Talk with your doctor before you try one. If you like your treatment, you’re more likely to stick with it and find relief.
Positive Airway Pressure (PAP) Devices
There are several kinds of positive airway pressure devices, or PAPs, that help open up your airways while you sleep. They deliver air through a mask.
Things to know about CPAP:
- It may be uncomfortable.
- Continuous air can dry your mouth and nose. You may get congestion, a runny nose, or nosebleeds.
- Some people get an upset stomach or a bloated belly.
With bilevel positive airway pressure, the air pressure is higher when you breathe in than it is when you exhale. This may help you exhale more easily.
Things to know about BiPAP:
- It's the best choice for people with more severe obstructive sleep apnea.
- It may not be effective for people with impaired breathing, reduced alertness when awake, or who have trouble swallowing.
- The masks may be uncomfortable or leak air.
- You may also have dry mouth, sinus pain, congestion, or eye irritation.
- Some people get mild belly bloating.
Auto-titrating positive airway pressure devices increase or decrease the positive airway pressure automatically. The machine detects the amount of air pressure you need as your needs change through the night.
Things to know about APAP:
- They sense your need for increased air pressure during REM sleep, so they’re good for people who have apnea mainly in this stage.
- Some people find APAPs more comfortable than other PAPs.
- Pressure changes may be too slow, so you notice the lag, wake up, and have poorer quality sleep.
- They're not for anyone with chronic heart failure or obesity hypoventilation syndrome.
Adaptive servo-ventilation devices also adjust air pressure according to your body’s needs. They have a pressure gauge to sense changes in your breathing during sleep to raise or lower air pressure as needed. The pressure adjustments happen continuously during the night as your breathing patterns change, so ASVs are more effective for people with central apneas than CPAPs or BiPAPs.
Things to know about ASV:
- It's good for people with central or complex sleep apnea.
- It may be dangerous for anyone with severe symptomatic heart failure.
- It's not recommended for people with profound or chronic hypoventilation, moderate to severe chronic obstructive pulmonary disease (COPD), chronically elevated partial pressure of carbon dioxide on arterial blood gas (ABG), or restrictive or thoracic neuromuscular disease.
Upper Airway Stimulation Therapy
Upper airway stimulation therapy is a new sleep apnea treatment. It’s also called hypoglossus nerve stimulation.
Your doctor will put three small devices in your chest during surgery to track how you breathe as you sleep. They can stimulate your throat muscles to move your tongue or palate forward to open your upper airways if you need it.
This therapy is good for people with moderate to severe obstructive sleep apnea. If PAP therapy hasn’t worked for you, it’s another option that works well and has few side effects.
Appliances and Mouthpieces
A few gadgets may help your airways stay open as you sleep:
Oral appliances. Your dentist can fit you with an oral appliance that looks like a mouth guard worn by athletes to move your tongue and jaw forward as you sleep. They’re best for treating milder sleep apnea or snoring. Some people get jaw pain when they use oral appliances.
Oral pressure therapy (OPT). Instead of a mask like a PAP device, you wear a mouthpiece. It connects by a tube to a vacuum that puts your tongue in the right position to help your airways stay open as you sleep.
Nasal dilators. Small devices called dilators can help your nostrils stay open during sleep. Internal dilators are small inserts that go inside your nostrils. External dilators are strips that you stick to the outside of your nose to pull your nostrils open. While dilators may help mild snoring, they don’t work well for sleep apnea.
Surgery to remove extra tissue that blocks your airways may treat sleep apnea. But it’s not right for everyone. It can be painful, and your sleep apnea may come back later.
- Soft palate surgery. This trims extra tissue in the back of your throat or tongue, or removes tonsils to widen your airways. It's also called uvulopalatopharyngoplasty (UPPP).
- Septoplasty or turbinate reduction. This is nose surgery to straighten a deviated septum or trim extra tissues in your nasal passages. It may help air flow easier through your nose.
- Radiofrequency volumetric tissue reduction. This shrinks and tightens your soft palate, tonsils, or tongue with heat.
- Palatal implants. This surgery treats mild sleep apnea or snoring. Small rods are inserted into your soft palate to stiffen the tissue and prevent airway blockage.
- Genioglossus advancement. This moves your tongue forward by making a cut into your jawbone, then moving that piece of bone up to push your tongue up.
- Maxillomandibular osteotomy and advancement. This surgery for more severe sleep apnea cuts and repositions your jaw to widen your throat so you breathe better. You’ll need to have your jaw wired shut for a few days.