Treating Sleep Apnea

CHAPTER 14

  

Treating Sleep Apnea

PART 1

Lifestyle Changes Can Change Everything

Sometimes lifestyle modifications can be all that is necessary to cure sleep apnea.

  • Sleeping on your side or stomach. When you sleep on your back, your tongue and soft palate may rest on the back of your throat and block your airway. Try sewing one or more tennis balls in the back of your pajamas to keep yourself from sleeping on your back. This simple technique can be surprisingly effective!

  • Avoid alcohol, tranquilizers, and sleeping pills. They can relax the muscles in the back of your throat, allowing it to collapse

  • Keep nasal passages open. Try using a saline nasal spray or a neti pot (a small pot used to pour water into the nostrils) to keep your nasal passages clear. Nasal decongestants and antihistamines are generally recommended for only short-term use, so talk to your doctor about using them

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PART 2

Continuous Positive Air Pressure (CPAP)

Continuous positive air pressure (CPAP) is the most common treatment for sleep apnea, and it’s usually very effective for moderate-to-severe sleep apnea.

A CPAP machine is like a vacuum cleaner in reverse: instead of sucking air in through a hose, it blows it out. Attachments at the end of the hose may be designed to go into your nostrils, or cover your nose, or cover both your nose and mouth. The gentle pressure of the air pushes your throat open so that it can’t collapse while you sleep, thus preventing sleep apneas. The flow of air is continuous and it blows at a constant, fixed pressure, all night long. Generally CPAP machines are equipped with a humidifier, and they also usually warm the air that’s blown out.
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PART 3

Different Sleep Requires Different Pressure

The amount of air flow delivered by the CPAP machine is individualized—it’s not a one-size-fits-all device. To determine the best adjustment for you, you will be asked to sleep overnight in the sleep lab wearing the CPAP mask while the sleep technician monitors your sleep. This is called a CPAP titration study.
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PART 4

CPAP Learning Curve

Getting used to using a CPAP machine can take time. You may need to try different types of masks or other types of interfaces until you find one that feels comfortable and works well. It can take as much as 4-6 weeks to become comfortable with the CPAP and be able to use it every night. READ MORE

If you have problems with the CPAP machine, don’t give up. Once you get used to it, you’ll probably be so happy with the results that you’ll want to use it every night. You’ll very likely find that you are less drowsy and have more energy. You may feel rested for the first time in years. Using CPAP can be the launching point for other changes in your life, too, like beginning an exercise program or starting a new activity. LESS
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PART 5

Oral Appliances

Oral appliances, or dental devices, are generally less effective than CPAP, but some people find them easier to use. There are many different types of oral appliances. They are usually plastic devices that are designed to prevent soft tissues from collapsing and pressing on the airway. Some are designed to bring the jaw forward, which may relieve snoring and mild sleep apnea. Others lift the soft palate, and still others stop the tongue from falling back over the windpipe. READ MORE

If you’re interested in trying an oral appliance, see your dentist. Many devices are available, and you will probably need to try a number of them before you find one that fits well. When you’ve found one that works for you, you should continue to follow up with your dentist every 6 months to see if the device still fits you and to assess how well it is working to relieve sleep apnea. LESS
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PART 6

Surgery

A number of different types of surgery may be performed for sleep apnea.

  • Tonsillectomy and adenoidectomy remove the tonsils and adenoids (respectively) to enlarge the air passages.

  • Nasal surgery may be done to remove polyps or correct a deviated septum for greater airflow through the nose

READ MORE
  • Uvulopalatopharyngoplasty removes tissue from the rear of the mouth and the top of the throat. Tonsils and adenoids are usually removed as well. This procedure often cures snoring but may not cure sleep apnea, because tissues farther down in the throat may be blocking airflow.

  • Maxillomandibular advancement moves the jaw forward from the rest of the facial bones, enlarging the space behind the tongue and soft palate.

  • Tracheostomy is generally performed only if sleep apnea is life-threatening and other treatments have failed. In it, a permanent opening is made in the neck. At night a tube is inserted into the opening so that you can breathe through it, bypassing the blocked air passage farther up in the throat.

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