Sleep Aponea - Treatment
OSA may pose serious health risks since it disrupts normal sleep patterns and reduces oxygen levels. This condition can increase a person's risk for excessive daytime sleepiness, driving and work-related accidents, high blood pressure, heart disease, stroke, diabetes, obesity, memory and learning problems and depression.
A sleep physician can help you select a treatment plan that is right for you. Depending on the treatment, he or she may work in collaboration with other members of the sleep team, including dentists, psychologists, physician assistants, nurses and technologists. Your plan may include any combination of these treatments:
CPAP (Continuous Positive Airway Pressure)
CPAP is considered the gold standard for the treatment of obstructive sleep apnoea. It involves using a small pump that delivers air under pressure through a hose and mask that covers your nose. Like blowing air into a balloon, the pressurised air can help to open the airway in the throat. Results are immediate and predictable when used.
Whilst studies show CPAP is the most effective treatment to reduce obstructive breathing , it has been shown that 25-50% of patients are unable to tolerate or comply with treatment for a variety of reasons. These include skin irritation due to mask straps, claustrophobia … etc …
Oral Appliance Therapy
An oral appliance is a device that fits in your mouth over your teeth while you sleep. It may resemble a sports mouth guard or an orthodontic retainer. The device prevents the airway from collapsing by holding the tongue in position or by sliding your jaw forward so that you can breathe when you are asleep. Some patients prefer sleeping with an oral appliance to a CPAP machine. A dentist trained in dental sleep medicine can fit you with an oral appliance after you are diagnosed with sleep apnoea. Oral appliance therapy is recommended for patients with mild to moderate apnoea who cannot tolerate CPAP.
Surgical therapies are not as effective in treating sleep apnoea as CPAP and oral appliances. There are a variety of surgical options you can elect to have if CPAP or oral appliance therapy does not work for you. The most common options reduce or eliminate the extra tissue in your throat that collapses and blocks your airway during sleep. More complex procedures can adjust your bone structures including the jaw, nose and facial bones. Weight loss surgery may also be an option. Talk to your sleep medicine physician about what surgery is right for you.
In some cases weight loss can help improve or eliminate your sleep apnoea symptoms if you are overweight or obese. Overweight people often have thick necks with extra tissue in the throat that may block the airway. There is no guarantee that losing weight will eliminate your sleep apnoea, though it may help. This approach is unlikely to make a difference in patients with a narrow nasal passage or airway.
If you have mild sleep apnoea or you only snore when you sleep on your back, you may be able to improve or eliminate your symptoms by changing your sleep position. Your airway may open if you sleep on your side instead of your back. There are a variety of products that you can wear when you go to sleep that prevent you from sleeping on your back. You can also attach a tennis ball to the back of your shirt or pyjamas. Positional therapy does not work for everyone. For many patients, the airway may become blocked no matter the sleep position.
There are a variety of lifestyle changes that you can make to help you reduce your snoring and improve your sleep apnoea symptoms. Behavioural changes such as quitting smoking or not drinking alcohol may improve sleep apnoea symptoms. Alcohol relaxes your throat muscles which can cause you to snore or for your airway to collapse. If you have allergies, taking a decongestant before you go to bed may help improve airflow through your nose.
If you have difficult staying with your treatment plan or cannot sleep even with treatment, your doctor may recommend Cognitive Behavioural Therapy. A behavioural sleep specialist will help you eliminate the thoughts and behaviours that are preventing you from getting restful sleep or complying with your treatment.