Sleep apnea is treated with lifestyle changes, oral appliances, breathing devices, surgery, or a combination of these. Sleep apnea is not typically treated with medications. The goal of treatment is threefold:
- Restore normal breathing during sleep.
- Relieve symptoms of snoring and daytime sleepiness.
- Treatment may decrease risk of medical conditions associated with sleep apnea, such as high blood pressure, heart disease, stroke, and diabetes.
Mild sleep apnea may improve simply with changes to your daily habits and activities. This may include:
- Weight loss if you are overweight or obese.
- Sleep on your side to help open your airway. There are pillows or special shirts that can help you avoid sleeping on your back.
- Avoid alcohol and sedative medications that can make it more easy for your airway to collapse when you sleep.
Mouthpieces can help patients with mild sleep apnea or snoring with no sleep apnea. These appliances lift the jaw and tongue to help open up the airway during sleep. They are typically custom made and fitted by dentists or orthodontists.
The most common breathing device used to treat sleep apnea is the Continuous Positive Airway Pressure (CPAP) machine. It is a mask that you wear at night that covers your mouth and nose, or just your nose. The mask is attached to a machine that gently blows air into your throat to keep your airway open as you sleep. It is important to keep using the machine every night even if you no longer snore or your symptoms improve. Your symptoms will return if you stop using your CPAP machine.
The machine is usually set up by a technician who will adjust the settings based on your sleep physician’s prescription. You may need to have the machine adjusted periodically for the best results.
Some people experience side effects from using the CPAP, including:
- Dry nose
- Dry mouth
- Skin irritation
- Abdominal bloating from air blowing into your stomach
If you experience these symptoms, work with your sleep medicine physician or his/her nurse or staff. They may suggest modifications to the mask, a different type of mask, or prescribe humidified air or nasal sprays to treat dry mouth or nose.
Some patients who have difficulty with the above treatments may need surgical procedures to correct structural causes contributing or causing sleep apnea. These procedures are typically performed by otolaryngologists (head and neck surgeons). The type of procedure depends on the unique anatomy of the patient and their pattern of obstruction. Nasal surgery to treat congestion, deviated septums or enlarged turbinates can be performed. Many patients with sleep apnea have redundant soft tissue in the upper or lower throat and upper voicebox (epiglottis) that need resection or stabilization. For example, large tonsils or adenoids may be blocking the airway. Surgery to widen the palate, advance the upper jaw (maxilla) or lower jaw (mandible) can also help open the airway in select patients.
Some of these procedures can be done under local anesthetics in a clinic, while others are done under general anesthesia in a hospital or surgical center. The risks, benefits and recovery time all vary depending on the procedure.