February 17, 2022
It’s estimated that nearly 22 million Americans suffer from sleep apnea, with 80% of moderate-severe cases remaining undiagnosed. The most common form of sleep apnea is known as obstructive sleep apnea (OSA), which is characterized by a blockage or collapse of the airway, causing cessation of breathing for a short period of time during sleep. These cessations of breathing or “apneas” range from a few seconds up to several minutes and can occur up to 30 times per hour.
Common symptoms of sleep apnea include snoring, frequent breaks in breathing, daytime sleepiness or fatigue, morning headaches, insomnia, depression, frequent nighttime urination, acid reflux, and uncharacteristic irritability.
OSA negatively impacts both the quantity and quality of sleep that you get, putting you at a higher risk for experiencing negative events like a car crash or developing a potentially life-threatening condition, such as diabetes or heart disease. These risks make it very important that those with sleep apnea get treated for their condition.
The three most common treatment options for OSA include CPAP machines, oral appliance therapy, and surgical intervention. Curious which method is best suited for your needs? This article provides you with information on a variety of treatment options that may be available to you.
- Continuous Positive Airway Pressure (CPAP) Machines
- Oral Appliance Therapy
- Surgical Interventions
- Inspire Device
- eXciteOSA Therapy
Continuous Positive Airway Pressure (CPAP) Machines
CPAP stands for “Continuous Positive Airway Pressure” and is one of the most common forms of treatment for people suffering from sleep apnea.
What is a CPAP Machine?
CPAP machines are a form of ventilator that provides the patient with a continuous flow of pressurized air. This stream of air prevents collapsing of the airway that would otherwise obstruct breathing throughout the night.
The machine consists of a small mechanical ventilator, which is usually placed on a bedside table. Air is taken in from the surrounding atmosphere and flows through a tube that is attached to a mask worn by the patient.
Since their introduction, CPAP machines have been the most commonly prescribed treatment for sleep apnea. The machines have become smaller and quieter than earlier versions.
What are the Benefits and Common Problems of CPAP Machines?
CPAP machines can be a great way to treat severe cases of sleep apnea and conditions associated with severe diagnoses of OSA. Using a CPAP can lower your risk of hypertension, diabetes, and stroke, and can greatly improve your cardiovascular and respiratory function, mood, and daytime cognitive functioning.
However, these machines are not without their drawbacks, which can include:
- CPAP masks can make wearers feel claustrophobic
- Facial irritations and breakouts can occur from the straps on the CPAP masks
- Masks can leave indentions or lines that last well after waking up
- CPAP users can’t sleep on their stomachs and, in general, CPAP users have reported problems finding a comfortable sleep position
- Masks can leak, which may cause the air to blow on a partner
- CPAP users have reported feeling embarrassed by their CPAP machine
- Bed partners can have difficulty adjusting to the sounds that CPAP machines make
- Allergies can cause masks to be uncomfortable
- CPAP machines are hard to transport for travel
So while a CPAP machine is a great way to treat severe sleep apnea, it can be uncomfortable, inconvenient, and difficult to adjust to. Additionally, the largest distributor of CPAP machines, Philips Respironics, recalled millions of CPAP machines last year due to findings that a faulty piece of material in their CPAP machines could be causing severe illness. This caused a shortage of CPAP machines.
Is A CPAP Machine Right For You?
Whether or not a CPAP machine is the right treatment for you depends on the specifics of your situation. Generally, you should follow your doctor’s recommendations if you suffer from sleep apnea. If your sleep apnea is severe enough to warrant a CPAP machine, that’s probably the right choice for you.
However, there is a growing area of treatment for sleep apnea that doesn’t require a bulky CPAP machine. This field of sleep apnea treatment is called oral appliance therapy.
Oral Appliance Therapy
Oral appliance therapy is an effective, non-invasive option for people who suffer from mild-to-moderate sleep apnea seeking an alternative to a traditional CPAP machine, and has been found to be a great supplementary option for those with severe OSA.
What is Oral Appliance Therapy?
An oral device is a mouth-guard-like appliance that’s worn exclusively during sleep, similar to a mouth guard used for sports, or a mouth guard designed to stop teeth grinding. The device realigns the jaw into a forward position to prevent blockage of the airway.
