Obstructive sleep apnea (OSA) is a condition which interrupts your natural sleep cycles due to an obstruction in your airway. While many people see snoring as the worst side-effect of sleep apnea, it actually has long-term consequences on your health.
Sleep apnea is very common – it’s estimated that one in four adults are at risk. Even more alarming is 85 percent or more of those with sleep apnea symptoms are believed to be undiagnosed. Those that are diagnosed have an important decision to make: what treatment option should they choose?
Each option for sleep apnea treatment has its own advantages and disadvantages. Learn more about your choices to help you make an education decision when you discuss them with your medical health professional.
CPAP – (Continuous Positive Airway Pressure)
Even if you’re not familiar with obstructive sleep apnea, you may have heard of a CPAP machine. They are the most commonly used treatment for mild to severe OSA.
A CPAP device consists of two key parts: a mask and a pump. The mask is placed over your face or nose and the pump pushes air through your nostrils. This increased pressure opens the airway to prevent obstruction and allows the wearer to breathe.
>> Read More: Why Is Sleep Apnea So Under-diagnosed In Women
Advantages of CPAP
The biggest advantage that CPAP machines have in treating sleep apnea is how effective they are. Even in cases of severe obstructive sleep apnea, CPAP machines are proven to open the airways and prevent interrupted breathing.
Results from using a CPAP typically begin to show very quickly. Many see daytime fatigue and decreased attention spans fade away quickly with continuous CPAP use.
Disadvantages of CPAP
While they are effective, CPAP machines are considered far from comfortable. The mask can cause discomfort and sometimes lead to issues with dryness in both the nasal or oral passages.
The CPAP machine also requires being used every night. Many patients using CPAP machines choose not to use the device, which impacts their treatment. Likewise, travel can be difficult as the patient will need to bring their CPAP with them.
Another option to help clear the airway for proper breathing is through the use of an oral appliance. These appliances appear similar to mouth guards and are much simpler to use than a CPAP machine. They’re worn during sleep and position the patient’s mouth and jaw to maintain an open airway.
Oral appliances are available in both over-the-counter and custom-fit options. While the over-the-counter options are cheaper, they won’t be designed specifically for your needs. In many cases, they’re good to decrease snoring, but aren’t effective for clearing your airways and treating the sleep apnea completely.
Custom-fit oral appliances affect a variety of aspects of your mouth during sleep, including:
- Positioning and stability of your tongue
- Positioning and stability of your lower jaw
- Positioning of your soft palate
- Positioning of your uvula
In addition to offering better treatment, custom-fit appliances will fit better and be more comfortable. As many patients that use oral appliances do so because they find CPAP masks difficult to wear, the comfort of an oral appliance is likely a key factor in choosing an oral appliance!
Advantages of oral appliances
Comfort is one of the most significant advantages of oral appliances. Particularly when compared to CPAP masks, patients can become acclimated to wearing these devices in just a few weeks. Custom-fit appliances are even more comfortable.
Travelling with an oral appliance is easier than with a CPAP machine by leaps and bounds. The small mouthpiece can fit inside of a case to be packed away with your luggage, whereas a CPAP machine needs extra precautions and preparation, especially when flying.
Disadvantages of oral appliances
Not unlike a CPAP machine, the appliance itself can be cumbersome when initially used. Sleeping with a large device in your mouth isn’t always comfortable – though as mentioned above, most wearers will acclimate over time.
Oral devices can also cause either excessive saliva production or a harsh dryness in the mouth. Increased saliva production sometimes leads to drool dripping back into the throat, as the device blocks it from escaping the mouth. This can cause the person to choke and wake up. Dry mouth, of course, is rather uncomfortable.
The last major drawback of an oral appliance is initial jaw pain. The joints and muscles in the mouth can become fatigued from being forcibly repositioned throughout the night. Like general discomfort, your mouth eventually adapts and this pain goes away.
>> Read More: CPAP Alternatives for Sleep Apnea
Surgical treatment options for sleep apnea
If CPAPs or appliances don’t fit a patient’s needs, there are some surgical options available. There are a variety of different surgeries that can treat airway obstruction. Here are some of the most common:
Nasal Surgery – Options like a septoplasty or turbinate reduction are designed to correct your nasal passages. They open your airways by straightening a deviated septum or reducing curved structures in your nose.
Genioglossus Advancement – The genioglossus is a major muscle in your tongue that handles the movement associated with “sticking out” your tongue. A genioglossus advancement shifts the anchor point of this muscle forward. This can help your tongue relax during sleep, which may otherwise be obstructing your airways.
Maxillomandibular Advancement – Jaw abnormalities are common in those suffering from sleep apnea. Maxillomandibular advancement is a surgery that repositions the upper and lower jaws forward. This opens the airway and is currently considered the most effective solution for sleep apnea. However, its recovery time is significant, and it is usually recommended only after other solutions have failed to provide relief.
Advantages of sleep apnea surgery
The advantages of surgery depend on the specific surgery received. In general, they are designed to help correct the cause of your sleep apnea and relieve the symptoms. Along with treatment, the primary advantage of surgery is avoiding the need for external devices. Because CPAP machines and oral appliances only work when they’re being used, surgery can be a more convenient long-term option for many.
Disadvantages of sleep apnea surgery
Any consideration of surgery should always start by considering the risk. Even the most minor surgery can have complications. It is often recommended to try less severe treatments before opting for surgery.
Medical costs involved with surgery and post-surgical care can also be prohibitive. Depending on the surgery recommended, there may be a significant period of recovery that would be unnecessary if a CPAP machine or oral appliance would suffice.
How to minimize sleep apnea symptoms
Physicians, dentists and other specialists can help you treat sleep apnea, there are steps you can take outside of a doctor’s office:
Obesity is a common factor in sleep apnea patients. A higher BMI increases your risk for sleep apnea significantly. Studies have shown that neck size is a reliable predictor for sleep apnea, with larger sizes increasing your risk. Achieving a healthy weight can reduce or treat OSA entirely.
Cut down on alcohol
While OSA is typically a chronic issue, those that drink alcohol before bed can experience episodes of obstruction even if they otherwise do not. For those that do have sleep apnea, alcohol can increase the severity – causing an even greater impact on your ability to gain a restful night’s sleep. Avoid alcohol before going to bed.
In some cases, sleep apnea symptoms can be avoided by sleeping on the side. Supine sleeping, or sleeping on the back, has been shown to increase obstruction. While those with severe sleep apnea might not find any relief regardless of position, side-sleeping can be beneficial for those with mild cases.
This is a guest post from Pointe Dental Group located near Detroit, offering general dentistry, cosmetic dentistry, periodontics, and sleep medicine in Grosse Pointe Farms and Shelby Township, Michigan