Sleep apnea is a relatively common sleep disorder in which a person experiences many breathing pauses during a night’s sleep. It puts a person at higher risk for heart disease, diabetes, stroke, and more, so it’s essential to treat it to prevent serious health complications.1
This article discusses the various treatment options for apnea.
What Is Sleep Apnea?
Sleep apnea occurs when people have pauses in breathing, sometimes lasting 10 seconds or longer, during sleep.
Some people may have hundreds of these pauses during the night.
Further, this interrupted breathing and fragmented sleep results in physiological changes, including oxygen deprivation and sudden heart rate and blood pressure increase. Over time, this causes changes in the body that can lead to dangerous health complications.
Who Is Most Likely to Have Sleep Apnea?
It is more common in people of advanced ages, men, and people with obesity.
However, it can occur in women, children, and babies, too.
Sleep apnea symptoms can seriously impact a person’s life, from mental health to job performance and interpersonal relationships.
Some symptoms include:
- Choking or gasping at night
- Daytime sleepiness and fatigue
- Mood changes, including anxiety and depression
- Inability to concentrate
- Frequent urination at night
- Morning headaches
- Erectile dysfunction
- Teeth grinding (bruxism)5
There are various causes of sleep apnea.
Most commonly, there is a physical obstruction of the upper airway, including the nose, tongue, or soft palate. Also, this could be due to structural factors (like a deviated septum or enlarged tonsils), or other factors like obesity, drinking alcohol or smoking.
Obstructive vs Central Sleep Apnea
There are multiple treatment options available for sleep apnea. The correct treatment for you will depend on individual factors like the severity of your sleep problem, the root cause, and the type of sleep apnea.
Positive airway pressure (PAP) therapy is usually the first-line treatment for sleep apnea. However, there can be exceptions in cases of mild sleep apnea or when dental appliances are appropriate.
All PAP devices involve a mask covering the nose and mouth and delivering airflow to keep the upper airway open.
There are a few different types of PAP therapy devices. The two most common types include:
- Continuous positive airway pressure (CPAP): CPAP is considered the gold standard treatment for this sleep disorder and has been shown to be effective at reducing symptoms and improving quality of life. It involves continuous airflow at one single pressure. But, some people do not tolerate CPAP well, in which case we may consider other PAP devices and therapies.
- Bi-level positive airway pressure (BiPAP): BiPAP machines are similar to CPAP but involve two different air pressures for inhaling and exhaling.8 A BiPAP machine may be tried if CPAP therapy is not tolerated. It is also a more successful treatment for central sleep apnea.
Other types of assistive devices to treat sleep apnea include dental appliances or oral mandibular advancement devices. Depending on individual needs, these may advance the lower jaw or stop the tongue from blocking the upper airway.
There are over 100 oral appliances to treat this disease that only need Food and Drug Administration’s(FDA) approval.
Custom-made oral mandibular advancement devices are effective for mild-moderate sleep apnea.
Some people prefer dental appliances over PAP therapy because it is less invasive and often more affordable and more comfortable.
PAP therapy is highly effective when used consistently and correctly, but it is not a cure for sleep apnea. If PAP therapy discontinues, apnea episodes will return.
Some lifestyle changes may improve symptoms for people with mild sleep apnea. These recommended changes include:
- Weight loss: In people who have apnea and obesity, losing weight may help relieve symptoms. This can work by shrinking tongue fat. Keep in mind that sleep apnea can make weight loss difficult, and not everyone with apnea has obesity.
- Reducing or eliminating alcohol: Alcohol is a depressant. Moreover, drinking alcohol, particularly at night, can increase breathing pauses during sleep by causing the tissue to relax into the upper airway. Those with sleep apnea should consider quitting alcohol.
- Quitting smoking: Smoking makes apnea worse. Tobacco can cause the upper airway to swell and increase obstruction. Quitting smoking can help your health in many ways, including improving sleep apnea symptoms.
- Side sleeping: Sleeping on your back can exacerbate apnea episodes. Switching to side sleeping helps to reduce these episodes. Using a wedge pillow may help adjust to this new sleeping position.
- Nasal sprays or breathing strips: These over-the-counter options may help reduce snoring and apnea symptoms for people with nasal congestion or sinus issues.
For some people suffering from this disease, surgery may be appropriate. However, there is expert debate on the role of surgery.
If a person does not respond adequately to CPAP therapy and if they have structural obstructions then the doctor performs surgery.
Some surgeries that can treat sleep apnea include:
- Tonsillectomy: The tonsils are removed, which can be an obstruction for some people. This is particularly found in children with sleep apnea.
- Somnoplasty: Soft tissue in the uvula or soft palate is reduced through radiofrequency.
- Uvulopalatopharyngoplasty: Soft tissue in the soft palate or back of the throat is surgically removed to widen the airway.
- Nasal surgery: This can include the surgical correction of a deviated septum or other nasal abnormalities that may be causing an obstruction.
- Maxillomandibular advancement: An invasive surgery typically reserved for severe sleep apnea, in which the lower facial structures are moved forward to create a wider airway.
- Hypoglossal nerve stimulator: The insertion of a pacemaker that signals the hypoglossal nerve to contract the tongue and upper airway during sleep to improve breathing.
There are some alternative remedies for sleep apnea that don’t involve assistive devices or surgery. You should discuss alternative remedies with your healthcare provider and use them in combination with an approved plan of care.
Some alternative remedies for sleep apnea include:
- Acupuncture: Acupuncture is a form of traditional Chinese medicine that involves sticking thin needles along the body’s “acupressure points.” A 2016 systematic review found that acupuncture was effective at improving sleep apnea symptoms and improving oxygen saturation. However, many of these studies were biased.
- Orofacial or myofunctional therapy: In this therapy, the facial muscles are strengthened, and the tongue position is improved. Myofunctional therapy has been helping to treat sleep apnea since the 1990s. As per the systematic review which states that it can reduce apnea by 50% in adults and 62% in children.
Leaving your sleep apnea untreated can be extremely risky.
Illustration by Jessica Olah / Verywell
Some risk factors for sleep apnea—like age, sex, and genetics—you can’t control.
However, there are some modifiable lifestyle factors that you can control, including adopting a healthy diet, reducing or eliminating alcohol (particularly at night), and quitting smoking. These can all help prevent apnea from developing.
Sleep apnea is a common but serious sleep disorder in which a person experiences breathing pauses many times during the night. Lifestyle changes might help in treating mild sleep apnea. Its treatment for moderate to severe includes PAP therapy devices, custom dental appliances, and, in some cases, surgery.