Sleep Apnea Treatment Options
Dr. Angel Rivera
If you have been diagnosed with sleep apnea, you may be wondering what your treatment options are. Sleep apnea is a sleep disorder that causes pauses in your breathing while you sleep that can lead to a number of health problems, including mood swings, headaches, heart disease, and many others. There are several different Treatment Options For Sleep Apnea, and the best option will depend on your individual situation. In this article, we will discuss various aspects of sleep apnea including the most common sleep apnea treatments, symptoms, and how doctors diagnose it.
What is sleep apnea?
Sleep apnea is a sleep disorder that causes you to stop breathing during sleep. This usually happens because the airway becomes blocked from either your tongue or soft tissue in your upper airway. These pauses in breathing, also called apneas, can occur up to 30 times per hour with severe sleep apnea. If left untreated, sleep apnea can lead to health problems such as high blood pressure, heart disease, and stroke, among many others.
There are three different types of sleep apnea. The most common type, obstructive sleep apnea (OSA), is caused by a blockage in the airway. Central sleep apnea (CSA) is a less common type of sleep apnea that occurs when the brain fails to send the right signals to the muscles that control breathing causing apneic events. Complex sleep apnea, or mixed sleep apnea (MSA), is a combination of both obstructive sleep apnea and central sleep apnea. Please note that if you suffer from obstructive sleep apnea it can be genetic, although that isn't always the case, while central sleep apnea is never caused by genetics.
What are the symptoms of sleep apnea?
The most common symptoms of sleep apnea are loud snoring and pauses in your breathing that can lead to gasping or choking from the apnea events due to lack of oxygen. Excessive daytime sleepiness (EDS), and difficulty staying asleep, also known as insomnia, are also common symptoms of sleep apnea. Due to excessive daytime sleepiness, you may become irritable, have mood swings, or have difficulty concentrating while awake. Subsequently, your lack of focus can also lead to accidents. Morning headaches, dry mouth, and sore throat are also possible. Not everyone who has sleep apnea will have all these symptoms and if you think you may have sleep apnea we recommend you see your doctor or healthcare provider.
What are the risk factors for sleep apnea?
Some people with obstructive sleep may develop the condition due to several risk factors. Some of the most common include:
- Being overweight or obese
- Having a large neck circumference
- Drinking alcohol
- Being over the age of 60
- Being a man
- Having family members who have had sleep apnea
- Having a narrowed airway
- Using opiates or any drug that relaxes the muscles
- Nasal congestion
- Medical conditions like Parkinson's disease, congestive heart failure, and type 2 diabetes
Sleep apnea can happen to anyone at any age. If you have any of these risk factors you should ask your doctor about any preventative measures you can take, such as regular exercise and eating healthy to prevent obesity, that may help you avoid developing obstructive sleep apnea.
How do doctors diagnose sleep apnea?
Sleep apnea is usually diagnosed through a sleep study, also called polysomnography. This is an overnight test in a sleep center or sleep lab that records your brain waves, heart rate, blood oxygen levels, breathing patterns, and movements during sleep. A sleep specialist will review the results of this test to determine if you have sleep apnea, what type it is, and the best course of action for treatment.
At-home sleep studies are also an option for sleep apnea diagnosis. These portable machines are used to conduct a sleep study from the comfort of your own home. They typically involve placing a couple of sensors on your body while you sleep to track your breathing patterns. The results are then reviewed by a sleep specialist to determine your treatment plan. At-home sleep tests are not as accurate as a sleep study performed at a lab with specialists, but they are more comfortable and convenient.
What are the common Treatment Options For Sleep Apnea?
There are two common treatment options that are the most popular options if you have sleep apnea and we will describe each in detail below.
Positive airway pressure therapy
Positive airway pressure therapy, or PAP therapy is the most common treatment for sleep apnea. This type of therapy involves wearing a mask that connects to a machine that supplies pressurized air into your nose and throat while you sleep. The mask helps keep your airway open and prevents pauses in your breathing.
