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How is sleep apnea treated?

After a diagnosis of obstructive sleep apnea, your healthcare provider may recommend one or more of the following medically supervised therapies:

  • Weight loss: If you are overweight, losing weight may help relieve the pressure on your airway that's causing nighttime pauses in breathing. Your doctor will probably recommend a weight loss program. If she or he doesn't, be sure to ask about weight loss as a treatment option.
  • Continuous Positive Airway Pressure (CPAP): Your doctor may recommend that you be fitted with a nasal mask through which air is gently forced into your nostrils to keep the upper airway open. Using the device takes some getting used to, and about two weeks of nightly use are needed for maximum benefit.
  • Oral appliances: If your sleep apnea is mild and you are not overweight, a dentist can fit you with an appliance that keeps your upper airway open. Snoring, even without sleep apnea, may decrease by using this device. It's similar to a sports mouth guard and works by repositioning the lower jaw, tongue, and soft palate. Similar appliances are available over-the-counter, but studies have found that they are much less effective than those fitted by a doctor.
  • Surgery: If your condition is severe and other therapies have failed, your doctor may recommend a uvulopalatopharyngoplasty, a surgical procedure that enlarges the airway by removing certain soft tissue from the throat. This may include the uvula, the tonsils, and the adenoids, as well as a portion of the soft palate. Remember, however, that any surgery carries some risk, and success rates for this operation vary, so discuss the pros and cons with your healthcare provider before proceeding with the operation.
  • Prescription medications: People who suffer from excessive daytime tiredness because of sleep apnea may benefit from modafinil (Provigil), a medication that improves wakefulness.

Warning: Do not take sleep aids if you have or suspect you have sleep apnea. Sleep aids are not recommended for people with sleep apnea because they depress the central nervous system and can exacerbate pauses in breathing.

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There are a number of treatments for sleep apnea. The most accepted is by way of a device called a CPAP (continuous positive airway pressure) machine. These work by blowing air under pressure into the patient's mouth or nose by way of a flexible tube, keeping the airway open during sleep. Other treatments include dental appliances that hold the jaw slightly forward and occasionally surgery to create more room in the nose and throat.

Medications are usually not helpful in treating sleep apnea. The most common and effective treatment is nasal continuous positive airway pressure (CPAP). You wear a mask over your nose while you sleep, and a machine gently blows air through your nasal passages to prevent your throat from collapsing during sleep. The device must be worn every night to be effective.

There are a number of other treatments. Behavioral changes are an important part of the treatment program, and in mild cases, behavioral therapy may be all that is needed. You should avoid using alcohol, tobacco and sleeping pills, which make your airway more likely to collapse during sleep and prolong the apneic periods. Overweight people almost invariably benefit from losing weight; even a 10% weight loss can significantly reduce the number of apneic events. Sometimes in mild sleep apnea, breathing pauses occur only when you sleep on your back; in this case, using pillows and other devices that help you sleep in a side position can reduce apneic events.

In addition to CPAP, cases of mild to moderate sleep apnea can be treated using a dental appliance that repositions the lower jaw and the tongue. Possible side effects include damage to teeth, soft tissues and the jaw joint. These should be fitted by a dentist or orthodontist with experience in the use of these devices.

Several surgical procedures can increase the size of the airway, but they all have risks, and the success rate for curing sleep apnea is not high. Some of the more common procedures performed include:

  • Uvulopalatopharyngoplasty (UPPP). This involves removing portions of the uvula and soft palate to stop throat structures from vibrating and causing snoring.
  • Removing nasal polyps. This sometimes improves, but almost never cures, sleep apnea.
  • Surgically correcting structural deformities in the face and/or lower jaw.
  • Tracheostomy. This is used in people with severe, life-threatening sleep apnea. In this procedure, a small hole is made in the windpipe and a tube inserted into the opening. The tube remains closed during waking hours and is only opened during sleep so air flows directly into the windpipe and lungs, bypassing any upper airway obstruction. Although this procedure is highly effective, it is an extreme measure and is not often used.
  • Surgical procedures to treat obesity. Surgery can result in weight loss and thus improve the severity of sleep apnea.

In sleep apnea, airway obstruction results in interrupted breathing throughout the night. There are dental appliances that can be used to position the jaw or tongue during sleep to maintain an open airway. They are usually used if continuous positive airway pressure (CPAP) is not tolerated, and they can be effective treatment for some people. A CPAP machine requires wearing a mask over the nose and uses air blown through a tube to continuously maintain an open airway during sleep.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.