In each edition of Ask Dr. Lisa, our medical sleep expert, Dr. Lisa Shives, answers your questions about why you can’t get the sleep you need. In this installment, Dr. Lisa answers a question from a woman looking for answers to her sleep apnea treatment…
Kathryn Coverston asks: I’m a Post Polio Syndrome patient and suffering from newly-diagnosed sleep apnea as a result of the neuromuscular damage to my diaphram. My respiratory doctors are testing me on AVAP machine with s/t mode settings (I have researched this extensively with the Salk Institute in LaJolla, CA) and I’m still having trouble sleeping with the mask on my face. They say that there is a mouth device that may work, but Kaiser doesn’t usually prescribe it. Any thoughts or advice?
Dr. Lisa says: Such a patient usually has a more complex ventilation problem, i.e. it is not just OSA that is the problem. Therefore an oral appliance is not appropriate treatment. This type of patient really needs a machine and the right machine; not all servoventilators are the same. This patient needs a sleep center that really knows equipment so that close follow up can happen and so necessary changes can be made in the sophisticated settings.
Dr. Shives works with SleepBetter.org to provide a medical view of sleep issues. She is one of only a few practitioners with a fellowship in Sleep Medicine in addition to board certification by both the American Board of Internal Medicine and the American Board of Sleep Medicine.