Colin Snow
Sleep apnea is a sleep disorder that causes your breathing to stop and start throughout the night. While the standard treatment involves the use of a continuous positive airway pressure (CPAP) machine, it is not suitable for everyone. CPAP machines can be uncomfortable, noisy, and clunky, and some patients may experience claustrophobia. If you are one of the many people for whom CPAP therapy is not an option, there are several alternative treatments available, including different PAP machines, oral appliances, behavioural changes, and surgery.
Explore related products
What You'll Learn
Surgery
One surgical option for patients with mild to moderate OSA is genioglossus muscle advancement. This surgery involves advancing the chin bone with the genioglossus muscle, which is attached to the underside of the chin and moves the tongue forward during contraction. This prevents the collapse of the tongue onto the throat. Maxillomandibular advancement (MMA) surgery is another option, which advances the upper and lower jaw, resulting in a significant expansion of the airway. This surgery may be suitable for individuals with moderate to severe OSA. Maxillomandibular expansion (MME) surgery is a further option to expand the upper airway, but it requires a combination of surgery and orthodontic treatment.
Thyrohyoidopexy is a procedure performed in patients with mild to moderate OSA and significant obstruction behind the tongue. This procedure is done through an incision in the neck and involves pulling the tongue and epiglottis down and forward by repositioning the hyoid bone. Tongue reduction surgery may be helpful when the tongue is abnormally enlarged, as reducing its size may cause less collapse into the airway, improving airflow and breathing.
Trans Oral Robotic Surgery (TORS) is a procedure that provides the surgeon with a 3-D image, allowing them to safely remove obstructive tissue from behind the tongue. As part of the TORS procedure, the epiglottis may be trimmed to prevent it from falling into the airway during sleep.
Upper airway surgery, bariatric surgery, and maxillomandibular advancement have been found to be effective in particular patient groups. A tracheotomy is the most effective surgical treatment, but it is not socially acceptable and is associated with major side effects.
Treating Acne: Night Routine Tips for Clear Skin
You may want to see also
Explore related products
Oral appliances
MADs are the most frequently used oral appliances in the treatment of OSA. They are secured to the teeth and move the lower jaw forward, which in turn repositions the tongue and pulls it out of the airway. This improves breathing by keeping the airway open while sleeping, and also helps to reduce or eliminate snoring. MADs look similar to mouth guards and come in a range of designs, varying in size, material, the number of teeth they cover, and how adjustable they are. Two-piece MADs are more comfortable and tend to be more successful in treating sleep apnea than one-piece oral appliances. Over-the-counter MADs, or "boil and bite" devices, are fitted by heating and moulding the appliance to the teeth.
TRDs consist of a soft plastic splint placed around the tongue that holds it forward and out of the mouth throughout the night. They tend to make the mouth very dry and can be uncomfortable. Most insurance plans at least partially cover these devices when used for OSA.
Another oral appliance called a tongue muscle stimulation device has been approved by the Food and Drug Administration (FDA) for the treatment of snoring and mild sleep apnea. It is a small mouthpiece worn during the daytime that sends small electric signals to the tongue to strengthen muscle tone. Over time, this helps to keep the airway open and prevents the tongue from blocking the airway during sleep. For the first six weeks, the mouthpiece is worn for 20 minutes a day, after which use is reduced to once a week for 20 minutes. Initial research suggests that in people with mild OSA, a tongue muscle stimulation device can reduce paused breathing events by almost half.
Explore related products
BiPAP machines
While CPAP therapy is the most commonly recommended treatment for obstructive sleep apnea (OSA), it is not the only treatment option. Some people may find the constant pressure of a CPAP machine uncomfortable, and there are alternative PAP machines, such as BiPAP machines, that may be considered.
