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Sleep Apnea Treatment Options

People with sleep apnea experience reductions or pauses in their breathing while they are sleeping. These pauses, or arousals, prevent restorative sleep and cause symptoms like snoring and feeling breathless or choking. CPAP provides a constant stream of pressurized air that keeps your airway open. It’s the best sleep apnea treatment for many people and can help prevent or treat serious complications, such as heart disease, high blood pressure, diabetes and depression.

Treatment for obstructive sleep apnea can include lifestyle changes, such as losing weight, avoiding alcohol and sedatives, quitting smoking, and not driving or operating machinery while drowsy. Your doctor may also prescribe upper airway stimulation or surgery.

CPAP

Obstructive sleep apnea (OSA) occurs when your throat relaxes while you’re sleeping, creating a blockage that reduces or stops airflow. It can cause loud snoring, frequent awakenings with the sensation of choking or gasping and high blood pressure.

Several different types of CPAP machines are available, including adjustable CPAP called bilevel therapy that delivers two levels of pressure, one for breathing in and one for breathing out. Other advanced machines, such as adaptive servo-ventilation, work similarly but adjust the level of pressure on the fly in response to central sleep apnea events. These devices can also help treat Cheyne-Stokes respiration in some cases. Other therapies include hypnotic medications and respiratory-stimulating drugs for central sleep apnea and phrenic nerve stimulation, which delivers impulses to your phrenic nerve to help initiate breathing.

Oral Appliances

The ‘gold standard’ therapy for sleep apnea is to pneumatically splint open the upper airway using continuous positive airway pressure (CPAP). Unfortunately, patients often have difficulty accepting and adapting to CPAP, as it can be noisy, intrusive, uncomfortable, or both.

Oral appliances offer an effective alternative. Similar to an athletic mouth guard or orthodontic retainer, these devices are placed in the mouth at night before sleep and function by repositioning the tongue or lower jaw, resulting in a wider upper airway.

We offer several different types of oral appliances to treat sleep apnea and snoring. Depending on your individual needs, we can determine which one is best for you by conducting an overnight sleep study at our in-lab facility or via home sleep testing. Follow up visits with both the dentist and sleep medicine specialist are recommended, to ensure your ongoing success.

UAS

The UAS is a device that has been recently approved by the FDA for use in patients with moderate-to-severe obstructive sleep apnea who do not tolerate CPAP. The device is implanted under the skin in the upper chest during a brief outpatient procedure and senses breathing patterns. It applies mild stimulation to the hypoglossal nerve through a small electrode that can be activated with a remote control, helping keep the airway open during sleep.

Our surgeons are experienced in this new technology and can perform the procedure with minimal scarring, pain or recovery time. This is a last resort option for patients who cannot adhere to CPAP therapy and may be an option if other surgical interventions such as the removal of the tonsils, uvula, or jawbones are unsuccessful. The clinical study published in 2016 demonstrated improvement in polysomnography and symptoms with a low rate of complications and serious events.

Surgery

If a sleep-related health problem is severe enough, your doctor may recommend surgery. The most common type of surgery is uvulopalatopharyngoplasty (UPPP), in which surgeons remove part or all of your tonsils and uvula. This reduces or eliminates snoring and often improves OSA as well.

Surgery is also used to treat central sleep apnea, in which your brain doesn’t send signals that keep breathing-related muscles working properly. This form of sleep apnea usually happens during Stage 2 and REM sleep, but it can happen at any stage.

Sleep apnea can cause serious or even deadly complications. It can make you fall asleep while driving a car or operating machinery, increasing your risk of accidents. It can leave you feeling tired all the time, affecting your work and social life. And untreated obstructive sleep apnea increases your risk of heart damage and heart failure. To minimize the risks, get treatment as soon as possible. Follow-up visits are important, too.

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