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How is sleep apnea treated?

The goals of treating sleep apnea are to restore regular breathing during sleep and relieve the symptoms caused by sleep apnea, including loud and chronic snoring, daytime sleepiness and problems staying awake while driving, morning headaches, problems with memory, learning or concentrating, psychological problems, etc.  The treatment of sleep apnea is individualized to each patient, but usually starts with the following behavioral modifications:

  • Weight loss – even a moderate amount of weight loss (5 – 10 lbs) may provide a significant improvement to sleep apnea
  • Sleeping on one’s side – this practice decreases the likelihood of airway closure during sleep
  • Drug use – Alcohol and the other drugs listed above increase chances of developing and/or worsening sleep apnea
  • Nasal sprays or allergy medications – may provide additional treatment to the airway inflammation and dryness

A second treatment option for patients with mild-to-moderate sleep apnea is the use of oral or dental appliances.  A dentist or orthodontist creates a custom-fit device specific to each patient based on their individual anatomical and physiological need.  These appliances are used to adjust the lower jaw and tongue to help keep the airway open while sleeping.

The most common, and often most recognizable, treatment for moderate-to-severe sleep apnea is through the use of continuous positive airway pressure, or CPAP.  A small machine delivers CPAP via a sealed mask placed over the mouth and nose or just the nose alone.  The flow of air provided by the CPAP travels down the throat and keeps the airway open.  An image is provided below.

While CPAP remains the most common and often most effective treatment for patients with moderate-to-severe sleep apnea, its use is associated with side effects.  Some patients may experience dry or stuffy nose, irritated skin on the face, sore eyes, and headaches.  Also, if the airflow isn’t properly adjusted initially or over time, stomach bloating and discomfort may occur.  Patients that do not respond well to the use of a CPAP machine initially or over the course of time may be treated with bi-level positive airway pressure, or BiPAP.  BiPAP differs because the machine slowly ramps pressure and airflow up and down for both inhalation and exhalation versus the continuous delivery of pressure and airflow from the CPAP machine.  The BiPAP settings are also based on individual PSG measurements taken during the sleep study.

The last line in treatment of moderate-to-severe sleep apnea involves surgical procedures that widen breathing passages.  However, these procedures are invasive and reserved for patients that do not respond to other procedures.

Also, no drug treatment currently exists that is approved for the treatment of sleep apnea.

Complications – What happens with untreated sleep apnea?

Untreated sleep apnea has been linked with several serious and potentially life-threatening diseases and health conditions.  These conditions are listed below:

  • Cardiovascular Disease – sleep apnea is associated with an increase risk for each of the following:
  • High blood pressure
  • Heart attack
  • Stroke
  • Irregular heartbeats (atrial fibrillation)
  • Heart failure
  • Heart surgery
  • Diabetessleep apnea is associated with impaired glucose tolerance and insulin resistance
  • Obesity
    • Pulmonary hypertension
  • Driving accidents/fatalities