Studies have also shown that when CPAP is prescribed to the appropriate people and with adequate education and support along the way, the rate of use can be substantially improved. For example, in our clinic, around 80% of the patients we see will use CPAP nightly.

In a future newsletter, we will discuss how a team approach to CPAP can help with the initial adjustment to CPAP and with settling in for the long term. After all, it does not matter how great the benefits of CPAP are, if the people who need it will not use it.

19% of the people with severe OSA died over an average 13 years of follow-up, compared with 7.3% of those with mild and moderate OSA, and only 4% of those without OSA. The people with severe OSA had a 3.2 times greater death rate than those without OSA. Most of the differences in death rates were due to cardiovascular disease or stroke.

The study then looked at the people with severe OSA who did not use CPAP routinely. In the group who failed to treat severe OSA, the death rate was even more dramatic: 4.3 times higher compared to those without OSA. More importantly, deaths from cardiovascular disease were 5.2 times higher in the subjects who did not use CPAP. In contrast, the patients with severe OSA who were using CPAP had a lower death rate (2.9 times higher than those without OSA). This means that CPAP use was associated with a 2.3 fold reduction in cardiovascular deaths in those with severe OSA who used CPAP compared to those who did not use CPAP.

Although additional research is needed, it appears that CPAP may help people with severe OSA live longer by reducing the risk of heart-related deaths and strokes.

People who sleep next to a person who snores know that snoring becomes louder with a shift to the back. The loud snorer will be told to “roll over” and may receive the prompt of an elbow or fist to the ribs to move back to his/her side. In addition, sleep studies show that OSA is worse when the person sleeps on the back. Snoring and OSA are caused by narrowing behind the tongue, which become more significant when sleeping on the back due to the gravitational pull on the jaw and the backward shift of the tongue that reduces the opening behind the tongue.

1. Select The Right Doctor

To select a quality sleep medicine physician, first ask your primary care physician for a recommendation. He or she may already be familiar with some sleep medicine physicians who have provided satisfactory care for their patients. Often, your county medical society will also have a list of physicians by specialty and may have some recommendations regarding sleep medicine specialists. In general, a good assurance of quality is board certification in Sleep Medicine. A specialty certification in Sleep Medicine is currently provided by the American Boards of Internal Medicine, Psychiatry and Neurology, Family Medicine, Pediatrics, and Otolaryngology. Physicians who have passed the certifying examination, identified as Diplomates, have received specialized training and experience in the field. Choosing which specialty’s practitioner is right for you can be done with the help of your primary care physician. In general, certified sleep specialists from internal medicine, psychiatry and neurology, and family medicine can manage most adult sleep disorders. This internet link will allow you to select a Board Certified Physician in your area. http://absm.org/.

2. Select An Accreditated Sleep Center

Because of the wide array of sleep testing facilities in the Metroplex, the selection of a sleep testing center may be a bit more difficult. Your physician may be closely associated with a testing facility or hospital and may direct you to the sleep testing facility. Here are some questions to ask. Is the technologist doing your test registered as a polysomnographic technologist? Is the facility accredited by the American Academy of Sleep Medicine (AASM)? Many facilities claim to follow AASM standards, but that is not the same as accreditation. AASM accredited facilities have received a thorough review, demonstrated quality care, and must follow the highest standards. We at Sleep Medicine Associates of Texas believe in AASM accreditation as it promotes excellent quality operations, testing, patient safety and appropriate credentialing and continuing education of staff. This link lists AASM accredited sleep centers. http://sleepcenters.org/.

3. Select a Quality CPAP Vendor

Providers of CPAP equipment vary greatly in quality and degree of specialization. Some provide nasal CPAP as only a small part of a wide array of other medical equipment and home services. In general, you will do best to find a medical equipment company with a focus on respiratory therapy and sleep medicine. At Sleep Medicine Associates, we see a quality advantage for a CPAP medical equipment program which is integrated with the sleep clinic and testing facility. For our patients who need CPAP, we find it a great advantage to have a CPAP vending program nearby which can smoothly provide continued care after the testing. When you select a medical equipment company, find out if it specializes in nasal CPAP equipment. Does it have technical specialists who have an extensive background in sleep medicine?