How is sleep apnea treated?
While there are currently no cures for Sleep Apnea, there are things you can do to greatly reduce the impact on your daily life. Losing weight, specialized dental appliances, CPAP machines and surgery are all viable options.
For decades, most people who were diagnosed with sleep apnea were prescribed the CPAP machine. The problem with this device is that many people stop using it because of discomfort or they remove it unconsciously during sleep. This has led to increased use of alternative options such as oral appliances. These appliances are extremely effective in treating sleep apnea and have a high rate of patient acceptance and use. In the most recent studies oral appliance therapy, provided by experts, has been shown to be equally effective to CPAP therapy using a comparison called “Mean Disease Alleviation”.
Historically, a patient had to fail CPAP to be considered a candidate for oral appliance therapy. However, oral appliance therapy is now considered a first line treatment and equal to CPAP in mean disease alleviation in all severities from simple snoring to severe OSA. This is very reassuring to patients who have given up on using their CPAP.
There are several options for treating snoring and sleep apnea. Treatment is usually aimed at eliminating the cause of the blockage of breathing. Treatment choices range from simple to complex. Below is a list of types of treatment:
Oral Appliance Therapy
(OAT) is a comfortable treatment choice for many sleep disorders. It is recommended for simple snoring, mild to severe sleep apnea, and for CPAP intolerant patients.
These appliances typically work by advancing the jaw and keeping the tongue from blocking the airway, and by tightening the throat muscles, causing the throat to be more open so you can breathe better. These devices may appear similar to athletic mouthpieces and orthodontic retainers, but they are significantly different. Oral appliances are generally quite effective and are well tolerated by most patients. Each FDA approved appliance is custom manufactured and fit comfortably to effectively treat snoring and sleep apnea.
Continuous Positive Airway Pressure CPAP
In many cases a CPAP (continuous positive air pressure) machine is used to treat sleep apnea. CPAP is typically a shoe-box-size compressor that pumps air through the nose and down the throat splinting the tongue forward to open the airway. It is considered the “gold standard” for treatment of sleep apnea. However, many patients find the apparatus uncomfortable and difficult to wear while sleeping. Nonetheless, CPAP can be the treatment of choice, especially for those diagnosed with severe sleep apnea.
Many people only experience snoring and sleep apnea when they sleep on their back. While sleeping on your back maybe more comfortable than sleeping on your side, sleeping on the back is more likely to lead to collapse of the airway. When sleeping on your side the airway is less apt to collapse. Using positional therapy means that you use an aid to keep you from sleeping on your back.
Surgery works to correct snoring and sleep apnea by widening the airway through removing tissue from the back of the throat. Removal of the tonsils and adenoids is often the easiest and most effective treatment for children with sleep apnea. Another surgical option is to advance the upper and lower jaws to open the airway. This is among the best options for treating sleep apnea, but it is also a very invasive procedure. By surgically moving the upper and lower jaw forward the entire airway can be enlarged, hence treating sleep apnea. This procedure is usually performed on patients with moderate to severe sleep apnea. Sometimes this surgery can provide cosmetic benefits as well as solving sleep issues. More recently, nerve stimulators are proven to be an option in select patients and these are implanted like a pacemaker under the skin to stimulate the tongue to move forward to reduce air blockage.
Orthodontics can be another treatment option but not usually in the case of an adult. It has successfully been used in treating some children with sleep apnea. In addition to straightening teeth, orthodontics can be used to “widen” the jaws opening the airway. Much research is still needed to validate that this modality can help adults.
Sleep Apnea is not always associated with a person’s weight; however, many patients suffering with sleep apnea are overweight. Losing extra pounds can help with reducing snoring and sleep apnea, but is not reliable in eliminating obstructive sleep apnea. Besides helping eliminate some sleep issues, weight loss has many other beneficial health effects. Weight loss to normal weight is always encouraged!
Co-Therapy-Treatment for Sleep Apnea is the unique combination of several concurrent treatments. For example, it could be a custom oral appliance with a strapless CPAP mask connected to a CPAP machine. This would likely be beneficial if you are unable to tolerate a regular CPAP mask, the higher pressure of a CPAP machine, or maybe just didn’t like the current delivery of air from the CPAP. There are many other options in combining co-therapy treatments to remove the obstacles to successfully treating your sleep related breathing disorder and getting you the rest you need to lead a happy healthy life. If you fall in the moderate to severe side of the spectrum of sleep apnea, have failed other therapies and are frustrated with results of your treatment so far, then combined therapy is a great option.
Alcohol, smoking and some specific drugs can exaggerate sleep problems. Their use should be moderated or eliminated based upon expert medical opinion from your doctors. Sleep aids seen on TV and on the Internet have been shown by research to be mostly ineffective and are not encouraged. We also encourage a regular sleep schedule with adequate hours of sleep to enable your body to function and heal properly.