Sleep Apnea
Sleep apnea treatment
Sleep apnea can be treated in a number of ways. For mild cases of the condition, lifestyle changes—such as losing weight or quitting smoking—might be sufficient for managing your symptoms. If your sleep apnea is caused by allergies, a healthcare provider will recommend the best course of treatment for your allergies.
In some cases, devices that open the airways, such as a continuous positive airway pressure (CPAP) machine, are required. When previous treatment options fail or your sleep apnea is severe (or even life-threatening), surgery may be necessary.
What is a CPAP machine?
A CPAP18—or continuous positive airway pressure—machine is one treatment option for sleep apnea. The device is worn during sleep. A CPAP mask creates a seal with your mouth or nose, providing air at a pressure just high enough to prevent the collapse of your airway and prevent obstructive episodes.
CPAP machines do not breathe for you—you can breathe in and out normally on your own. Rather, the device allows you to breathe without much effort and sleep without being woken up by disruptions in breathing.
Some people need different air pressures during the inhalation and exhalation cycle to help them breathe more normally and comfortably. A variety of masks and machines are available. If either are uncomfortable, you can ask your provider for suggestions about other options.
What is a CPAP mask?
A CPAP machine requires you to wear a mask during use. There are a variety of CPAP masks and headgear offered in a range of styles and sizes so that you can find the one that’s most comfortable and best for you.
Because sizing may vary across different brands and styles of masks, you may need to try on multiple masks to find one that offers the best fit for you.
Available CPAP mask19 options include:
- Nasal masks: These masks cover the nose to supply air pressure. A nasal mask might be right for you if your provider has prescribed a high air pressure or if you tend to move around a lot while you sleep.
- Nasal pillow masks: Nasal pillows fit at the nostrils. This option may be preferred if you feel claustrophobic in masks that cover more of your face, you wear glasses, or you want a full field of vision for activities like reading or watching television.
- Full-face masks: These masks cover both the nose and mouth. Full-face masks might be the right option if you have nasal obstruction or congestion that makes breathing through your nose difficult. It can also be preferred if you breathe through your mouth at night, despite trying a nasal mask, nasal pillow with a heated humidity feature, or chin strap (or both) to keep your mouth closed.
Surgery for sleep apnea
Generally, surgery21 is considered as an option for treating sleep apnea only after other treatments have failed. At least a three-month trial of other treatment options is usually suggested before considering surgery.
However, for people with certain jaw structure problems, surgery might be a good first option.
Some surgeries used to treat sleep apnea include:
- Tissue removal: The most common procedure is called a uvulopalatopharyngoplasty22 (UPPP), where tissue is removed from the rear of the mouth and the top of the throat, shortening the soft palate, and removing the uvula. This type of surgery may be successful in stopping throat structures from vibrating and causing snoring. A tonsillectomy23 (removal of the tonsils) performed with an adenoidectomy (removal of the adenoids) may also be another option, especially in the pediatric population. Tissue removal is generally less effective than CPAP, however, and isn’t considered a reliable treatment for obstructive sleep apnea.
- Tissue shrinkage: Another option is to shrink the tissue at the rear of the mouth and throat with palate radiofrequency ablation24. This procedure can help decrease snoring and airway resistance in mild to moderate sleep apnea.
- Jaw repositioning: Maxillomandibular advancement25 is an invasive surgical procedure that moves the jaw forward and away from the rest of the facial bones. This enlarges the space behind the tongue and soft palate, making obstruction less likely.
- Hypoglossal nerve stimulation: This requires surgery to implant a stimulator for the nerve that controls tongue movement (hypoglossal nerve). This stimulation helps place the tongue in a position that promotes airway opening, making it easier for you to breathe.
- Creating a new air passageway (tracheotomy26): This form of surgery may be necessary if sleep apnea is severe and life threatening and other treatments have failed. In this procedure, a surgeon makes an opening in the neck and inserts a metal or plastic tube through which you breathe. The opening is kept covered during the day and is uncovered at night to allow air to pass in and out of your lungs, bypassing the blocked air passage in the throat.
- Implants: The Pillar procedure27 is a procedure that implants polyester rods into the soft palate. More research is needed to determine the long-term effectiveness of these implants. Other types of surgery may help reduce snoring and help treat sleep apnea by clearing or enlarging air passage:
- Weight loss surgery (bariatric28 surgery) may also help reduce snoring and help treat sleep apnea by clearing or enlarging the airways
Coping with sleep apnea
Living with sleep apnea may require you to make some adjustments in your life to help you manage29 the effects of the condition. The disruptions in sleep caused by sleep apnea can lead to daytime drowsiness, making it difficult to perform day-to-day activities.
If you have difficulty falling asleep, there are relaxation exercises30 you can practice to help you get to sleep more easily.
Sleep apnea medication
Your healthcare provider may prescribe the following options for treatment.
May be prescribed
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Strong evidence suggests first line treatment with CPAP, which has been shown to be effective in reducing sleep apnea and its related conditions while improving quality of life. Medications have not proven to be as effective, nor will they replace CPAP as the mainstay of therapy.
Modafinil and Armodafinil are generally given as adjunctive therapy for excessive daytime sleepiness caused by sleep apnea in patients who are already treated with positive airway pressure. These two medications do not treat sleep apnea directly.
Acetazolamide and theophylline are respiratory stimulants that may be considered in patients who do not tolerate or benefit from CPAP. They are not immediately considered in patients with sleep apnea because of their potentially harmful side effects and lack of long-term data.
CPAP cleaning
Daily cleaning20 of CPAP supplies is important to keep your airway open while you sleep by maintaining a seal between your face and the mask.
If the mask’s cushion starts to lose the grip to your face, it will start to allow pressurized airflow to leak out. If too much airflow leaks out, you will no longer have an adequate seal keeping your airway open, possibly causing you to stop breathing and defeat the purpose of the device.
There are a number of ways to keep your CPAP mask and machine clean. It is recommended to clean the mask’s cushion with warm, soapy water and use mild dishwashing detergent to remove the oils left on the mask from your skin. Washing the cushion soon after you’re done using it can minimize the amount of time that these oils remain on the surface and extend the lifetime of your cushion.
The distilled water in the CPAP’s heated humidifier chamber should be cleaned and replaced daily. Doing so prevents bacteria from growing in the sitting water. It’s important to routinely clean and replace your CPAP supplies in order to keep you healthy—especially when you are sick.
Related Conditions
Disclaimer: The information on this site is generalized and is not medical advice. It is intended to supplement, not substitute for, the expertise and judgment of your healthcare professional. Always seek the advice of your healthcare professional with any questions you may have regarding a medical condition. Never disregard seeking advice or delay in seeking treatment because of something you have read on our site. RxSaver makes no warranty as to the accuracy, reliability or completeness of this information.
If you are in crisis or you think you may have a medical emergency, call your doctor or 911 immediately.
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