Author Archives: danliao91

Obstructive sleep apnea (OSA) is a sleeping disorder,and is a highly common problem that occurs during the different cycles of sleep, which has been largely associated with the amount of stress that is exerted on the body. The disorder stems from the recurrent episodes of partial or complete upper airway obstruction during sleep. The vast majority of the people are usually not aware if they have OSA, and these cases are often left untreated for long periods of time, most of which can lead to chronic diseases in the mid 50’s and over the age of 65. OSA has been recognized as the second most popular cause of hypertension, also known as high blood pressure. Hypertension is characterized by the elevation of blood pressure in the arteries, which requires the heart to pump harder and increase the rate of contraction to get blood around the body. The most popular method for treating OSA with hypertension is through pharmaceutical drugs, which includes fluoxetine, tryptophan, and protriptyline; however, these treatments are not as effective as experts say. I argue that drug treatments for OSA and hypertension are ineffective, instead combining multiple treatments such as spine adjustment, physical intervention of nasal airway, and pharyngeal exercises will provide better results in relieving OSA and lowering hyptertension.

This is an overview of OSA. (Krames Patient Education)

For most people who want instant relief from the effects of OSA, over the counter drugs or prescribed drugs are the most common solutions; however, according to studies done by Laurent Stephane from the University of Paris, treatment of OSA and hypertension by antihyptertensive drugs with promising preclinical results have been more difficult and less productive than what the results show. The study composed of  relatively new novel drugs that have entered preclinical trials. However, these drugs are just actually improvements on the previous generations of drugs such as neutral endopeptidase, which acts as an inhibitor for endopeptides. From the extensive tests done on these drugs on rats, there is a low accountability of the drugs producing desired effects. The article even suggests that surgery has been the favored treatment for hypertension, along with the rehabilitation of oral exercises and developing healthier lifestyles.

Fig. 1 This is the structure of aldosterone synthase inhibitor, which is a drug used to treat hypertension. (Antes et al., 2011)

One way of treating OSA is by EPAP (expiratory positive airway pressure) devices; they are placed in each nostril, and have two small valves that remain open on inspiration, but offer resistance to expiration. This device is concocted from extensive studies done on the upper-airway cross-sectional areas by CT scans during respiration. In order to reduce hypertension symptoms, there is another method other than surgery called deep brain stimulation. This treatment is relatively new, however, has promising results. The stimulation on the brain is done by placing electrodes at regions where blood pressure is controlled, and electrical pulses are sent to the brain to inhibit pressor regions. The result is that there is a decrease in the amount of blood needed in certain areas of the body, thus decreasing the amount of contraction the muscles need. Another way of treating OSA is by spinal adjustments, which can be performed by either physiotherapists or chiropractors. Pharyngeal exercises such as singing have shown improvements in OSA patients with hypertension.

Fig. 2 This picture shows how valves on EPAP devices regulate air flow (Doshi et al., 2012)

Fig. 3 The EPAP device is placed in the opening of the nose, and covers the entirety of the nose. ((Kryger et al., 2011)

In this world where everything can be solved by the intake of drugs and antibiotics, the demand of these drugs is always increasing. However, we must ask ourselves, are drugs the only way to solve everything? Through more research and developmental treatments, OSA can be effectively treated by managing a healthier lifestyle along with corrective surgery or EPAP devices, which can reduce the risks and problems of hypertension.

Sources:

Amaro, C. S., Amodeo, C., Bortolotto, L. A., Drager, L. F., Gonzaga, C. C., Paula, K. G., Pedrosa, P. P. &  Sousa, M. G. (2011). The most common secondary cause of   hypertension associated with resistant hypertension. Hypertension, 11(59), 811- 817.

Esler, M., Laurent, S. & Schlaich, M. (2012). New drugs, procedures, and devices for hypertension. Lancet, (380): 591–600.

Video link:

https://www.youtube.com/watch?v=wk8c4rNrQ-A

Websites used:

http://bioinf.mpi-inf.mpg.de/ccb/

http://www.sleepdt.com/provent-nasal-epap-a-skeptic-turns-believer/

http://www.sleepdt.com/a-novel-non-prescription-nasal-epap-device-theravent-to-treat-snoring/