Obstructive sleep apnea is a serious health condition that impacts millions of Americans. Not only does it cause disturbed sleep, it can lead to heart problems, type II diabetes, metabolic syndrome, and a host of other problems. Untreated, sleep apnea can be deadly.
Until recently, there’s really been one treatment for sleep apnea, and that is positive away pressure therapy. Most patients receive this through the standard, ‘CPAP’ machines. Unfortunately, that’s not the best solution for every patient. Fortunately, there are some hopeful new treatments for sleep apnea. We’ll exam those, then review the more commonly available options.
EPAP: Expiratory Positive Airway Pressure
EPAP systems are deceptively simple. The user places two, disposable, adhesive valves over their nostrils when they go to sleep. As they breath in, the valves open. This helps airways to remain unobstructed. On exhale, the sleeper’s breath goes through small channels in each valve. This causes pressure that helps airways to remain open. This can lead to a reduction in obstructed breathing incidents, and fewer sleep disruptions. So far, research indicates that this treatment is being well-received.
HypoGlossal Nerve Stimulation
This is a new treatment that has only been FDA approved for a bit more than four years. Hypoglossal nerve stimulation involves the insertion of a device into the patient’s chest. This device can be switched on and off by the patient. When it’s on (during sleep) the device monitors breathing. It also provides stimulation to the hypoglossal nerve. This nerve controls movements in the tongue that help to keep the airway open. The treatment seems to be promising so far. Patients are experiencing improved symptoms, reporting a small number of side effects, and complying with treatment protocols. This treatment is ideal for people with moderate to severe OSA.
Standard OSA Treatments
Oral Pressure Therapy
Oral pressure therapy uses a mouthpiece in combination with tubing and a small vacuum device. As the patient sleeps, the vacuum moves the tongue and soft palate into the ideal position for unobstructed breathing.
Positive Airway Pressure
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This is the most common treatment for sleep apnea. The patient wears a mask that introduces pressurized air to the upper air passages. This stops these passages from collapsing or becoming obstructed. Different devices vary in the exact method they use to deliver that pressurized air. When successful, this treatment can lead to significantly better sleep.
Some people have craniofacial differences that cause OSA. In these cases, surgical intervention can help immensely. This surgery can involve removing excess tissue from the soft palate, even taking out the tonsils and adenoids. Because obesity is a major contributing factor to sleep apnea, weight loss surgery is often considered to be a valid surgical option for treating sleep apnea.
Similar to a mouth guard that you might see on an athlete, oral appliances reposition the tongue and lower jaw to open the upper airway and improve breathing. These appliances must be fitted by a dentist who has training in the field of sleep medicine. This is a viable option for people who have mild to moderate symptoms, or who haven’t had success with PAP therapy.
Some patients with minor to moderate sleep apnea can find relief by making a few lifestyle changes. These include losing weight, reducing or eliminating alcohol consumption, quitting smoking, and not using drugs that depress the central nervous system.