First, the good news. Obstructive sleep apnea (OSA) is pretty easy to diagnose and it can be treated successfully. The bad news is that treating it is not always easy. OSA is a life-long disease, and like many other chronic diseases it can be managed over a patient's lifetime, but rarely "cured". The person who treats a chronic disease like OSA is the patient with the disease, and treatment almost always carries not only benefit but also some burden. So if you are a patient with OSA the success of your prescribed treatment depends on your willingness to use it.
The answer to how OSA is treated is too important and too complicated to cover adequately in the space allotted here, so for now I will just cover some general principles that you (here I am assuming that you are a patient with OSA) and your doctor might consider. I will list the treatments available and then cover each one in more detail in the answers to questions about specific treatments.
The goals of treatment are to prevent the abnormal breathing events in sleep. You want the signs and symptoms of OSA to disappear, and your sleep quality to improve. You want to avoid the long-term cardiovascular and neurologic consequences of OSA.
You also want to avoid situations that could place you in danger, situations that might not be so risky for patients without OSA. This means that you need to fully understand OSA, the risks having it, and the importance of treating it. You should know that alcohol within two hours of your bedtime can make your sleep apnea worse. You should know that smoking can make OSA worse. Certain sleeping medications should be avoided. It is terribly important that other doctors you see know that you have sleep apnea, so make sure you give them a copy of your sleep study report. Surgery in patients with OSA carries increased risk, especially if opioid (narcotic) pain relief will be required.
The treatments that are currently available include:
- Weight loss, both by diet alone or diet plus weight loss surgery
- Restricting sleeping position (avoiding back sleeping)
- Devices that hold the lower jaw and or tongue forward
- Positive airway pressure
- Upper airway surgery
- Stimulant medication for sleepiness
The bottom line is that treatment for OSA is available. However you must be a full participant in that treatment, be fully informed about your OSA, and be prepared to inform other caregivers.
More Answers from Phil Westbrook