Sleep apnea causes your breathing to stop repeatedly during your sleep. This may happen a few times a night or several hundred times a night. Your doctor can diagnose the condition by doing a sleep study in the clinic, sleep apnea treatment options include losing weight, avoiding alcohol and smoking, using a CPAP machine, and changing sleeping positions.
CPAP
CPAP machines have been the go-to treatment for sleep apnea for decades, and still work well for many people. “It’s important for everyone to consider getting evaluated,” says Dr. Zinchuk. “If you’re feeling groggy and tired, even after what you thought was a good night of rest, that could be sleep apnea.”
A CPAP machine delivers pressurized air through a mask to keep the windpipe open while you sleep, eliminating the breathing pauses that cause apnea. It also reduces daytime sleepiness and may prevent or slow the progression of a heart condition called atrial fibrillation, which can lead to a stroke and sudden cardiac death. Other treatments include oral appliances (such as a mouthguard or orthodontic retainer), changing sleeping positions, avoiding alcohol or sedatives before bedtime, losing weight, and exercising regularly.
APAP Machine
A CPAP machine delivers a constant flow of air pressure through the nose or mouth. APAP stands for automatic positive airway pressure, and this device automatically adjusts pressure throughout the night based on your breathing patterns. It may increase the pressure during periods when you tend to have the most apnea episodes, and it decreases the pressure when you are sleeping prone or supine.
This type of apnea machine is the most widely used device for treating sleep apnea, but it can take some time to get comfortable wearing a mask and falling asleep using a PAP therapy. Weight loss, nutritional strategies, exercise, and avoiding alcohol or sleeping pills can also reduce the severity of your symptoms. An APAP machine is particularly helpful for people who experience noticeable changes in their apnea episodes based on specific circumstances, such as weight fluctuations or alcohol consumption.
Dental Devices
With sleep apnea, the tongue can flop back or drift to the roof of the mouth while you’re sleeping and cut off your airway. Dentists create appliances that prevent this from occurring so the brain gets enough oxygen while you sleep.
The most common sleep apnea dental device is called a mandibular advancement splint or MAD, which looks like a sports mouthguard and fits in the mouth to hold the lower jaw in a forward position. Another type, a tongue-retaining device, holds the tongue in place to keep the airway open.
Both types can reduce snoring and mild to moderate obstructive sleep apnea. They also improve energy levels and may decrease the risk of related health problems. They are less invasive than surgery and more comfortable than a CPAP mask.
Upper Airway Stimulation
Surgically implanted devices that monitor and deliver mild stimulation to key airway muscles to keep the throat open are becoming a popular treatment option for those with obstructive sleep apnea. Brigham and Women’s Faulkner Hospital offers this new, minimally-invasive procedure called upper airway stimulation.
The device works by stimulating the hypoglossal nerve that controls movement of the tongue. The device helps to prevent the tongue from collapsing into the airway during sleep. The procedure is very effective, and there are very few side effects. However, it may not be right for everyone. It’s important to have a sleep study done before considering this surgery. It also takes time for patients to adjust to the device. During the activation visit, the device is turned on for the first time at a very low level to help the patient get used to it.
Surgery
Obstructive sleep apnea is caused by a blockage of the throat or nose. It can also be caused by a low level of oxygen in the blood (hypoxemia), or nervous system problems like amyotrophic lateral sclerosis, or Lou Gehrig’s disease.
Treatment for obstructive sleep apnea includes lifestyle changes. Losing weight and avoiding alcohol, sedatives, and sleeping on your back can help reduce apnea events. Treating allergies and nasal congestion can also improve breathing.
If those don’t work, there are medical devices and surgery that can help open the airway. Tonsillectomy/adenoidectomy removes the tonsils and adenoids, which widens the area where the mouth, throat, and nasal passages connect. Uvulopalatopharyngoplasty removes tissue from the back of the palate and pharynx, which also helps. Another option is a surgical procedure called a tracheotomy, which makes a hole in the windpipe to allow air to flow.