Continuous positive airway pressure (Treatment) is the most commonly prescribed treatment for obstructive sleep apnea. Here's what it does, why it works, and how to get past the rough first few weeks.
Sleep Apnea treatment depends upon the type of sleep apnea, how severe it is, what are its causes, and last but not least your overall health.
For Obstructive sleep apnea (OSA), Positive airway pressure (PAP) therapy is one of the most common and effective treatments. Depending on the person, your sleep apnea treatment may include an oral appliance, positional therapy, lifestyle changes, or surgery sometimes.
Some people might also be told newer therapies or devices when standard options are not suitable or tolerated. A sleep professional can help determine which approach is the safest and most appropriate after a proper diagnosis.
Positive Airway Pressure, or PAP Therapy uses gentle air pressure to keep your airway open during sleep. It generally includes a machine, tubing, and a mask for nasal interface. For many people with OSA, PAP is the main treatment because it can reduce breathing interruptions, snoring, and daytime sleepiness when used regularly. The pressure and the type of device should be selected with a sleep professional rather than getting adjusted on your own.
CPAP stands for continuous positive airway pressure. It basically delivers a steady level of pressure throughout the night to prevent the airway from collapsing.
APAP, or auto-adjusting positive airway pressure is a therapy that automatically changes the pressure within a prescribed range as your breathing changes during sleep.
Both can be effective therapies for obstructive sleep apnea (OSA). The choice depends on certain factors such as your sleep study, pressure needs, comfort, and your healthcare provider’s assessment.
BiPAP, also called bilevel PAP or BPAP, provides two pressure levels: a higher pressure when you inhale and a lower pressure exhale.
This therapy can make breathing more comfortable for some people.
It may be considered when a person needs higher pressures, faces any difficulty tolerating CPAP, or has certain breathing or medical conditions.
BiPAP is not automatically a better version of CPAP; the right mode depends on the your diagnosis and medical needs and requirements.
Adaptive servo-ventilation, or ASV, is a specialized form of PAP therapy that continuously responds to changes in the breathing pattern of an individual. It is mainly used for some of the selected forms of central sleep apnea and other complex breathing patterns rather than routine OSA.
ASV is not appropriate for everyone, mainly people with certain types of heart failure, so it should only be used after a sleep specialist has evaluated and studied the underlying condition.
EPAP stands for expiratory positive airway pressure. Some nasal EPAP devices use tiny valves that are placed over or inside your nostrils. The valves make it harder to exhale, creating a strong pressure that can help keep the airway open during sleep.
Unlike CPAP therapy, these devices do not require a powered machine. They are not suited to every person with sleep apnea. Hence, a sleep specialist should determine whether this type of therapy is appropriate or not.
Oral appliances are devices that are worn in the mouth while you are sleeping. They help to prevent the upper airway from getting blocked.
These devices may be considered for some adults with obstructive sleep apnea (OSA), particularly when CPAP is not preferred or cannot be tolerated.
A mandibular advancement device, or MAD, holds your lower jaw slightly forward while you sleep.
Moving the jaw forward can also move your supporting tissues and your tongue forward, thereby making more room in your upper airway.
MADs are commonly used for selected adults with OSA, especially people who cannot tolerate CPAP or are looking for an alternative option.
Some of the possible issues because of MADs include jaw discomfort, tooth movement, or changes in the bite. That’s the reason why professional fitting and continuous monitoring matters.
Tongue-retaining devices, or TRDs, make use of a gentle suction that holds the tongue in a forward position during sleep. These devices can reduce the chance of the tongue falling backward and narrowing the airway.
TRDs may be a great option for some people who are not a good fit or an ideal fit for other oral appliances, although comfort and effectiveness vary.
Medication is not a general replacement for PAP therapy or other established treatments for obstructive sleep apnea.
However, sleep apnea treatment is evolving, and certain medicines may be appropriate for selected patients with specific conditions, including obesity-associated moderate-to-severe OSA.
Surgery may be recommended by your sleep professional when there is a clear problem contributing to OSA, when PAP cannot be used or is not adequately effective, or when another treatment is more appropriate for the individual's circumstances.
Surgery is not the first choice for everyone. A sleep specialist can assess the airway and discuss expected benefits, risks, and alternatives.
The type of sleep apnea surgery depends on where and why the airway is narrowing.
Some of the best options may include tonsil or adenoid removal, certain procedures that remove or reposition selected tissues in the throat, and upper- or lower-jaw advancement surgery.
On the other hand, for people with obesity bariatric surgery may also be considered. The best surgical approach mainly depends on the individual and may require a proper airway assessment before sleep apnea treatment.
Hypoglossal nerve stimulation is an implanted treatment for selected adults with obstructive sleep apnea.
The stimulation helps keep the tongue and upper airway intact to support smooth airflow during sleep.
HNS is best suited for specific patients, generally after standard treatments such as PAP have failed, cannot be tolerated, or are otherwise unsuitable.
The eligibility for this treatment depends on factors such as the severity and pattern of OSA, anatomy, and the requirements of the particular device. A specialist must assess whether it is appropriate.
Oropharyngeal, or myofunctional, exercises are designed to strengthen and improve the function of the tongue, throat, lips, and other muscles involved in keeping the upper airway stable.
Lifestyle changes can support sleep apnea treatment and may improve symptoms from getting touch, although they do not eliminate the need for prescribed therapy in many people. Helpful lifestyle changes can include maintaining a healthy weight or working toward weight loss when appropriate, getting regular physical activity, avoiding smoking, limiting alcohol, and keeping a consistent sleep schedule.
Untreated sleep apnea can affect more than sleep quality but can also contribute to daytime sleepiness, difficulty concentrating, and problems with memory or decision-making. Over time, if sleep apnea is left untreated, you can experience an increased risk of cardiovascular and metabolic problems, including high blood pressure, heart disease, stroke, and type 2 diabetes.
Start by describing what you are experiencing, including snoring, witnessed pauses in breathing, gasping, morning headaches, poor-quality sleep, or any daytime sleepiness.
Some of the useful questions include:
Asking these questions can help you and your sleep specialist make a treatment plan that is considered effective, realistic, and safe.
