Nursing Teaching on Management Measures for Central Sleep Apnea

Nurse educated the patient and caregiver on management measures for central sleep apnea as follows:

1. Individuals with history of chronic opioid use and/or opioid abuse can present with suppression of the higher centers in the brain controlling the respiratory activity. Intake of opioid medications, such as, hydrocodone, oxycodone, codeine, and methadone, with alcohol can significantly increase the risk of suppression of the higher centers in the brain controlling the respiratory activity. This can result in poor signal transmission to the muscles controlling the respiratory activity, thus contributing to development of central sleep apnea. Individuals with history of chronic opioid use for pain control must observe compliance with practicing alternative pain control measures and slowly wean themselves off of chronic opioid intake. Alternating opioid with non-opioid pain killer intake can be a good start.
2. Individuals with history of chronic psychotropic medication use and/or abuse, as a side-effect of the medication intake, can present with suppression of the higher centers in the brain controlling the respiratory activity. Excessive intake of psychotropic medications, such as, sedative-hypnotics, anti-anxiety medications, antidepressants, antipsychotics, and mood stabilizers, can significantly increase the risk of suppression of the higher centers in the brain controlling the respiratory activity. This can result in poor signal transmission to the muscles controlling the respiratory activity, thus contributing to development of central sleep apnea. Individuals with history of chronic psychotropic medication intake can seek assistance with behavioral therapy and alternative measures for anxiety control to help reduce dependence on medication. Compliance with prescribed physical exercise, as tolerated, can help release of chemicals called endorphins. Endorphins enhance feelings of pleasure & well-being and also contribute to reducing pain & discomfort, which in long run leads to behavior changes and reduced need for intake of psychotropic medications.
3. If CPAP is being used for management, information regarding how long and how frequently the CPAP was used could be stored on the device chip. This information along with the pressure settings at which the apneic episodes were best prevented can be studied from the chip recording. Observe compliance with doctor visits, as scheduled. Do not forget to take your CPAP machine for the visit, as the chip reading could provide a lot of input regarding improving on the management part of sleep apnea.
4. Individuals with history of chronic alcoholism and/or alcohol abuse can present with suppression of the higher centers in the brain controlling the respiratory activity. This can result in poor signal transmission to the muscles controlling the respiratory activity, thus contributing to development of central sleep apnea. Individuals with history of chronic alcoholism and/or alcohol abuse must observe compliance with recommendations for abstinence from alcohol intake or alcohol consumption in moderation to help prevent episodes of central sleep apnea.
5. Individuals with implanted stimulation device for sleep apnea management & prevention must check periodically with the doctor regarding the functionality of the device, remaining battery life, and timely replacement of the battery.
6. Individuals with sleep apnea must observe compliance with participation in repeat sleep studies, as ordered by the physician. This helps to monitor one’s response to the management measures currently in place. Participation in sleep studies can also help with monitoring poorly controlled or worsening symptoms of sleep apnea, so that, plan of care could be accordingly altered.
7. Individuals with history of poorly managed cardiac conditions, such as, heart failure and arrhythmias, can present with compromised pumping activity of the heart. This can result in reduced amount of blood pumped out of the heart and consequently, deficient blood supply to the vital organs, such as, brain. Reduced blood supply to the brain can lead to compromised brain function and poor signal transmission to the muscles controlling the respiratory activity, thus contributing to development of central sleep apnea. Effectively controlling the cardiac conditions & arrhythmias from further progression & worsening can help reduce the episodes of central sleep apnea.
8. Individuals with history of head injury, secondary to falls/accidents/and other causes, can present with abnormal or deficient brain function, poor signal transmission to the muscles controlling the breathing, thus contributing to development of central sleep apnea. Caregivers of individuals with head injury must keep a close watch for development of symptoms of central sleep apnea and report to the physician on their notice for an early intervention. Observing compliance with general fall & safety precautions can contribute towards reducing the chance for falls & head injuries, thus contributing towards preventing episodes of central sleep apnea.