BiPAP, or Bilevel Positive Airway Pressure, is a form of non-invasive ventilation that delivers pressurised air to treat sleep apnea and other respiratory health conditions. Unlike CPAP machines, which deliver a continuous pressure of airflow at one pressure setting, BiPAP machines allow for two different pressure settings for inhalation and exhalation. This means that users who find it uncomfortable to exhale against the constant pressure of a CPAP machine may prefer the lower expiratory pressure offered by a BiPAP machine. BiPAP machines are also capable of providing breathing support on a timed basis and can even start breathing if you cannot inhale for a specified period of time.
If you are experiencing symptoms of sleep apnea, it is important to consult with a healthcare professional to determine the best treatment option for your individual needs. Treatment options may include different PAP machines, oral appliances, behavioural changes, or surgery.
Explore related products
Lifestyle changes
Weight Loss and Exercise
Obesity is a major risk factor for sleep apnea. Losing weight can reduce symptoms and, in some cases, even cure sleep apnea. Regular aerobic exercise can help with weight loss and improve breathing. It is also effective in reducing the severity of sleep apnea symptoms.
Relieve Congestion
Taking a nasal decongestant or antihistamine can help open up clogged nasal passages, making it easier to breathe during sleep. This is especially helpful for those who tend to breathe through their mouths due to congestion.
Quit Smoking
Cigarette smoking worsens sleep apnea by increasing airway swelling and inflammation. Quitting smoking can help alleviate these symptoms and improve breathing.
Sleep Position
Changing your sleep position can be beneficial. Sleeping on your side, known as the "lateral position," can help reduce the collapse of the upper airway and improve breathing during sleep.
Reduce Alcohol and Sedative Consumption
Alcohol and sedatives relax the muscles in the throat, increasing the likelihood of airway obstruction during sleep. Reducing or avoiding their consumption, especially close to bedtime, may help alleviate sleep apnea symptoms.
Healthy Diet
Adopting a healthy and balanced diet can contribute to weight loss and improve overall health, which may positively impact sleep apnea symptoms.
Explore related products
Weight loss
Several studies have shown that weight loss improves OSA symptoms and can even cure the condition in some patients. The amount of OSA improvement is proportional to the amount of weight lost. For example, a 10% weight loss predicts a 26% decrease in the apnea-hypopnea index (AHI), a measurement of how many times a person stops breathing or breathes shallowly per hour during sleep.
Patients should discuss weight loss strategies with their doctor, who can help determine the best approach for their personal circumstances, overall health, and OSA severity. Weight loss can be achieved through a reduced-calorie diet and increased physical activity. Exercise can help alleviate OSA symptoms, and in some cases, weight loss can even cure OSA.
In addition to lifestyle changes, medications can aid in weight loss for OSA patients. Recently, the FDA approved Zepbound, the first medication for the treatment of moderate to severe OSA in adults with obesity. Zepbound works by activating receptors of hormones secreted from the intestine to reduce appetite and food intake.
Frequently asked questions
Alternatives to CPAP machines include different PAP machines, oral appliances, behavioural changes, and surgery.
PAP stands for Positive Airway Pressure. All PAP devices generate a stream of pressurised air that is delivered to the windpipe to promote steady and unobstructed breathing. Examples of PAP machines include BiPAP and APAP machines. BiPAP machines allow for different pressure settings for inhalation and exhalation. APAP machines employ built-in sensors to assess your breathing and modify the level of air pressure.
Oral appliances are small, lightweight, and do not require electricity. They are similar to a mouthguard and are fitted to your mouth by a dentist. Oral appliances can address anatomical factors that contribute to sleep apnea, such as a small lower jaw or a tongue that obstructs the airway.
Regular exercise, losing weight, relieving congestion, and quitting smoking can help treat sleep apnea.
Surgery can be suited to your anatomical needs. For example, if you have big tonsils, a floppy soft palate, or a tongue that blocks part of your throat, surgery may help you breathe more easily. In some cases, hypoglossal nerve stimulation can prevent your tongue from blocking your airway.
