Therapy for sleep apnea is specifically designed for each individual patient. Your sleep apnea treatment may include any number of the following options.
Behavioral changes are an important part of a treatment program, and in mild cases of sleep apnea, behavioral therapy may be all that is needed. The patient may be advised to:
- Avoid the use of alcohol.
- Avoid the use of tobacco.
- Avoid the use of sleeping pills and other sedative medications.
- Lose weight if overweight (even a 10 percent weight loss can reduce the number of sleep apnea events for most patients).
- Use pillows and other devices to help sleep in a side position. Patients with sleep apnea should avoid sleeping on their backs. This position increases the risk for breathing problems during sleep.
A machine called a continuous positive airway pressure (CPAP) is the most common and effective treatment for patients with moderate to severe sleep apnea. The machine delivers a steady stream of humidified air through a mask that is placed over the nose during sleep. The mask does not breathe for the patient. Instead, it pushes air into the patient's mouth when he or she inhales. This flow keeps the airway open, preventing sleep apnea and snoring. “It’s noninvasive, and most people get used to wearing it in a few weeks,” says registered sleep technologist Stephanie Betz. If used correctly, says pulmonologist Richard Strobel, MD, with Lehigh Valley Health Network, CPAP is more effective than palate surgery or any other treatment.
Patients who use a CPAP should tell their doctors if their weight changes. If you lose or gain weight, the pressure settings on the machine may need to be adjusted. If you notice a recurrence of symptoms, another sleep study may be necessary.
In addition to CPAP, patients with central sleep apnea may benefit from bilevel positive airway pressure (BiPAP). This device provides more air pressure when the patient inhales and less pressure when the patient exhales. Some machines can be set to automatically provide air if the device detects a breath has not been taken in a certain amount of seconds.
Another airflow device, called an adaptive servo-ventilation device (ASV), may be used to treat central sleep apnea and complex sleep apnea. This device detects the patient's normal breathing pattern and stores it in a built-in computer. When the patient falls asleep, the machine uses the stored information to regulate the patient's breathing pattern and prevent sleep apnea.
Patients may also wear devices in their mouths at night to help control sleep apnea. Some devices bring the lower jaw forward in order to open the throat and control symptoms of mild obstructive sleep apnea. You will need to talk to your sleep physician and/or dentist to determine the best oral appliance for you. Once you find an oral device that works for you, you should visit your dentist every six months for the first year. After the first year, visit your dentist and health care provider annually to make sure the device is effectively relieving symptoms of sleep apnea.
Oxygen administration may safely benefit certain patients but does not eliminate sleep apnea or prevent daytime sleepiness. Its role in the treatment of sleep apnea is controversial.
Mild sleep apnea may be treated with surgery. During surgery, the extra tissue from the throat or nose that is blocking the airway passage is removed. Examples of these procedures include:
- Tonsillectomy and adenoidectomy – removal of the adenoids (lymph tissue located in the space above the roof of your mouth) and tonsils (the small, round pieces of tissue located in the back of the mouth)
- Uvulopalatopharyngoplasty (UPPP) – a procedure used to remove excess tissue at the back of the throat (tonsils, uvula and part of the soft palate)
- Other common procedures to remove nasal polyps or other growths or tissue in the airway, and correct structural deformities
In addition, surgical reconstruction for deformities of the lower jaw may benefit some patients. Surgical procedures to treat obesity are sometimes recommended for sleep apnea patients who are morbidly obese.
Specific treatment will be determined by your doctor based on:
- Your age, overall health and medical history
- Severity of the disease
- Your tolerance for specific medications, procedures or therapies
- Expectations for the course of the disease
- Your opinion or preference