There are different treatment options for obstructive sleep apnea (OSA). Which option is right for you depend upon the severity of your sleep apnea (which is determined from a sleep study), the physical structure of your upper airway, and other aspects of your medical history.
The various options are listed below so that you can discuss them with your doctor. Only your doctor or sleep specialist can tell you which treatment option is best for you.
When thinking about treatment options, remember that with an obstructive apnea, there are physical blockages or obstructions in the airway during sleep. (In OSA, obstructions occur during sleep but not during waking hours partly because all muscles, including the muscles in the airway, relax during sleep.) Obstructions that cause breathing to stop completely for at least ten seconds are termed apneas. When breathing is substantially reduced for at least ten seconds, it is a hypopnea. Frequent apneas and hypopneas lead to numerous brief awakenings during sleep and to sleepiness during waking hours. Preventing apneas and hypopneas prevents the sleep fragmentation, so treatment reduces the sleepiness. (For simplicity, here "apneas" include hypopneas as well.
A number of companies have custom designed anti-snoring pillows for snoring and mild sleep apnea;to position your jaw slightly forward and help to keep your airway open. You will awake more refreshed and feel more energized throughout your whole day.
Reflux (GERD)
Researchers report nearly three-fourths of people with chronic acid reflux (GERD) suffer night-time symptoms not typically associated with the disease. These include coughing, snoring and chest pain. Research indicates that elevating your head and esophagus above your feet can help prevent the back flow of irritating stomach acids into your esophagus (causing uncomfortable burning in your stomach as you sleep.
An Anti-Snoring Pillow (placed on top of a standard size pillow)will comfortably raise your head above your feet and can help prevent the back flow of irritating stomach acids into your esophagus.
Positional alarms are also on the market: they are intended to prevent supine sleeping by making a noise when one begins to sleep on the back. However, they may disrupt sleep so much that the subsequent sleep fragmentation causes a concern.
One study found sleeping on the back but with the back elevated from the waist up may also reduce the collapsibility of the airway and therefore reduce the apneas. Foam wedges, not soft pillows that can actually push the chin towards the chest and worsen apnea, should be used.
Weight loss: Sleep apnea can be weight-related. Additional fat around the neck may make the airway narrower, making obstructions more likely to occur. For some overweight people, especially those with mild cases, losing weight can be an effective treatment. Or weight loss may reduce the severity of the sleep apnea. However, it may be hard to lose weight when you have untreated sleep apnea: you may be too tired to exercise and you may eat to stay awake. Also, it may take some time before the weight loss is achieved, so in light of the potential consequences of untreated OSA, using another treatment option while working towards the weight loss goal may be an option. Losing weight may also improve your health in other ways, but it is always advisable to talk to your doctor before beginning a weight-loss program.
Remember that sleep apnea occurs in thin people as well; the airway can close during sleep for a number of reasons, not just excess weight.
Avoiding alcohol and other CNS depressants: Alcohol and medications that act as central nervous system (CNS) depressants-such as pain killers, sedatives, and muscle relaxants-can worsen sleep apnea by relaxing the airway muscles further and/or by reducing the respiratory drive and causing more apneas to occur. Hence avoiding alcohol and CNS depressants close to bedtime may be helpful. Ask your doctor or pharmacist if medications you take prescription or over-the-counter or herbal, affect your sleep apnea. The prescribed sleep apnea treatment may be adjusted to take into consideration the use of medications that are CNS depressants.
