Sleep Apnea Treatments
Positional Sleep Therapy
If sleep apnea occurs only when sleeping supine (on one’s back) but not non-supine (on one’s sides or stomach) it is termed supine-exclusive sleep apnea. In such cases, positional sleep therapy may be all that is needed. To prevent unintentional supine sleep, an electronic device is worn that will mildly buzz during supine sleep. This buzz does not usually cause an awakening but will gently prompt a return to side-sleeping. The device also records body position and snoring which can be downloaded as a graphical report. Recently, there have been several scientific studies documenting the effectiveness of positional therapy for the treatment of supine-exclusive sleep apnea.
In some cases, sleep apnea is supine-predominant (is worse when supine but still present non-supine) but is not supine-exclusive. In such cases, the positional device may be combined with an oral appliance. For CPAP users adding a positional device can reduce pressure requirements thus making CPAP therapy more comfortable.
Oral Appliance Therapy (OAT)
(See also oral appliance clinic)
Oral appliances are dental mouthpieces that fit very much like a sports mouth guard or removable orthodontic retainer. The device prevents the airway from collapsing by supporting the jaw in a forward position. OAT involves customization, selection, fabrication, adjustments, and long-term follow-up care by sleep professionals to ensure proper effectiveness.
Oral appliance therapy is used to treat snoring and obstructive sleep apnea (OSA). Specifically oral appliances are recommended for individuals who:
- Snore, but don’t have OSA
- Presented with mild to moderate OSA during a sleep study
- Were unsuccessful with CPAP or weight loss
- Desire an alternative to CPAP during travel
Custom-made oral appliances are scientifically proven to be more effective than over-the-counter devices and have fewer side-effects.
Often, positional therapy will be combined with oral appliance therapy for best results.
CPAP | BiLevel | ASV Therapy
(See also CPAP clinic)
Because of its effectiveness, Continuous Positive Airway Pressure (CPAP) is currently the most widely recommended treatment for all severities of Sleep Apnea. CPAP therapy is delivered via a mask through which air gently blows into the back of the throat. This pressurized room air keeps the airway from collapsing. The amount of air pressure needed is different for each person and may be determined by an overnight sleep study.
Currently, there are many different CPAP masks and devices available. Generally, there are three categories of masks: 1) Nasal Pillows, 2) Nasal and 3) Full-face. The type of mask used largely depends on an individual’s breathing style, facial structure, and the overall comfort. Positive Airway Pressure (PAP) devices consist of 1) CPAP, 2) Auto-CPAP, 3) Bi-level and 4) Adaptive Servo-Ventilation (ASV). It is important to realize that within each device category there are multiple models with different capabilities and features.
(See also Inspire Therapy)
Inspire® Upper Airway Stimulation (UAS) is an FDA-approved treatment for people with moderate to severe OSA who are unable to use or get consistent benefit from CPAP. In contrast to CPAP, Inspire therapy works inside the body with a patient’s natural breathing process. Based on the unique breathing patterns, the system delivers mild stimulation to key airway muscles. By stimulating these muscles, the airway remains open during sleep.