According to the American Association of Oral and Maxillofacial Surgeons, one in 15 adults has some form of sleep apnea. Apnea is the interruption of breathing while sleeping caused by either an obstruction or a lack of brain impulse, and can be experienced by adults, teens, children, and infants. Sleep apnea not only poses a health risk to the sufferer, it can be very concerning to loved ones. While the sufferer may be unaware, often partners sleep restlessly waiting for their next breath. Fortunately, Sleep apnea is a very treatable sleep disorder.
Types of Treatments
There are many treatments to resolve or diminish the causes of sleep apnea, from minor lifestyle changes to minor surgery. Once the type and severity of the apnea is diagnosed, a physician will recommend the most suitable treatment or combination of treatments.
Before opting for surgery, a physician may recommend several lifestyle changes that are known to frequently improve sleep apnea. Some of these remedies include:
- Weight loss
- Avoiding sedatives, which further relax the throat muscles and cause more problems
- Changing sleeping positions, and avoiding sleeping flat on the back
- Specially designed pillows and other positioning devices
Oral appliances are molded devices that fit into the mouth, worn while sleeping. They work by moving the bottom jaw and tongue slightly forward. With the jaw forward, the tongue and soft palate are less able to obstruct the airway. Oral appliances are frequently used for mild to moderate sleep apnea. While the appliance can be very effective, the down side may be comfort and expense. Over the counter appliances are readily available, but do not last as long or fit as well. Custom appliances, which are made by dentists, can cost around $1,500. In children, a custom appliance may not be cost effective, as it will soon be outgrown. Since it is easy to take out or become dislodged, children frequently do not use the appliance through the night.
CPAP and BiPAP Machines
CPAP, or Continuous Positive Airway Pressure, and BiPAP(Bilevel) is frequently used to treat those with mild to moderate obstructive sleep apnea. The CPAP works by passing pressurized room air through a tube and into a mask which covers the user’s mouth and nose. The continuous flow of air holds the muscles, soft palate and tongue firm so the throat stays open, allowing the user to breathe properly. The BiPAP is similar to the CPAP but is often better tolerated by some users because the machine blows air at two different degrees of pressure.
While it is a highly effective treatment, it is not a cure and users should be regularly evaluated to assure the condition is not worsening.
There are several surgical interventions used to treat sleep apnea, with the goal to remove excess tissue or adjust the lower jaw to open the airway.
• Maxillomandibular advancement is a procedure where the upper and lower jaw is moved forward, enlarging the space between the tongue and soft palate.
• Uvulopalatopharyngoplasty (UPPP) is a procedure used to remove tissue from the rear of the mouth and top of the throat. Very often, the tonsils and adenoids are removed as well.
• Tracheostomy is a procedure is used in the most severe and life threatening cases of sleep apnea. In this procedure, a surgeon creates an opening in the neck where a tube is inserted allowing the air to bypass any obstructions.
Additional Therapies for Sleep Apnea
• Supplemental oxygen may help in the treatment of Central Apnea
• The treatment of associated medical problems, such as hear or neuromuscular disorders.
• Adaptive Servo-ventilation (asv) is a new device which stores information on the user’s breathing patterns and uses it to prevent pauses in breathing
Sleep apnea is an area that is under intense research. There is no doubt patients will continue to see new devices and treatment therapies to better manage or cure apnea.