How is obstructive sleep apnea treated, and is there a cure?
There are many approaches to treating OSA, depending on how severe it is and what exactly causes it. None of these are cures, but they can prevent apnea events or reduce how often they happen.
Possible treatments include:
- Conservative (nonmedical) treatments.
- Positive airway pressure and adaptive ventilation devices.
- Oral appliances (mouthpieces).
- Nerve stimulators.
- Surgery.
Conservative treatments
These nonmedical treatments or approaches can improve OSA or resolve it. They aren’t cures, but they can reduce OSA to the point where it stops happening or isn’t severe enough to cause symptoms. These include:
- Weight loss. A 10% decrease in body weight can significantly improve OSA for people with excess weight or obesity.
- Position changes while sleeping and sleep aid items. Sleeping on your back makes sleep apnea more likely to happen. Special support pillows and similar items can help change the position in which you sleep, keeping you off your back so soft tissue doesn’t press on your windpipe and block breathing.
- Nasal sprays, adhesive strips, etc. These over-the-counter (OTC) products improve breathing by making it easier for air to travel through your nose. While they can’t help moderate or severe OSA, they can sometimes help snoring and mild OSA.
Positive airway pressure (PAP) and adaptive ventilation
Positive airway pressure is a method that uses a specialized device to increase the air pressure inside your airway while you inhale. This method can treat sleep apnea.
Pushing pressurized air down your windpipe keeps it open so you can breathe. These devices push air through a hose that attaches to a special mask you wear on your face while you sleep. Masks can cover your nose, mouth or both, and many different types and styles are available.
The best-known PAP device is the Continuous Positive Airway Pressure (CPAP) machine. However, there are other types of PAP machines, too. These devices increase the air pressure inside your airway and lungs when you inhale, keeping surrounding tissue from pressing your airway shut.
Oral devices
OSA happens when soft tissue in your head or neck — especially around your mouth and jaw — presses downward on your windpipe. Special mouthpiece devices can help hold your jaw and tongue in a position that keeps pressure off your windpipe. Dentists and sleep medicine specialists often work together to make these for people who need them.
Nerve stimulators
The hypoglossal nerve (the name comes from Greek and means “under the tongue”) is what controls your tongue’s movements. A nerve stimulator attached to the hypoglossal nerve can stimulate that nerve, pushing your tongue slightly forward when you breathe while you’re sleeping. That keeps your tongue from relaxing and pressing backward on your windpipe while you sleep, which is one of the ways that OSA happens.
An electrode attaches to the nerve under your jaw and connects to a device implanted under the skin in your chest. You can turn the stimulator on before you sleep and turn it off after you wake up. The electrical current is strong enough to keep your tongue from relaxing too much but mild enough that it’s not uncomfortable.
Surgery
Surgeries on your nose, mouth and throat can help prevent blockages of your nose, throat and windpipe. However, the impact of these in adults is usually limited and varies from person to person. These surgeries include:
- Somnoplasty: This procedure uses radiofrequency (RF) to reduce soft tissue around the upper parts of your windpipe.
- Tonsillectomy/adenoidectomy: Removing your tonsils and adenoids can widen the opening where your mouth, throat and nasal passages connect. That makes it easier for air to pass through and reduces soft tissue blocking your breathing. This procedure is most helpful for children with OSA.
- Uvulopalatopharyngoplasty (UPPP): This procedure removes your uvula (the teardrop-shaped soft tissue that hangs at the back of your mouth). It also removes soft tissue from your soft palate and pharynx. These widen the area where your mouth and throat meet, making it easier for air to pass through.
- Jaw surgery: Different surgery procedures can subtly change the position of your jaw so that soft tissue can’t easily press back on your airway. These procedures are especially helpful for people with OSA for structural reasons like micrognathia.
- Nasal surgery: One common form of nasal surgery is septoplasty, which straightens the soft tissue in your nose, making it easier for air to travel through your nose and nasal passages.
What can or can’t I eat or drink with sleep apnea?
People with OSA should avoid heavy drinking, frequent use of sleeping pills or other drugs (recreational and otherwise) that cause heavy sedation. These can make OSA worse. Your healthcare provider can talk to you about drugs that can cause that and how you can avoid the effects.
Complications/side effects of the treatment
The complications and side effects of the treatments depend on many factors, especially the treatments themselves. Your healthcare provider is the best source of information for what you can do to minimize the side effects or prevent them when possible.
How can I take care of myself/manage symptoms?
OSA can severely disrupt your life and even create the potential for life-threatening complications and events (see more about these under the Outlook/Prognosis section below). That means you shouldn’t try to self-diagnose or self-treat it. If you think you have OSA, you should schedule an appointment with a specialist or ask a primary care provider to refer you to one.
How you can help with diagnosis
If you suspect you or a loved one has OSA, you might be able to help a healthcare provider diagnose it. Video and audio recordings of a person sleeping, especially where you can hear breathing, can give a provider key evidence they need to speed up the diagnostic process.
How soon after treatment will I feel better?
Many factors can affect how long it takes to recover or feel better when you have sleep apnea. The type of treatment you receive, especially if it’s an ongoing treatment like nightly use of a PAP device, can also make a difference.
For some people, treatment may be enough for them to feel better very quickly. To see the full benefits, others may need three to six months of consistent nightly treatment. Your healthcare provider can tell you more about the timeline for your recovery and when you should expect to feel better.
Positive airway pressure devices can sometimes bring very fast results. Older devices may take some tweaking and adjusting (a process known as “titration”) of their settings, but many newer PAP devices can often adjust their settings automatically.
While some people may need to get used to wearing a mask to sleep, most people can overcome that fairly quickly. If you find yourself struggling with this, you aren’t alone. Many people struggle to acclimate to the masks. You can talk to your provider for tips on how to get used to wearing a mask or for recommendations on different types of masks that might work better for you.
