Continuous positive airway pressure (CPAP)
The best treatment for Obstructive Sleep Apnoea is considered to be Continuous Positive Airway Pressure therapy (CPAP). A small air pump blows air through a mask which is worn over your nose or nose and mouth. The mask then directs this pressurised air through your airways, helping to hold them open. This prevents full or partial airway closures and enables you to gain good quality sleep. You can read more about CPAP in our CPAP guide.
Weight loss
If you are overweight or obese, weight loss is a natural and effective way of reducing the severity of Obstructive Sleep Apnoea. It can help by making your treatment less intrusive. Sometimes it may even mean you no longer require treatment. The best way to lose weight is by reducing your portion sizes and becoming more physically active. For more information on weight loss, please visit our Weight loss guide.
Smoking cessation
Giving up smoking is a positive lifestyle change that can reduce the impact of Obstructive Sleep Apnoea. It can increase the ability of your airways to clear mucus and debris, making them less narrow. It will also halt the development of irreversible airway and lung disease that can make sleep apnoea harder to treat.
Alcohol avoidance
Alcohol avoidance can reduce the impact of Obstructive Sleep Apnoea. Whilst alcohol may help you to fall asleep, its effects are often short-lived. After a couple of hours, sleep becomes fragmented as the intoxication wears off. Combined with frequent arousals from Obstructive Sleep Apnoea, this can cause you to wake up feeling like you have not slept at all. It is best to avoid alcohol for at least a few hours before bed.
Positional therapy
If you experience Obstructive Sleep Apnoea only when lying on your back, you have what is called ‘positional’ sleep apnoea. When you lie on your front or side your apnoeas cease. Positional Therapy aims to prevent you from lying on your back in the first place. It can involve wearing:
- A device worn on the back of the neck that vibrates when you roll onto your back which will discourage lying in that position (for example the Night Shift device)
- A backpack that makes lying on your back uncomfortable.
Mandibular advancement device
This type of device is worn in the mouth over your upper and lower jaws like a brace. It is designed to pull your lower jaw forward, opening your airways and making them less able to collapse. The device can be used to treat mild to moderate Obstructive Sleep Apnoea, providing you have at least ten teeth on both your lower and upper jaw. It should only be made and fitted by a trained orthodontist – the generic devices you can buy online are not usually as effective.
Tongue retainer
This type of device is worn in the mouth. It sucks the tongue forward into a small chamber worn at the front of the mouth to stop the tongue from moving back into the throat and narrowing the airways. This device is not quite as effective as the Mandibular Advancement Device and is mainly used when a person has positional sleep apnoea when lying on their back.
Surgery
There are three main types of surgery for Obstructive Sleep Apnoea:
- Upper Airway Surgery – Removes blockages and opens your airways. Success rates vary and side effects include bleeding, pain and difficulty swallowing.
- Skeletal Facial Correction – Repositions your jaw and opens your airways, making them less likely to collapse. In a select number of people this type of surgery can be successful.
- Tracheostomy – A small breathing hole is made through your neck into your windpipe. Usually a small tube is inserted into the hole to keep it open. This is used to treat severe Obstructive Sleep Apnoea when you are extremely obese and other treatments have failed.
Nerve stimulation
A small device can be implanted into your upper body that sends a pulse of electric current to your tongue as you breathe. This causes the muscles of the tongue to contract to prevent it from moving back into the throat and narrowing the airways. The device can be switched on before bed and turned off in the morning using a remote control. It can be used to treat moderate to severe Obstructive Sleep Apnoea where CPAP has failed. It is currently available in certain US States.
Bilevel positive airway pressure (BiPAP)
A BiPAP machine uses air pressure to help you breathe. BiPAP delivers a high pressure of air when you breathe in and a low pressure of air when you breathe out, assisting your natural breathing patterns. It is usually used to treat other conditions such as Central Sleep Apnoea, but can be used to treat Obstructive Sleep Apnoea if CPAP is unsuccessful.
Provent
A sticky pad containing a valve is placed over each nostril. When you inhale the valves open, allowing a free flow of air. When you exhale the valves close, forcing you to breathe out through smaller air channels. This creates resistance and raises the pressure in your airways which helps hold them open. While Provent therapy is not effective for everyone, it can be used to treat certain patients with mild to moderate sleep apnoea and those who cannot tolerate CPAP.
Oral Pressure Therapy (Winx)
The equipment consists of a vacuum pump which is connected to a mouthpiece. When the equipment is worn, the pump creates a mild vacuum within the mouth which pulls the soft palate forwards and stabilises the tongue. This discourages the soft palate and tongue from moving back into the throat and narrowing the airways. Winx therapy is not effective for everyone but can be used if other treatments have been unsuccessful.
