Eli Hendel M.D.
A Medical Corporation

Sleep Apnea

 Sleep Apnea Basics


If you have this condition, you stop breathing during sleep. There are two types of sleep apnea:

Central Sleep Apnea (CSA) – In this case the brain ceases to give a signal to breathe

Obstructive Sleep Apnea (OSA) – In this case there is a signal from the brain to breathe, but there is a blockage which causes a cessation of flow of air into the lungs during sleep.   

The initial evaluation for sleep apnea consists of a comprehensive history and physical examination to determine the clinical probability of a sleep-breathing disorder. Most insurance companies, including Medicare, require that the doctor first demonstrate the presence of clinical probability of a sleep disorder, in order to cover the next step, sleep studies.

A sleep study is done by the patient spending the night in a certified sleep lab or at home using equipment furnished by this office and returned in 24 or 48 hours back to the office, to be analyzed.

If treatment is indicated, equipment is prescribed by a contracted provider of your insurance company. Treatment can consist of:

CPAP (Continuous Positive Airway Pressure) – This a machine that provides continuous air flow at a single pressure as guided by the sleep study

BIPAP (Bi-level Pressure) – This is a machine that provides two airflows at two pressures -one for inspiration and a lower pressure for expiration. This must be for specific indications as determined in the sleep study.

ASV (Adaptive Servo Ventilation) – This is a special machine that senses when there is a lack of initiation of breath, and the machine initiates a breath on its own. It is a very sophisticated machine with complex settings for special situations (usually for individuals with heart disease).

The choice of treatment must be carefully selected by the doctor, after analysis of the sleep study. The doctor will fully review sleep study results with you.