Treatments for Sleep Apnea

Continuous Positive Airway Pressure (CPAP)

Continuous positive airway pressure is the most recommended, non-surgical treatment for all levels of sleep apnea. CPAP uses air pressure to hold the tissues open during sleep. CPAP works by delivering a steady stream of air through a mask to keep your airway open during sleep. A machine gently blows pressurized air to the mask through a flexible tube. When a person breathes the gentle pressure holds the nose, palate, and throat tissues open. The pressure is felt, but you can still breathe easily. The pressure is set according to the patient's needs at a level that eliminates the apneas. There are a variety of masks available, including nasal masks, full-face masks, and nasal pillows. The CPAP machine is a little larger than the size of a toaster and is usually portable. CPAP has been shown to be effective in improving many levels of obstructive sleep apnea.

Dental Appliances

Dental appliances are intended to treat sleep apnea by keeping the airway open. There are three different ways that this can be done. By pushing the lower jaw forward, by preventing the tongue from falling back over the airway, or by combining both methods. Dental appliances are an excellent treatment for mild to moderate obstructive sleep apnea. The most common type of dental appliance is the MAD (mandibular advancement device) because it is often adjustable so that the dentist can move the jaw further or reduce the advancement as necessary. The goal is to find the most comfortable and effective position for the patient. Not all dentists have the necessary knowledge of sleep apnea, so you should ask your sleep doctor to refer you to a dentist who is familiar with apnea and who works with oral appliances.

Medications

Many medications have been studied for sleep apnea. However, because obstructive sleep apnea is due to an anatomic airway narrowing, it has been difficult to find a medication that will help. In people with nasal airway obstruction causing obstructive sleep apnea, nasal steroid sprays have been shown to be effective.

Topical nasal decongestants also can temporarily improve nasal swelling. The problem is that they cannot be used for more than 3-5 days without decreased effectiveness and withdrawal symptoms. There is limited success in treating central sleep apnea with stimulants (i.e. Privigil)

Sleep Apnea Surgical Treatments

Most surgical treatments try to remove or reduce the blockage of the airway. Surgery is not the best solution for everyone with sleep apnea. It can sometimes reduce snoring, but not stop the apneas. A sleep specialist can determine if a surgical procedure is suitable and recommended for each individual case.

The types of surgeries are conventional surgeries, UPPP, and laser surgeries. The conventional surgery usually involves removing tissues that block the airway and may involve operating on the nose, soft palate and tongue. UPPP (uvulopalatopharyngoplasty) is where the surgeon would cut away the uvula (the tissue that hangs from the middle of the back of the roof of the mouth.) This may help to reduce snoring but may not necessarily help with the sleep apnea. In laser surgery, the doctor uses a laser to reduce the size of the uvula and soft tissue at the back at the throat. This surgery is also probably more effective in reducing snoring and less in helping with the sleep apnea. The most invasive but most successful surgical procedure for curing obstructive sleep apnea is the Bi maxillary-mandibular advancement (75-90% success). After all surgeries, a sleep study is conducted to see if the symptoms subsided.

Sleep apnea can be treated. This is why it is important that you go in for a sleep study to help determine which treatment is best suited for your needs.

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