How is sleep apnea treated, and is there a cure?
There are many approaches to treating sleep apnea, depending on the specific type of sleep apnea and how severe it is. While none of these is a cure, they can help prevent apnea events or reduce how often they happen or how severe they are.
Many treatments should be a part of your daily (or nightly) routine. That can ultimately reduce or even eliminate sleep apnea’s effects on your life for as long as you use these treatments.
Possible treatments include:
- Conservative (nonmedical) treatments.
- Positive airway pressure and adaptive ventilation devices.
- Oral appliances (mouthpieces).
- Nerve stimulators.
- Surgery.
- Medications (central sleep apnea only).
Conservative treatments
These nonmedical treatments or approaches can typically improve obstructive sleep apnea or resolve it. They aren’t cures, but they can reduce apnea to the point where it stops happening or isn’t severe enough to cause symptoms. These include:
- Weight loss. A 10% decrease in body weight can significantly improve sleep apnea for people who have excess weight or obesity.
- Position changes while sleeping and sleep aid items. Sleeping on your back makes sleep apnea more likely to happen. Special support pillows and similar items can help change the position in which you sleep, keeping you off your back so soft tissue doesn’t press on your windpipe and block breathing.
- Nasal sprays, adhesive strips, etc.These over-the-counter products improve breathing by making it easier for air to travel through your nose. While they can’t help moderate or severe sleep apnea, they can sometimes help snoring and mild sleep apnea.
- Treating the underlying condition.Treating conditions such as heart failure can often improve central sleep apnea.
- Medication changes.Working with your doctor to decrease or stop opioid pain medications may be able to improve or even resolve central sleep apnea.
Positive airway pressure (PAP) and adaptive ventilation
Positive airway pressure is a method that uses a specialized device to increase the air pressure inside of your airway while you inhale. This method can treat obstructive, central and mixed sleep apneas.
Pushing pressurized air down your windpipe keeps it open so you can breathe. These devices push air through a hose that attaches to a special mask you wear on your face while you sleep. Masks can cover your nose, mouth or both, and there are many different types and styles to choose from.
The best-known PAP device is the Continuous Positive Airway Pressure (CPAP) machine. However, there are other types of PAP machines, too (see our CPAP Machine article for more about the different types of devices, including adaptive servo-ventilation devices). These devices increase the air pressure inside of your airway and lungs when you inhale, keeping surrounding tissue from pressing your airway shut.
Oral devices
Obstructive sleep apnea happens when soft tissue in your head or neck, especially around your mouth and jaw, press downward on your windpipe. Special mouthpiece devices can help hold your jaw and tongue in a position that keeps pressure off your windpipe. Dentists and sleep medicine specialists often work together to make these for people who need them.
Nerve stimulators
The hypoglossal nerve (the name comes from Greek and means “under the tongue”) is what controls your tongue’s movements. A nerve stimulator attached to this nerve can stimulate it, pushing your tongue slightly forward when you breathe while you’re sleeping. That keeps your tongue from relaxing and pressing backward on your windpipe while you sleep, which is one of the ways that obstructive sleep apnea happens.
An electrode attaches to the nerve under your jaw and connects to a device implanted under the skin in your chest. You can turn the stimulator on before you sleep and turn it off after you wake up. The electrical current is strong enough to keep your tongue from relaxing too much, but mild enough that it’s not uncomfortable.
A similar kind of nerve stimulation is also possible with central sleep apnea. This type of stimulation affects the phrenic nerves. This pair of nerves connect your spinal cord to the diaphragm, a layer of muscle underneath your lungs that controls your ability to inhale and exhale. Stimulating the phrenic nerve causes those muscles to flex, helping you breathe.
Surgery
Surgeries on your nose, mouth and throat can help prevent blockages of your nose, throat and windpipe. However, the impact of these in adults is usually limited and varies from person to person. These surgeries include:
- Somnoplasty. This procedure uses radiofrequency (RF) to reduce soft tissue around the upper parts of your windpipe.
- Tonsillectomy/adenoidectomy. Removing your tonsils and adenoids can widen the opening where your mouth, throat and nasal passages connect. That makes it easier for air to pass through and reduces soft tissue that can block your breathing. This procedure is most helpful for children with obstructive sleep apnea.
- Uvulopalatopharyngoplasty (UPPP). This procedure removes your uvula (the teardrop-shaped soft tissue that hangs at the back of your mouth). It also removes soft tissue from your soft palate and pharynx. These widen the area where your mouth and throat meet, making it easier for air to pass through.
- Jaw surgery. Different surgery procedures can subtly change the position of your jaw so soft tissue can’t easily press back on your airway. These procedures are especially helpful for people who have sleep apnea for structural reasons like micrognathia.
- Nasal surgery. One common form of nasal surgery is septoplasty, which straightens the soft tissue in your nose, making it easier for air to travel through your nose and nasal passages.
Medications for central sleep apnea
In addition to positive airway pressure, adaptive ventilation and phrenic nerve stimulators, there are some medications that may help central sleep apnea. Some examples of these medications include hypnotic (sleep-promoting) medications, respiratory-stimulating drugs and more. However, none of these medications are formally approved or definitively accepted for this use.
What can or can’t I eat or drink with sleep apnea?
People who have sleep apnea should avoid heavy drinking, and frequent use of sleeping pills or other drugs (recreational and otherwise) that cause heavy sedation. These can make sleep apnea worse. Your healthcare provider can talk to you about drugs that can cause that and how you can avoid the effects.
Complications/side effects of the treatment
The complications and side effects of the treatments depend on many factors, especially the treatments themselves. Your healthcare provider is the best source of information for what you can do to minimize the side effects or prevent them when possible.
How to take care of myself/manage symptoms?
Sleep apnea is a condition that can severely disrupt your life and put you at risk for life-threatening complications and events (see more about these under the Outlook/Prognosis section below). Because of this, you shouldn’t try to self-diagnose or self-treat it. If you think you have sleep apnea, you should schedule an appointment with a sleep specialist or ask a primary care provider to refer you to a sleep specialist.
How you can help with diagnosis
If you suspect you or a loved one has sleep apnea, you might be able to help a healthcare provider diagnose it. Video and audio recordings of a person sleeping, especially where the provider can hear breathing, can give a provider key evidence they need to speed up the diagnostic process.
How soon after treatment will I feel better?
The time it takes to recover or feel better after treatment for sleep apnea depends on the treatments themselves. Some people will feel better almost immediately, while others may need three to six months of consistent nightly treatment to see the full benefits. Your healthcare provider can tell you more about the timeline for your recovery and when you should expect to feel better.
Devices that treat sleep apnea, especially positive airway pressure devices, often bring very fast results. Older devices may take some tweaking and adjusting (a process known as “titration”) of the settings, but many newer devices can often adjust automatically to meet your needs (especially if your sleep apnea is mild or on the low end of moderate).
While some people may need to get used to wearing a mask to sleep, most people can overcome that fairly quickly. Many people see improvements immediately when they sleep through the night using a positive airway pressure device.