For milder cases of sleep apnea, your doctor may recommend only lifestyle changes, such as losing weight or reducing alcohol consumption. If you have nasal allergies or problems breathing through your nose, your doctor might recommend treatment for your allergies or treatments to improve nasal flow. If these don't improve your signs and symptoms or if your apnea is moderate to severe, there are other treatments available. Some people try several options before they find the one or a combination of treatments that works best for them.
Positive Airway Pressure
If you have moderate to severe sleep apnea, you might benefit from using a machine that delivers air pressure through a mask while you sleep. This helps to keep your upper airway passages open and can prevent obstructive sleep apnea and snoring.
There are many PAP machines from different manufacturers. There are also many different ways to deliver pressure that use a variety of “masks” that are used directly into nostrils (nasal pillows) to ones that are placed over the nose, over the mouth, or over both the nose and mouth (full face masks). Different masks also have different attachments (head gear and hoses)—some that point upwards and others, sideways.
It is hard to predict which type of mask might be most comfortable for any given patient. You might need to try more than one type of mask to find one that's comfortable and works best for you. Don't stop using the PAP machine if you have problems. It takes persistence and practice to adjust to the mask, the headgear and straps, and the air pressure itself. Check with your doctor or sleep technician to see what adjustments can be made to increase your comfort.
(Continuous Positive Airway Pressure) is the most common method of treating obstructive sleep apnea that involves using a machine that provides constant air pressure through the nose and mouth to keep your breathing airways open.
(Automatically-adjusting Positive Airway Pressure) automatically adjusts the pressure required to keep the airway open based on the sensors that detects breathing flow patterns during sleep.
is a type of positive airway pressure device that has two pressure settings: the prescribed pressure for inhalation (ipap), and a lower pressure for exhalation (epap). The lower pressures during expiration may improve the comfort of using the device in some patients who need higher pressure and have trouble adjusting to this. In some patients with underlying lung disease, the use of different pressures inspiratory and expiratory may help with breathing.
Oral appliances, or mandibular advancement devices, are something like a mouth guard or dental device. They work by increasing the space in the back of the throat by moving the jaw forward changing the position of the tongue. While CPAP is usually more effective than oral appliances, oral appliances might be easier to use, and therefore in some patients, they may be used for more total hours per night—providing good control of apneas.
The most effective of these devices are those that are customized for each individual by a qualified dentist. If this therapy is a good option for you, a sleep doctor will need to refer you to a qualified dentist. Some devices require ongoing adjustment to determine the right settings. Regular follow-up is recommended to ensure that your sleep apnea is well controlled and that fit remains good. More details on the side-effects and indications for oral appliances can be found below.
There are several types of disposable nasal devices. Some work by opening the nostrils, to make breathing easier, and reducing the narrowing that may occur when breathing through a narrow air passage. Off-the-shelf treatments can help reduce snoring, but as sole treatments, are not usually effective for sleep apnea.
There are some nasal therapies, requiring a prescription. One such therapy opens the airway during inspiration, allowing the user to breathe in freely, and then narrows during exhalation. This increases pressure, helping to keep the airway open until the start of the next inspiration. This type of nasal therapy requires a completely dry face free of oils created naturally or applied to the skin prior to sleep for the adhesive to stick to the skin. This therapy should not be used by those with certain lung or heart disorders, very low blood pressure, acute respiratory infections or perforated eardrums. This therapy can be used in combination with other treatments. It can be hard to predict who responds best to this treatment.
In adults with sleep apnea, surgery is usually only an option after other treatments have failed. Generally, at least a three-month trial of other treatment options is suggested before considering surgery. The different options available should be discussed with your doctor. Outcomes can be variable.
Snoring and sleep apnea become worse when a Sleep Apnea Patient sleeps on their back. This may happen because of gravity pulling the lower jaw and the tongue backward, causing the back of the throat to become narrower, thus obstructing the flow of air. For people who have sleep apnea and sleep mainly on their back, positional therapy may be an option.