Treatment

CPAP Machine

Treatment depends in part on the severity of the sleep apnea and varies from patient to patient.  People with mild apnea have a wider variety of options, while people with moderate-to-severe sleep apnea would be treated with nasal continuous positive airway pressure (CPAP) machine.


Continuous Positive Airway Pressure (CPAP) is the leading therapy for sleep apnea . Patients wear a face or nasal mask during sleep. The mask, connected to a pump, provides a positive flow of air into the nasal passages in order to keep the airway open. Most insurance companies now pay for sleep testing and for CPAP treatment. The majority of people who use CPAP find immediate symptom relief and are delighted with their increased energy and mental sharpness during the day. Many patients have said, "CPAP changed my life!" But some patients find CPAP masks uncomfortable, even though it may control their sleep apnea. Many need extra assistance to get a mask that fits correctly. Side effects are usually mild and temporary, and include nasal congestion, sore eyes, headaches and abdominal bloating. Many people get used to CPAP over two-to-twelve weeks, and according to some research studies, less than one-half of CPAP patients discontinue treatment. Follow-up is the most important factor in patient compliance. Health professionals have advanced technology and compliance reporting tools available that allow them to help patients with CPAP treatment soon after they begin making use of it. These methods complement compliance when coupled with patient education and a positive first experience with CPAP.

Weight Loss

Carrying extra weight can lead to a wide range of comorbidities: health problems that exist in addition to obesity. The chronic conditions most commonly associated with excessive weight are heart disease, stroke, and diabetes. Other issues include hypertension, inflammatory disorders, joint pain, mobility challenges, and, of course, obstructive sleep apnea.  In some instances, OSA can be treated by simple weight loss in some patients.

Oral Appliance

Oral appliances (OA) have emerged as an alternative to continuous positive airway pressure (CPAP) for obstructive sleep apnea (OSA) treatment. The most commonly used OA reduces upper airway collapse by advancing the mandible (OA). There is a strong evidence base demonstrating OA, improve OSA in the majority of patients, including some with more severe disease. However OA are not efficacious for all, with approximately one-third of patients experiencing no therapeutic benefit. OA are generally well tolerated, although short-term adverse effects during acclimatization are common. Long-term dental changes do occur, but these are for the most part subclinical and do not preclude continued use. Patients often prefer OA to gold-standard CPAP treatment. Head-to-head trials confirm CPAP is superior in reducing OSA parameters on polysomnography; however, this greater efficacy does not necessarily translate into better health outcomes in clinical practice. Comparable effectiveness of OA and CPAP has been attributed to higher reported nightly use of OA, suggesting that inferiority in reducing apneic events may be counteracted by greater treatment adherence. Recently, significant advances in commercially available OA technologies have been made. Remotely controlled mandibular positioners have the potential to identify treatment responders and the level of therapeutic advancement required in single night titration polysomnography. Objective monitoring of OA adherence using small embedded temperature sensing data loggers is now available and will enhance clinical practice and research. These technologies will further enhance efficacy and effectiveness of OA treatment for OSA. 

Surgery

If you have exhausted other apnea treatment options, you may want to discuss surgical options with your doctor or sleep specialist. Surgery can increase the size of your airway, thus reducing your episodes of sleep apnea. The surgeon may remove tonsils, adenoids, or excess tissue at the back of the throat or inside the nose. Or the surgeon may reconstruct the jaw to enlarge the upper airway. Surgery carries risks of complications and infections, and in some rare cases, symptoms can become worse after surgery.