Each oral device is custom-fit for each patient. A board-certified dental sleep physician will take measurements and casts of your mouth, complete a total clinical evaluation of your respiratory system and your mouth, and then custom-build a device specifically for you.
Generally, you’ll return to your sleep physician after you receive and start using your oral device to make sure it’s functioning properly. You’ll also schedule annual assessments to ensure your oral device still fits correctly.
Benefits of Oral Appliance Therapy
Commercially available oral devices have made tremendous advancements in the last few years, and oral appliance therapy has become a viable alternative to CPAP machines. Oral devices are also an effective treatment method for those who suffer from persistent snoring.
While CPAP therapy is widely considered to be the most effective treatment option for those who suffer from severe OSA, new studies are finding that those with severe OSA can also find relief with an oral appliance.
Additionally, many dental sleep medicine doctors have found greater rates of success with oral appliance therapy due to the higher rates of compliance they offer. Why? Because they are non-invasive, easy to travel with, and popular among bed partners who don’t want to deal with the noises and bulkiness associated with CPAP machines.
Surgery for Obstructive Sleep Apnea
The reality is that few cases of OSA require surgery. Generally, changes in lifestyle along with oral appliance therapy or a CPAP machine will provide relief and produce acceptable clinical results.
However, in extreme cases of sleep apnea, there is often no alternative to surgery.
There are several different kinds of clinical surgery for sleep apnea, including:
- Uvulopalatopharyngoplasty (UPPP) – In this procedure, soft tissues around the palate are trimmed, removed, or repositioned to widen the airway.
- Radiofrequency Volumetric Tissue Reduction (RFVTR) – This treatment uses controlled cauterization to shrink and tighten tissues in the nose and throat.
- Turbinate Reduction and Septoplasty – These treatments open your nasal passages to increase airflow.
- Genioglossus Advancement – This surgery moves the major tongue attachment forward by making a cut in the lower jaw and moving the bone forward.
- Hyoid Suspension – The hyoid bone is a u-shaped bone in the neck to which many of the major structures of the throat are attached. In this procedure, the hyoid bone is pulled forward and secured into place to avoid blockage of your airway by the soft tissues of the throat.
- Maxillomandibular osteotomy (MMO) and advancement (MMA) – These surgeries are extremely invasive but are a treatment for severe cases of sleep apnea. The bone of your jaws will be cut, and the lower or upper jaw will be moved forward to improve breathing. Your jaw must be wired shut during recovery, which can last several months.
There are several other clinical procedures, but these are the most commonly used. It’s important to understand that surgery for OSA is invasive and requires a hospital stay. Before considering surgery for OSA, it’s important to consult a sleep physician who is able to diagnose the severity of your OSA and advise you on the best path to improving your health.
Inspire: A Same-Day Outpatient Procedure
Inspire devices are surgically implanted in order to deliver mild stimulation to key airway muscles, allowing the body to maintain a steady airflow during sleep. The difference? Inspire is a fairly new treatment and isn’t quite as invasive as the procedures above, but still requires surgery. There is no hospital stay, and a person can leave the same day that the device is implanted.
Inspire works through a remote system. Once a person is ready for bed, they turn the device on via their remote. In turn, the device opens up their airway, allowing for non-obstructive rest.
A New Therapy on The Market: eXciteOSA
A new, exciting therapy has emerged for those who suffer from snoring to mild-moderate OSA. eXciteOSA is a daytime therapy option that improves sleep by strengthening the muscles of the tongue. Developed by Signifier Medical Technologies, eXciteOSA is starting to find traction within the dental sleep medicine community. Certain providers, such as Sleep Dallas, are able to prescribe eXciteOSA to qualifying individuals. To find out if you’re a candidate for the device, you can take their online quiz here.
What Sleep Apnea Treatment is Right for Me?
While educating yourself on the different options associated with treating obstructive sleep apnea is important and gives you power over your health decisions, it’s essential to consult a sleep physician.
Sleep physicians such as Dr. Marie Dibra, and dental sleep physicians such as Dr. Kent Smith at Sleep Dallas, are able to help you determine not only the severity of your sleep breathing disorder but which treatment option will work best for you. Ready to take control of your sleep? Give us a call today at (844) 409-4657, or request a consultation online by clicking here.