There are many treatment options for Obstructive Sleep Apnea (OSA) that your sleep specialist will discuss with you. The optimal treatment will depend on the severity of your condition and your ability to commit to treatment.
The goals of treatment are the same, regardless of the treatment type that is prescribed:
- Improve sleep quality and daytime sleepiness/fatigue.
- Resolve snoring.
- Reduce the risk of complications, including heart attack, stroke, heart failure and motor vehicle accidents.
Continuous Positive Airway Pressure, commonly referred to as CPAP (pronounced sea’•pap), is effective in over 95% of sleep apnea and is often referred to as the gold standard in the treatment of mild, moderate and severe OSA. A CPAP device generates a flow of air under a prescribed pressure that is delivered via a breathing hose and nasal mask. The prescribed pressure acts as a pneumatic splint to hold the airway open during sleep. CPAP must be used each time an individual with OSA sleeps.
There are several models of CPAP devices available and even more mask styles (nasal, direct nasal and full face masks). A well fitted mask is vital to successful therapy, as is heated humidity and a some knowledge of how CPAP can treat OSA. While a CPAP device can function for five years or more, regular replacement of your mask and basic supplies are necessary to maintain optimal treatment. Your sleep specialist can provide you with guidance in selecting a CPAP service provider. The Ministry of Health partial funds the cost of CPAP therapy and private health plans also very commonly supplement the cost.
Dental Appliances (Mandibular Advancement Devices)
A dental appliance may help people with mild to moderate sleep apnea or snoring, being effective in 70% of cases. It requires specialized fitting by a dentist or orthodontist and works by adjusting the lower jaw and tongue forward to keep the airway clear or patent. Shifting of teeth can occur with long term therapy. Should not be used in patients with pre-existing temporal mandibular joint disease.
For a few selected individuals, surgery, radiofrequency therapy or palatal implants may be of benefit in providing relief to blocked airways. Your sleep physician will advise whether this is a viable option for your type or severity of sleep apnea. Surgery is an invasive procedure that involves cutting away of excess tissue in the back of the throat. Throat pain following this type of surgical intervention can last up to 2 weeks following the procedure.
This is a relatively new therapy that has undergone limited short term evaluation. It may be useful in mild-moderate sleep apnea. It has not been proven to adequately correct severe sleep apnea. Unlike other treatments there are no upfront costs, however, it requires ongoing expenditures to use this form of therapy. Retesting with therapy is important, to ensure that the treatment is effective.
No proven role.
For individuals who have been diagnosed with mild OSA, changes in lifestyle behavior may be enough to support the condition:
- Avoid alcohol and drugs that cause you to be sleepy.
- Lose weight if you are overweight or obese.
- Quit smoking.
- Keep on your side rather than your back – ask your physician about positional therapy devices.