March 10, 2017
It’s estimated that nearly 22 million Americans suffer from sleep apnea, with 80% of cases remaining undiagnosed. The most common form of sleep apnea is known as “obstructive sleep apnea” and is characterized by the 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 occur up to 30 times per hour.
Common symptoms of sleep apnea include snoring, frequent breaks in breathing, daytime sleepiness or fatigue, morning headaches, restless sleep, depression, frequent nighttime urination, acid reflux and irritability.
The condition negatively impacts the quality of sleep that you get, puts you at risk for car crashes and work accidents and can contribute to high blood pressure and heart problems. These risks make it very important that those with sleep apnea get treated for their condition.
The three most common treatment options include: CPAP machines, oral appliance therapy and surgical intervention. Let’s take a look at the basics of each option, and discuss the benefits and drawbacks of each different method.
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 provide 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 evolved into a smaller, quieter apparatus than earlier versions, and they’re usually the first device a doctor will prescribe to a patient suffering from moderate to severe sleep apnea.
The Benefits of CPAP Machines And Common Problems CPAP Wearers Encounter
CPAP machines are a great way to treat severe cases of sleep apnea. Using a CPAP will lower your risk of hypertension, diabetes, and stroke, and greatly improve your cardiovascular and respiratory function.
However, these machines are not without their drawbacks, which include:
- CPAP masks can make some wearers feel claustrophobic
- Facial irritations and breakouts can occur from the straps on the CPAP masks
- Masks can leave indentions or lines that last hours after awaking
- CPAP users can’t sleep on their stomachs
- Some CPAP users have problems finding a comfortable position to sleep in while wearing a mask
- Masks can leak, which may cause the air to blow on a partner
- CPAP users sometimes feel embarrassed when other people see their CPAP equipment
- Bed partners can have difficulty adjusting to the sounds that CPAP machines make
- Allergies can cause masks to be very uncomfortable
- CPAP machines are hard to transport for trips out of town
So while a CPAP machine is a great way to treat severe sleep apnea, it can be uncomfortable, inconvenient and difficult to adjust to.
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, adjustments to your sleeping positions, or any of the other drawbacks you may encounter while using a 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.
What Is An Oral Appliance?
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 devices realign the jaw into a forward position to prevent blockage of the airway.
Each oral device is custom-built 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 your oral device to make sure it’s functioning properly, and you’ll also schedule annual assessments to ensure your oral device fits correctly.
Use Of Oral Appliance Therapy To Treat Sleep Apnea Is Rising
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.
If you’re looking for an alternative to the CPAP machine or a treatment option for persistent snoring, an oral device may be just what you need. Inquire with a sleep specialist to learn more.
Sleep Apnea Surgery
Few sleep apnea cases 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.
What Is It?
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.
Sleep Apnea Surgery is Invasive and Requires Hospital Stay
Surgery is recommended only if it’s been determined that a CPAP or oral appliance therapy is not enough to effectively treat your sleep apnea. Not surprisingly, clinical surgeries are extremely invasive and will require a hospital stay. Most sufferers of sleep apnea will not require surgery, but can instead be treated with an oral device or CPAP machine.
What Treatment Is Right For Me?
Consult a sleep specialist to determine which treatment option will provide you with the best results. With options including oral appliance therapy, CPAP machines and surgery, your doctor will work with you to find a treatment that works for your individual case.