Treatment Overview
Treatment for obstructive sleep apnea (OSA) includes lifestyle changes, continuous positive airway pressure (CPAP) (to prevent the airway from closing during sleep), and surgery. The goals of treatment are to relieve symptoms such as snoring and excessive daytime sleepiness and prevent other problems, such as high blood pressure. Your doctor will base your treatment on how severe your sleep apnea is.
Generally, your doctor will have you try lifestyle changes and CPAP first. Surgery is an option only if these do not work.
You may need to be treated for other health problems before you are treated for sleep apnea. For example, people who also have infections need to take antibiotics. People who have an underactive thyroid gland (hypothyroidism) need to take thyroid medicine.
Children have the same treatment options as adults. However, surgery (tonsillectomy and adenoidectomy) generally is the first choice because enlarged tonsils or adenoids cause most cases of sleep apnea in children. Children are treated using CPAP if surgery is not possible or does not work.
Initial treatment
The first treatment for obstructive sleep apnea (OSA) consists of making lifestyle changes. These include:
* Losing weight (if needed). Small studies have indicated that losing weight reduces the number of times per hour you stop breathing (apnea) or breathe very slowly (hypopnea). 4 Experts agree that weight loss should be a component of managing sleep apnea. 4
* Going to bed at the same time every night.
* Sleeping on your side. Try sewing a pocket in the middle of the back of your pajama top, putting a tennis ball into the pocket, and stitching it shut. This will help keep you from sleeping on your back. Sleeping on your side may eliminate mild sleep apnea. 5
* Avoiding the use of alcohol and some medicines, especially sleeping pills and sedatives, before bed.
* Quitting smoking. The nicotine in tobacco relaxes the muscles that keep the airways open. If you don't smoke, those muscles are less likely to collapse at night and narrow the airways.
* Raising the head of your bed 4 in. (10 cm) to 6 in. (15 cm) by putting bricks under the legs of the bed. Using pillows to raise your head and upper body will not work.
* Promptly treating breathing problems, such as a stuffy nose caused by a cold or allergies.
All people who have sleep apnea should make these lifestyle changes. They may be all that is needed to relieve mild sleep apnea.
Some people use nasal strips, which widen the nostrils and improve air flow. Although these strips may decrease snoring, they cannot treat sleep apnea.
First medical treatment
Continuous positive airway pressure (CPAP) is nearly always the first medical treatment for sleep apnea.
* In CPAP, you use a breathing device that prevents your airways from closing during sleep.
* CPAP is the preferred treatment for moderate or severe sleep apnea.
* It may take time for you to be at ease when you use CPAP. You may find that you want to take the mask off, or you may find it difficult to sleep while using it. If you cannot get used to it, talk to your doctor. You might be able to try another type of mask or make other adjustments.
Other medical treatment includes:
* Devices that are similar to CPAP. These devices automatically adjust air pressure or use different air pressures when you breathe in or out. They are easier and more comfortable for some people to use.
* Oral breathing devices. These devices reposition your tongue and jaw during sleep, which opens up your airways.
Surgery might be the first treatment when a blockage can be fixed easily, such as when you have overly large tonsils.
Ongoing treatment
Ongoing treatment for obstructive sleep apnea (OSA) includes using continuous positive airway pressure (CPAP) or an oral breathing device and making changes in your lifestyle. Lifestyle changes include losing weight (if needed), improving sleep habits (such as going to bed at the same time every night and sleeping on your side), avoiding the use of alcohol and certain medicines (especially sleeping pills and sedatives) before bed, and stopping smoking.
If CPAP is not working, you may need another sleep study to find out whether your CPAP machine needs to be adjusted. You may also need to think about surgery. Surgical choices include:
* Uvulopalatopharyngoplasty, which removes excess tissue in the throat to make the airway wider. It is the most common surgery to treat sleep apnea in adults.
* Tonsillectomy and/or adenoidectomy, which removes the tonsils and/or the adenoids. It may be used if you have enlarged tonsils and adenoids that are blocking your airway during sleep. This is often the first treatment option for children because enlarged tonsils and adenoids are usually the cause of their sleep apnea.
* Other surgical procedures, which are used to repair bone and tissue problems in the mouth and throat.
Should I have surgery to treat obstructive sleep apnea?
Treatment if the condition gets worse
If your obstructive sleep apnea (OSA) gets worse, talk to your doctor. You may need another complete sleep study, and you may need to adjust your continuous positive airway pressure (CPAP) machine. You may also need treatment for problems that sleep apnea may cause, such as high blood pressure.
In some cases, you may need surgery. Surgical options include:
* Uvulopalatopharyngoplasty, which removes excess tissue in the throat to make the airway wider. It is the most common surgery to treat sleep apnea in adults.
* Tonsillectomy and/or adenoidectomy, which removes the tonsils and/or the adenoids. It may be used if you have enlarged tonsils and adenoids that are blocking your airway during sleep. This is often the first treatment option for children because enlarged tonsils and adenoids are usually the cause of their sleep apnea.
* Other surgical procedures, which are used to repair bone and tissue problems in the mouth and throat.
* Tracheostomy, which creates a hole in the windpipe (trachea). A tube is then put in the hole to bring air in. Doctors rarely use this surgery because it may cause other health problems. However, when other techniques have failed, almost all people who are treated with tracheostomy will be cured of their sleep apnea.
Should I have surgery to treat obstructive sleep apnea?
What To Think About
Research shows that continuous positive airway pressure (CPAP) decreases daytime sleepiness, especially in people who have moderate to severe sleep apnea. 6, 4 However, CPAP may not work as well for people who have mild sleep apnea. 4
If you use CPAP to treat sleep apnea, you need to use it every night. If you do not use it, your symptoms will return right away.
Laser-assisted uvulopalatoplasty may be used to treat snoring. It is sometimes used to treat mild to moderate sleep apnea, though it does not benefit all people. This surgery is not approved by the American Academy of Sleep Medicine to treat sleep apnea. 7
