Treatments for Obstructive Sleep Apnea (OSA) fall into several categories including behavioral therapy, surgery, dental appliances, and breathing-assistance devices. The specific therapy for sleep apnea is tailored to the individual patient based on medical history, physical examination, and the results of a polysomnography (sleep study).

Behavioral Therapy

Mild sleep apnea often times may be treated by some behavioral changes. These would include avoiding alcohol, tabacco, and sleeping pills which make the airway more likely to collapse during sleep and prolong apneic episodes.  Sleeping on one's side if apnea is only occurring when the person is on his or her back is another possible behavioral change. Overweight people diagnosed with mild sleep apnea can often times benefit from weight loss. Even a 10% weight loss can reduce the number of apneic episodes for most people.

Physical or Mechanical Therapy

For moderate to severe sleep apnea, nasal continuous positive airway pressure (CPAP) is the most effective treatment. For this procedure, a patient wears a mask over his or her nose during sleep and pressure from an air-blowing machine gently forces air through the nasal passages. The air pressure is adjusted so that is is just enough to prevent the airway from collapsing during sleep. The air pressure is constant and continuous. Nasal CPAP prevents airways from collapsing when used, but apnea episodes will resume if CPAP is stopped or used improperly.

For more severe sleep apnea, a person may need to use a Bi-level machine. The Bi-level machine is different than CPAP only in that it provides two different pressures. A higher pressure during inhalation and a lower pressure during exhalation are provided. Your referring physician will "prescribe" your pressure and a home health care company will set it up and provide training on its use and maintenance.

Surgery

Another option may be surgery. Some of the most common surgeries include removal of tonsils and adenoids, nasal polyps, other growths, and extra tissue in the airway. People with facial deformities and deviated septums may also benefit from certain surgeries.

Uvulopalatopharyngoplasty (UPPP) is a surgery that removes excess tissue at the back of the throat (tonsils, uvula, and part of the soft palate).

Laser-assisted Uvuloplasty (LAUP) is a relatively new surgery on the uvula and soft palate. It has been reported to diminish snoring, but no controlled studies have been done to show it reduces sleep apnea.

Tracheostomy

Tracheostomy is rarely performed. This procedure is usually performed when all other treatment options have failed and the person has severe, life-threatening sleep apnea. In this procedure a small hole is made in the windpipe and a tube is inserted into the opening. This tube stays closed during wake hours and the person breathes and speaks normally. It is opened for sleep so that air flows directly into the lungs, bypassing any upper airway obstruction.

Other procedures

Patients in whom sleep apnea is diagnosed due to deformities of the lower jaw may benefit from surgical reconstruction. For patients who have sleep apnea due to a large tongue, tongue-restraining devices may be used. There are also dental devices that will reposition the tongue and jaw so that the airway remains open while sleeping (usually for mild sleep apnea). Another new invention that is being tested is the oral positive airway pressure (OPAP), a dental appliance that conducts air through it. It may prove to be an alternative to the mask and headgear.

If you have any questions regarding treatment for sleep apnea, please contact your physician, or you may call the Mercy Medical Center Sleep Laboratory at 701.774.4189.