Understanding Obstructive Sleep Apnea
How Is Obstructive Sleep Apnea Treated? continued...
Mechanical therapy -- Continuous positive airway pressure (CPAP) is the preferred initial treatment for people with mild to moderate obstructive sleep apnea. With CPAP, patients wear a mask over their nose and/or mouth. An air blower forces constant and continuous air through the nose and/or mouth. The air pressure is adjusted so that it is just enough to prevent the upper airway tissues from collapsing during sleep. Other types of positive airway pressure devices are also available, including the BPAP, which has two levels of air flow that vary with breathing in and out.
Mandibular advancement devices -- For patients with mild sleep apnea, dental appliances or oral mandibular advancement devices that prevent the tongue from blocking the throat and/or advance the lower jaw forward can be made. These devices help keep the airway open during sleep. A qualified dental personnel who is trained in oral health, TMJ, and dental occlusion should help determine which type of oral device is best for you.
Surgery -- Surgical procedures may help people with sleep apnea. There are many types of surgical procedures, often performed on an outpatient basis. Surgery is reserved for people who have excessive or malformed tissue that is obstructing airflow through the nose or throat. For example, a person with a deviated nasal septum, markedly enlarged tonsils, or small lower jaw and a large tongue that causes the throat to be abnormally narrow might benefit from surgery. These procedures are typically performed after sleep apnea has failed to respond to conservative measures and a trial of CPAP. Types of surgery include:
- Upper airway stimulator -- This device, called Inspire, consists of a small pulse generator placed under the skin in the upper chest. A wire leading to the lung detects the person's natural breathing pattern. Another wire, leading up to the neck, delivers mild stimulation to nerves that control airway muscles, keeping them open. A doctor can program the device from an external remote. Also, those who have Inspire use a remote to turn it on before bed and turn off upon waking in the morning.
- Somnoplasty -- a minimally invasive procedure that uses radiofrequency energy to tighten the soft palate at the back of the throat.
- UPPP, or UP3, which stands for uvulopalatopharyngoplasty -- a procedure that removes soft tissue in the back of the throat and palate, increasing the width of the airway at the throat opening.
- Mandibular/maxillary advancement surgery -- surgically moving the jaw bone and face bones forward to make more room in the back of the throat -- an intricate procedure that is reserved for patients with severe sleep apnea and head-face abnormalities.
- Nasal surgery-- correction of nasal obstructions, such as a deviated septum.