Sleep Apnea Testing and Care in Southlake, TX

Sleep apnea is one of the most common conditions we see and one of the least often tested for. It drives blood pressure that will not respond to three medications, glucose that will not come down, and exhaustion that gets blamed on stress for years. Most people can be tested at home.

Who should be tested

Loud snoring plus witnessed pauses is the classic picture, but plenty of people have neither. We also test when we see:

• Blood pressure that stays high on three or more medications
• Atrial fibrillation, especially recurrent after treatment
• Type 2 diabetes with an A1c that will not move
• Morning headaches, or waking unrefreshed no matter how long you slept
• Falling asleep while driving, reading or in meetings
• Nighttime urination several times with no urologic explanation
• Treatment-resistant depression
• A large neck circumference, crowded airway, or significant nasal obstruction

We screen with STOP-BANG and the Epworth scale, then test if the score warrants it.

Home testing

A home sleep apnea test is a small device you wear for one night in your own bed. It measures airflow, oxygen saturation and respiratory effort, and it is accurate for uncomplicated obstructive apnea.

We order it, you pick it up, you sleep at home, and we go through the results together rather than sending a number through the portal.

Some situations need a full lab study: significant heart failure, chronic lung disease, neuromuscular disease, suspected central apnea, or a negative home test when the clinical picture still says otherwise. A negative home study in a high-suspicion patient should be repeated in the lab, not accepted.

Treatment

CPAP remains the most effective treatment and the one people most often abandon, usually in the first month.

Most of that comes down to mask fit and pressure, both of which are adjustable. A nasal pillow instead of a full face mask solves a great many problems. Heated humidification solves most of the dryness complaints. Ramp settings help people who cannot fall asleep against the pressure.

We follow up early rather than assuming silence means it is going well, and we look at your machine’s adherence and residual event data rather than only asking how it is going.

For mild to moderate disease, dental appliances made by a sleep-trained dentist work well and some patients strongly prefer them. Positional therapy helps when apnea only happens on your back. Hypoglossal nerve stimulation is an option for selected patients who cannot tolerate CPAP.

Weight and apnea

Weight loss reduces severity meaningfully and sometimes resolves mild disease. It is also true that apnea makes weight loss harder, which is a genuine loop and a reason to treat both at once rather than sequentially.

Our medical weight management program screens for apnea from the first visit for exactly this reason. See also obesity.

What improves with treatment

Blood pressure frequently improves within weeks. Glucose patterns in type 2 diabetes often follow. Atrial fibrillation is far less likely to recur after ablation in treated patients than untreated ones.

If your main problem is not apnea, our sleep disorders page covers insomnia, restless legs and circadian problems.

Apnea is followed through our chronic condition management program. See our primary care Southlake practice overview.