Other Treatments

Other or complimentary therapies for sleep apnea include:

Weight Loss

There is a proven correlation between obesity/overweight and sleep apnea. However one condition does not absolutely predict the other. Many patients who are overweight do not have sleep apnea. Conversely, thin patients who have severe cases of sleep apnea.

Maintaining the proper weight for ones height and frame clearly contributes to good health. Although the loss of unwanted weight does not always have a positive effect on sleep apnea, it’s often helpful.

Positional Therapy

Positional therapy makes use of various cushions, foam wedges, and specially designed sleepwear to encourage sleeping on ones side not back. Sleep apnea is often more severe when sleeping on ones back. Although positional therapy may be useful as a compliment to other treatments, it is rarely if ever recommended as a stand alone treatment for sleep apnea. It should also be noted that some patients have equally severe apneic events whether they sleep on their side or back.

Breathe-Rite Strips and Nasal Decongestants

These remedies may be marginally helpful but are only recommended in conjunction with a primary therapy such as surgery, C-PAP or oral appliance therapy.

Over-the-Counter Dental Appliances

Over-the-counter dental appliances are mostly ineffective and can be injurious to your teeth and bite. Most of these devices require boiling in hot water and are self fitting. The result is generally an ill fitting device that may not impact sleep apnea in any significantly positive way. Side effects can and often do include negative jaw stress and misalignment (temporal-mandibular joint – TMJ) as well as the shifting of the teeth and bite.

Medications and Sleeping Pills

Sleep apnea has traumatically negative impacts on getting and staying asleep not to mention the quality of sleep. This causes many who suffer from it to rely on sleeping pills, alcohol, histamines and Benadryl for relief. Sleep medications primarily focus on treating the symptoms of sleep apnea and not the disorder itself. Medications designed to promote sleep should only be taken in consultation with your physician.

Important Caution:

Medications to promote sleep have serious implications. Sleep apnea occurs during deep and REM sleep. That is the time when the muscles of the tongue and jaws are most relaxed. This state of relaxation promotes the apnea events that deny the body oxygen. Any medication that relaxes the muscles more will cause the sleep apnea to become worse.

A Pillow Firmly Placed over the Mouth and Nose of Your Bed Partner 

Not recommended.

All treatments to treat sleep apnea or to compliment another course of sleep apnea treatment should be undertaken in consultation with your physician.

A Few of the Reasons Why Patient’s Fail with C-PAP Therapy

• Inability to tolerate the mask
• Feelings of claustrophobia
• Movement in bed constricted (by the tube)
• Cannot sleep on the back (required by the therapy)
• Discomfort from flow of pressurized air
• Sinus issues
• Digestive issues
• Sense of bloating from pressurized air
• Beards that prevent the mask from sealing on the face
• The noise of the machine
• The unattractive appearance of the mask and tubing

“Although it has taken some time to adjust to the oral appliance it is 110% better than using the CPAP machine.”

– Catherine Perkins

How C-PAP Works: A Simple Explanation

C-PAP therapy involves a machine the blows air, under pressure, through a tube into a mask that is strapped to your face. It works like a vacuum cleaner in reverse. The objective of C-PAP therapy is to blow pressurized air into your mouth and/or nose to prevent an obstruction of the airway. The amount of air pressure required is determined by a sleep technician during an in lab sleep study. Once set, pressure levels cannot be adjusted by the patient. With the air way open, the CPAP user can breathe properly during sleep keeping blood oxygen levels at high, healthy levels. The result is a good and healthy night’s sleep.

Recent Enhancements in CPAP

Advances have been made in CPAP technology. Bi-PAP (Bi-Level PAP) is a device that self-adjusts while you sleep, lowering the pressure to a specific pressure as you breathe out and increasing the pressure to a specified level as you breathe in. Many patients find Bi-PAP more tolerable than traditional C-PAP.

A third type of PAP therapy is Auto-PAP. This machine not only adjusts for the inspiration and expiration, but can alter the pressure of air relative to the severity of the apnea event as each episode occurs.

Important Note: While refinements in CPAP technology have made the therapy more tolerable for some, the basic issues of toleration and comfort persists. In the final analysis, CPAP is a great therapy option for some and a total failure for others.

“I have had a really great experience with my oral appliance. There is no question that I’m waking up less times during the night and achieving more/better sleep… My wife also tells me that I never snore when wearing the device… To say I find it more comfortable then the C-PAP would be a huge understatement.”

– Kevin Halligan

Is C-PAP Therapy For You?

Most physicians will recommend C-PAP based on it being widely recognized as a “gold standard” of care.

Prescribing C-PAP make sense in many, even most cases. Prescribing C-PAP should not however be an automatic decision. Your personal sleep habits and circumstances need to be considered by your doctor. For instance, if you have great difficulty falling asleep and are highly sensitive to the slightest noise when trying to sleep, you might think twice about the suitability of C-PAP. If you simply can’t sleep on your back, this should give you reason to question if C-PAP will be workable. If constant travel is part of your life style, C-PAP may prove difficult or impractical.

It’s important to recognize that if you have serious concerns about C-PAP or have failed to remain compliant with C-PAP you have very effective alternative treatment options. One of the most common alternative and successful alternative treatments is oral appliance therapy.

The Exhausted Caveman: A Sleep Fable

Imagine a caveman who climbs into his cave bed after a hard day of dinosaur hunting. He falls asleep quickly. He has a nightmare about a saber tooth tiger chasing him and his blood stream is filled with cortisol and adrenaline. His heart rate accelerates dramatically. His blood metabolism changes for the worse and he awakens for an instant only to fall back to sleep. Imagine that this same saber tooth tiger dream occurs another hundred and fifty times that night and every night with the same physiological results.

The morale of the story:

If a real saber tooth tiger doesn’t kill the caveman, the one that keeps chasing him out of a good night’s might!

Question?

Are you living like the exhausted caveman? Is sleep apnea your saber tooth tiger?

You can think of surgery for sleep apnea in four categories:

For the Nose:

Surgeries for the nose focus on correcting deviated septum’s, widening the nasal passages, and removing growths or polyps.

For the Mouth and Oral Cavity:

Surgeries for the mouth and oral cavity focus on removing tonsils and adenoids, the soft palate (and uvula) or reducing the size of the back of the tongue.

Mandibular – Maxillary Advancement:

This surgical procedure moves sections of the upper and lower jaw forward to pull the tongue forward and open the airway space. This procedure tends to be highly effective but is only employed in severe cases of sleep patients when most other treatment options have failed.

Other Surgeries

Other surgical options include Hypoglossal Nerve Stimulation and Hyoid Bone Suspension. These procedures are rarely performed and are only employed for certain types of sleep apnea.

Surgical options should be carefully assessed with your physician. Surgery has a role to play in treating sleep related illness. It should not however be viewed as inherently superior or more effective than other treatment modalities.