What medical treatments exist for sleep apnea?
Obstructive Sleep Apnea (OSA) is a treatable condition and its successful treatment can improve all aspects of life. The therapy helps control the symptoms, although it will need to be lifelong in most cases.
here are a variety of treatment options that can reduce the symptoms. Your doctor will guide you and suggest the best one for you:
CONTINUOUS POSITIVE AIRWAY PRESSURE (CPAP)
Continuous Positive Airway Pressure (CPAP) is the standard treatment(1) for sleep apnea. Patients wear a mask during sleep which, connected to a flow generator, provides a continuous supply of air and keeps the airway open. Some versions of CPAP include humidifiers to avoid the possible side effects (nasal dryness or a sore throat)(2).
CPAP can be uncomfortable at the beginning and you may be tempted to stop using it. However, people who persevere usually soon get used to it and their symptoms and quality of life improve significantly(2). CPAP not only reduces snoring or tiredness but also reduces the risk of complications such as cardiovascular disease(3).
MANDIBULAR ADVANCEMENT DEVICE (MAD)
MAD is a dental appliance, similar to a gum shield. It is sometimes recommended for mild sleep apnea or as an option when CPAP is not well tolerated. MAD is designed to hold your jaw and tongue forward to increase the space at the back of your throat and compensate the narrowing of airway that causes snoring(2).
MAD may not be a suitable treatment for you if you don't have appropriate dental health(2). Consult your dentist to ensure that your teeth will support this treatment and that it is the right treatment for you.
Surgery is only used in limited circumstances and requires specialist advice. It is not routinely recommended because it carries the risk of more serious complications. It may only be considered as a last resort if other treatments have not helped(2).
Different surgical treatments can be used to treat sleep apnea(2):
- Tonsillectomy: tonsils are removed,
- Adenoidectomy: adenoids are removed,
- Tracheostomy: a tube is inserted directly into your neck and into your trachea to allow you to breathe freely,
- Bariatric surgery: the size of the stomach is reduced in order to lose weight and breathe easily
- Uvulopalatopharyngoplasty: this surgery removes excess tissue in the throat to enlarge your airway but it is performed less often nowadays.
Before treatment, the first advice your doctor will give you is to change some factors of risks related to your lifestyle. The following ones are required in most cases of OSA(2):
- Losing weight,
- Stoping smoking,
- Reducing the alcohol consumption, particularly before going to bed
- Avoiding sedative medications and sleeping pills,
- Sleeping on your side and not on your back.
(1) Clinical Guidelines for the Manual Titration of Positive Airway Pressure in Patients with Obstructive Sleep Apnea, Positive Airway Pressure Titration Task Force of the American Academy of Sleep Medicine, Journal of Clinical Sleep Medicine, Vol. 4, No. 2, 2008
(2) Obstructive sleep apnea-information prescription, www.nhs.uk
(3) Sleep Apnea and Cardiovascular Disease – AHA/ACCF Scientific Statement. Sommers and al. Circulation 2008; 118:1080-1011