What other treatments for snoring and Obstructive Sleep Apnea (OSA) are available?
TREATMENT options for a patient suffering from sleep apnea include Dental Device Therapy (learn about dental device therapy here), CPAP, Surgery, Positional Therapy, and Weight Loss.
CPAP (Continuous Positive Airway Pressure)
CPAP was developed in the early 1980’s and was the first viable solution for treating the insidious disease of Obstructive Sleep Apnea (OSA). Most physicians prescribe CPAP as a first treatment option, though many physicians now utilize dental devices as a first line of therapy for mild to moderate disease OSA. CPAP treatment consists of a pump that delivers positive air pressure to a mask that is fitted over the nose and/or the mouth. The air pressure is adjusted until the airway is forced open, much like blowing up a balloon.
CPAP is a very effective therapy WHEN it is used. If you’ve been diagnosed with sleep apnea and were prescribed a CPAP by your physician, you know exactly what we mean when we say WHEN it is used; compliance is the biggest challenge with this therapy. Most people find that wearing a mask and having air pushed down their throat is a challenge. The problems patients complain about from CPAP therapy are very real and often difficult, if not impossible, to overcome.
A partial list of the most common patient complaints from CPAP:
- Mask leaks
- An inability to get the mask to fit properly
- Discomfort or interrupted sleep caused by the presence of the device
- Noise from the device disturbing sleep or bed partner’s sleep
- CPAP restricted movements during sleep
- CPAP does not seem to be effective
- Pressure on the upper lip causes tooth related problems
- Latex allergy
- Claustrophobic associations
- An unconscious need to remove the CPAP apparatus at night
Do you currently use CPAP and have problems? Here are some tips that may help you sleep more effectively while using CPAP:
- Try a different CPAP mask
- Masks come in many shapes and sizes. Some go over just your nose; some your nose and mouth; others simply have a small tube that fits into your nose. Sometimes switching masks can help you.
- Call the company where you purchased your CPAP
- Work with the DME (Durable Medical Equipment) company where you got your CPAP. They are experts at helping people adapt to the therapy.
- Consider adding heat / humidification
- The constant air moving through your airway and across your mucous membranes tends to dry you out; so adding humidification to your CPAP can help. Heat can also be added and can make a significant difference, especially in Northern climates and the winter time.
- Ask about BiPAP
- If your pressure seems to be just too much, you may want to ask your physician if a BiPAP is a possible solution. BiPAP machines have a sensor in them that adjust the pressure based on whether you are trying to inhale or exhale. The sensor lowers the pressure when you are trying to exhale and makes it easier to get air out.
Surgery may also be a treatment option for Obstructive Sleep Apnea (OSA). The upper airway goes from your nose and mouth to the middle of your throat. The upper airway is dynamic and complex. Here is a partial list of surgeries that may be utilized to treat sleep apnea:
- nasal septal surgery
- turbinate reduction surgery
- Somnoplasty turbinate reduction
- Uvulopalatopharyngoplasty (UPPP)
- partial uvulectomy/ Pillar Procedure
- CO2 laser palatoplasty (LAUP)
- uvulopalatal flap
- Woodson Procedure (transpalatal palatopharyngoplasty)
- turbinate reduction
- tongue base reduction – soft palate for snoring
- Tonsillectomy (total/ partial)
- lingual tonsillectomy
- tongue base reduction
- glossectomy (anterior vs. posterior)
- linguoplasty (CO2)
- tongue-base suspension sutures (Repose procedure)
- hyoid suspension and advancement to mandible
- hyoid myotomy and suspension to thyroid cartilage
- Expansion hyoidplasty
- geniotubercle/genioglossus skeletal advancement (with multiple variants)
- jaw advancement (telegnathic) surgery (LeFort I, Bilateral Sagittal split Advancement Osteotomies)- ? Distraction Osteogenesis
- maxillary transverse expansion
Most surgeries are performed by Ear Nose and Throat physicians, though Oral and Maxillofacial surgeons are also generally able to perform surgeries to treat Obstructive Sleep Apnea. Surgery is appealing to many patients because if it works, you are usually cured. However, sSurgery carries many severe and potentially life-threatening risks that should be discussed in detail with your physician so that you can evaluate the risk and reward for this treatment option. Dental devices can often be used as an initial treatment, and surgery used later if desired.
Positional Therapy is often overlooked by the medical profession as a treatment option of Obstructive Sleep Apnea (OSA). Often times OSA is worse in the supine position (lying on you back). The severity of apnea is sometimes diminished when sleeping in positions other than on one’s back. There are various apparatuses available to help train an individual to sleep in a non-supine position (like on your stomach, or on your side). These include various mechanisms that strap to the back, or even a tennis ball sewn into the back of a shirt that is worn at night. These methods can help reduce the severity of Obstructive Sleep Apnea (OSA), but you should be cautioned not to attempt to treat OSA with positional therapy without proper medical supervision. Positional therapy alone is rarely a cure for OSA, but it can often be of helpful when used with other therapies.
Weight loss usually can help decrease snoring Obstructive Sleep Apnea (OSA) in most cases. However, precaution should be taken in relying on weight loss alone to treat OSA, because it is rarely a cure. You should work in conjunction with your trained sleep specialist and Dental Sleep Solutions® dentist to determine the effect of weight loss on your Obstructive Sleep Apnea (OSA).
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