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The patient, a gentleman in his late fifties from the Cumberland MD area, came to our Center for untreated sleep apnea due to failed surgeries and inability to tolerate either CPAP or bilevel positive airway pressure.
He had undergone six overnight recordings at two different sleep centers near his home, in Maryland, with demonstration of sleep apnea with excessive drops in oxygen levels. Since he was unable to tolerate positive airway pressure, he had undergone surgeries on his palate, larynx, nose, sinuses, the hyoid bone in his neck and the base of his tongue--without any lasting benefit.
On physical examination, he demonstrated a slightly elongated soft palate and a large tongue.
During his first overnight recording at our Center, he demonstrated severe sleep apnea with 48 episodes of breathing abnormality per hour and potentially dangerous drops in blood oxygen levels, such that we administered nasal oxygen as a protective measure. He was completely unable to tolerate CPAP or bilevel positive airway pressure.
In contrast, during his second overnight recording, he slept comfortably and soundly throughout the night with adaptive servo-ventilation (ASV). At final settings, ASV completely normalized his breathing and blood oxygen levels.
He stated that he would prefer ASV for treatment and was started immediately on a home trial of the device. He now sleeps throughout the night with ASV and reports that both his daytime sleepiness and sleep quality are greatly improved.
COMMENTS: Adaptive servo-ventilation adjusts on a continuous basis to patients' ever-changing needs during sleep--rather than forcing patients to adapt to it! This very fact renders it an ideal treatment for those unable to tolerate such older treatments as CPAP and bilevel PAP.
Many patients come to us from Ohio and from distant states because they have sleep apnea but could not tolerate either CPAP or bilevel PAP. Failure to ensure prompt and consistent treatment of sleep apnea is potentially very dangerous, since its complications are often devastating (for example, strokes, heart attacks and chronic heart failure).
We find that most of these patients do beautifully with adaptive servo-ventilation, and they tolerate it well. Adaptive servo-ventilation can be life-saving.
If this patient's story reminds you of your own--or that of a loved one--please do not hesitate to contact us at flamenco@netexp.net with any questions that you may have. We are here to help.
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