically have another sleep test in order to determine if the obstruction has been eliminated. Here is a list of common surgical procedures:

1. UPPP = Uvulopalatopharyngoplasty
   
2. Laser assisted Uvuloplasty
   
3. Radio frequency procedure or Somnoplasty
   
4. Mandibular Myotomy

Sometimes patients have very mild OSA that only occurs when laying flat on the back. These patients are encouraged to form a habit of sleeping on their sides. Anything that discourages them from sleeping on their backs can be effective. An example would be sewing a ball into the pocket of a T-shirt and wearing it backwards. Another example is placing pillows along the sides of the person making it difficult to roll over.

In the case where a patient’s obstruction is caused by a large tongue or jaw alignment problem, a possible solution is to discuss being fit for a dental/oral device with your dentist.

CPAP can be used to treat CSA
(Read about CPAP under OSA)

Oxygen therapy is another form of treatment for CSA

Anti-depressants such as Protriptyline, also known as Triptil or Vivactil, can be used to treat CSA. Depressants, such as Klonopin, can also be used as treatment.

RLS improves with Iron replacement.

Meds used to treat PLMS and mild to moderate RLS include Benzodiazepines, gabapentin, low dose carbidopa/levodopa, or opiates. Daily severe RLS can be treated by gabapentin or pergolide.

Younger patients should avoid using opiates as treatment.

1. Tryclyclic antidepressants can
   cause RLS
   
2. Meds for nausea, even though
   some of the meds used can
   cause nausea.
   
3. Caffeine can increase the
   symptoms of RLS
   
4. Use most antidepressants,
   Lithium, and Melatonin with
   great caution
   

There are many different causes of insomnia, and many different treatments as well. A specialist will decide what kind of treatment will benefit you the most.

Some of the most commonly prescribed medications are Stimulants such as Ritalin, Dexedrine, and Cylert. However, your doctor should decide what medication is best for you.

Treatment with clonazepam is very effective.

Typically sleepwalking is outgrown in adolescence and does not require medical intervention. However estimates show that up to 10% of adults may sleepwalk. Medications and hypnosis have both been used as treatments for sleepwalking.

Treatment is usually not necessary because sleep terrors tend to go away on their own. When treatment is required certain medications may be effective. For long-term management, hypnosis or relaxation therapy may be recommended.

Can be caused by stress and is most effectively treated by wearing a mouth guard. You may want to discuss this with your dentist if you think you grind your teeth at night.

Seizures are treated by using anticonvulsants or other medications.