If you have been diagnosed with sleep apnea, the first treatment option offered will likely be continuous positive airway pressure (CPAP), but what if you need alternative treatments for your sleep apnea? There can be major hurdles to tolerating CPAP, and if you can’t overcome these, you aren't totally out of luck. There are a handful of other treatment options that might offer relief.
Being overweight or obese is often a major contributor to having sleep apnea. If this is the case, shedding a few pounds (10% of body weight) may correct the situation. Extra weight can narrow your airway or make it more prone to collapse. If this is the case, diet and exercise may be all the treatment that you need. Unfortunately, many people have multiple contributions to having sleep apnea, and maintaining your ideal body weight may not be a complete fix for everyone.
You may be someone who snores or has more sleep apnea when you sleep on your back. If this is the case, you may find that sleeping on your side is the solution. This may be accomplished by propping your body with a pile of pillows. Another solution is to sew a tennis ball into the back of a t-shirt. Wearing this to bed will keep you from shifting to your back while you are asleep. Some people have decreased apnea if they have the head of their bed slightly elevated. This can be accomplished by using a sleep wedge, which is a ramp of foam that is highest at the head of the bed. In some cases, an adjustable bed can be used to raise the head enough to eliminate apnea.
There are specially designed oral appliances that may be helpful in correcting anatomical problems. If you have a short or recessed jaw, a mandibular advancement device may move things into better position. It is typically specially fitted at a dentist’s office. It is worn at night and it can successfully treat sleep apnea for some people.
The use of sedatives and alcohol can relax the muscles of your upper airway and make it more prone to collapse. Avoiding these agents in the hours before bedtime may improve your symptoms of sleep apnea and snoring. You may also need to be careful about the use of prescription medication such as sleeping pills and narcotic pain medications.
There are multiple surgical options that may be deployed. The most common is called uvulopalatopharyngoplasty (UPPP). UPPP is the surgical removal of excess tissue in the upper airway, including the back of the mouth and the throat. Other options include tracheostomy, which is a surgical incision at the front of the windpipe, as well as removal of the tonsils and adenoids or even surgical advancement of the jaw. Tonsillectomy may be the first treatment choice in children, but surgical options are otherwise typically a second-line therapy in adults.
Mowzoon, N et al. “Neurology of Sleep Disorders.” Neurology Board Review: An Illustrated Guide. 2007; 726.