How is Sleep Apnea Treated?

Treatments for sleep apnea include non-surgical approaches -- such as lifestyle changes, oral appliances, and Continuous Positive Airway Pressure (CPAP) treatment -- and surgical approaches.

What are the non-surgical approaches to treating sleep apnea?

Changing a few habits may be all that is needed to stop snoring and prevent mild sleep apnea. Even if you need further treatment, these changes are a good place to start. Sleeping on your side may reduce the blockage caused by gravity pulling relaxed throat tissue down. Losing weight also helps as excess fat deposits in the neck make the structures in your throat more bulky and floppy. Avoid alcohol and sedating medications at night, as these may relax your throat muscles more than usual. A blocked up nose makes snoring and sleep apnea worse. Treatment of allergies and sinus problems may improve this problem. Nasal strips may make breathing easier. Stopping smoking can also improve a stuffy nose.

Oral appliances may also be a part of the treatment options. A dental specialist can build and fit an oral appliance that can move the jaw and tongue forward while you sleep, thus preventing blockage.

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Continuous Positive Airway Pressure (CPAP) is the gold standard treatment for obstructive sleep apnea. The CPAP machine uses a mask and air pressure to hold the airway open. The machine is used at night and is generally the most effective treatment for sleep apnea. You will require a CPAP titration study performed in a sleep laboratory to arrive at the proper CPAP settings. A variety of masks and machines are available. Any CPAP setup must be tailored to meet your needs and preferences, so expect several adjustment before the setup suits you.

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How can surgery help sleep apnea?

The goal of surgery is to widen the air passages in the nose and the throat. Although non-surgical options of treatment are generally encouraged, surgical treatment can be useful if a patient is unable or unwilling to comply with non-surgical treatment, or if readily identifiable anatomic abnormalities are found where correction is likely to result in improvement.

Nasal surgery may involve reducing the turbinates, straightening a deviated septum, or endoscopic sinus surgery to remove nasal polyps or treat sinusitis. Problems in the nose can make snoring or sleep apnea worse and make CPAP harder to use. Surgery to open the nasal passages tends to help snoring and apnea problems and can help patients become more compliant with CPAP.

Palate surgery may be required if excess tissue of the soft palate is blocking the airway. The most common surgical procedure for sleep apnea is a Uvulopalatopharyngoplasty, or UPPP. This involves trimming the soft palate and uvula and removing any tonsillar tissue. This procedure is done under general anesthesia, may be combined with nasal or tongue surgery, may require overnight hospitalization, and takes a minimum of one week for recovery.

Tongue surgery may be needed if the base of tongue is found to be too large or too posterior. Tongue advancement procedures include hyoid myotomy and suspension, radiofrequency ablation of the tongue base, genioglossal advancement, and mandibular advancement. These surgeries attempt to move the tongue forward, so that it does not collapse against the back wall of the throat during sleep.

 

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