CPAP, or continuous positive airway pressure, machines are the most common type of PAP therapy and come in a variety of different models. Some newer machines have heated humidifiers to make wearing the mask more comfortable and others allow you to track your sleep data so you can see how well you're sleeping.
There are other types of PAP therapy such as BiPAP, or bilevel positive airway pressure, APAP, or automatic positive airway pressure, and adaptive servo-ventilation, or ASV, machines. These machines are all very similar to CPAP machines although the pressure isn't constant in these other options.
An oral appliance, also known as an oral device or dental device, is a device that is worn in your mouth while you sleep and it helps keep your airway open. This type of therapy is most commonly used for people who have mild to moderate sleep apnea. Oral appliances are made from plastic or metal and they fit over your teeth like a retainer or mouthguard and use wires and hinges to push your jaw forward, opening up the airway.
The two most common types of oral appliances are mandibular advancement devices (MADs) and tongue-retaining devices (TRDs). MADs work by moving your lower jaw forward and TRDs work by holding your tongue in place.
What are the other Treatment Options For Sleep Apnea?
If you have sleep apnea and don't want to or can't use PAP therapy, an oral appliance, or have mild sleep apnea, there are other treatment options available.
Sleep position therapy
Sleep position therapy is a treatment option for mild to moderate sleep apnea that involves sleeping in a specific position to keep your airway open. This type of therapy usually involves sleeping on your side instead of your back and using pillows to prop yourself up.
There are several different options for surgery should you have severe sleep apnea. Surgery is typically a last resort for sleep apnea treatment after other treatments have failed.
The most common type of surgery for sleep apnea is uvulopalatopharyngoplasty (UPPP). UPPP involves removing the excess tissue from the throat, such as the uvula, and enlarging the airway.
Palatal implant surgery can also be used where small silicone devices are inserted into your soft palate to keep it open.
Weight loss surgery, or bariatric surgery, is a type of surgery that is used to help people lose weight. This type of surgery is most commonly used for people who are obese and have sleep apnea.
Upper airway stimulation, also called hypoglossal nerve stimulation, is a new surgery involving the implantation of a device that stimulates the nerves in your upper airway. This is done through a device similar to a pacemaker that is implanted in your chest and it sends electrical signals to stimulate the muscles in the upper airway to breathe while you are asleep.
Tonsillectomy and adenoidectomy are surgeries that involve the removal of your tonsils and/or adenoids. Tonsils are small, oval-shaped tissues in the back of your throat and adenoids are small, bean-shaped tissues located at the roof of your mouth behind your nose.
These surgeries are some of the most common although there are a few others your doctor may recommend for special circumstances.
Treatment of other medical problems
If you have sleep apnea, there is a good chance that you may also have another medical problem that is causing your sleep apnea. Some of the most common medical problems that can cause sleep apnea are:
- High blood pressure
- Heart disease
- Taking certain medications
These are just some of the most common medical problems that can cause sleep apnea. If you have sleep apnea and one of these other medical problems is not treated, it can make your sleep apnea worse. Treatment for these other medical problems may help improve your sleep apnea and make it easier to use other treatments, such as PAP therapy.
If you have sleep apnea it can affect you and your bed partner from getting quality sleep. Restless sleep is not the only symptom though, as snoring and pauses in your breathing may also occur, among many other symptoms that can also increase your risk for other health problems too. There are a number of different treatment options available for sleep apnea and the best option for you will depend on the severity of your sleep apnea, your lifestyle, and other medical conditions you may have. The most common treatment options involve positive airway pressure machines and oral appliances although other options such as sleep positional therapy and surgery are also available if needed. If you think you may have sleep apnea or are looking for new treatment options please talk to your doctor or sleep specialist to determine the best treatment for you.
References and Sources:
Harvard Health Publishing