Treating and Managing Sleep Apnea

Breathing devices, known as positive airway pressure or PAP machines, are one of the most common treatment options for managing sleep apnea. Your healthcare provider will help you decide if PAP treatment is the right option for you.

• Continuous Positive Airway Pressure (CPAP): CPAP is a machine that provides continuous pressure, gently blowing air into your airway, to keep it open while you sleep. You wear a mask that either fits into your nostrils, over your nose and/or over your mouth. Because CPAP works so well, it's often the first treatment your healthcare provider will have you try. It should be used whenever sleeping for the best treatment.
• Auto-Adjusting Positive Airway Pressure (APAP): APAP is similar to the CPAP however it uses auto-adjusting positive airway pressure for airway opening instead of continuous pressure. The APAP varies the pressure according to the airflow limitation that occurs.
• Bilevel Positive Airway Pressure (BiPAP): BiPAP is another machine that helps by providing positive air pressure. This treatment provides a higher pressure when you breathe in and a lower pressure when you breathe out. 

Oral appliances, also called oral devices, are custom-fit devices worn in your mouth that assist in preventing your airway from being blocked. These devices are most effective in treating mild to moderate sleep apnea. There are two common oral appliances:

• Mandibular repositioning mouthpieces help prevent the jaw from sliding backwards and blocking your airway
• Tongue-retaining devices are mouthpieces that hold the tongue so that it does not block the airway.

A different type of oral appliance may be recommended for you to wear during the day. A removable tongue muscle stimulator helps to stimulate your tongue to improve tongue muscle function and tone your tongue to help prevent your tongue from falling backwards and blocking your airway while you sleep.

Your healthcare provider may recommend treatment called orofacial therapy which are exercises for your mouth and facial muscles. This can help improve the position of your tongue and strengthen the muscles that impact your sleep apnea including your lips, tongue, upper airway and face.

• The FDA recently approved a medication for the treatment of moderate to severe obstructive sleep apnea in adults who are also diagnosed with obesity. Your healthcare provider can help you decide if this treatment option is right for you.
• Your healthcare provider may adjust current medications you are taking that may affect your nighttime breathing or recommend a medication to stimulate breathing if this is determined to be impacting your sleep apnea.

If other treatment options are not right for you, you may be given surgical options. Sleep apnea surgery includes several different possible procedures that may reduce the tissue in the back of your throat, pull your tongue forward, or insert a nerve stimulator to open your airway so you can breathe easier while sleeping. You may also be considered for surgery to remove tonsils or adenoids if they are blocking your airway. In some cases, weight-loss surgery may be recommended if obesity continues to contribute to your sleep apnea.

Your healthcare provider often will recommend that you make some lifestyle changes along with other treatments.

• Maintain a healthy weight: Reaching and maintaining a healthy weight can help in managing sleep apnea.
• Avoid alcohol and sedatives: Stopping drinking alcohol at least four hours before bed and avoiding sedative medications such as sleeping pills may help your sleep apnea.
• Quit smoking: This may improve your symptoms because cigarette smoke can cause inflammation that narrows your airways.
• Change your sleeping position: Sleeping on your back may make your sleep apnea worse. Sleeping on your side may help in reducing the severity of your symptoms. You can use pillows to assist with positioning yourself to sleep on your side.