There are several options currently available to treat OSA, and each patient’s circumstances are unique. Dr. Patel offers a range of treatment options intended to improve sleep quality and daytime function, as well as reduce the risk of health problems associated with OSA. Dr. Patel is committed to working with each patient to choose the best possible option that meets their needs.
Surgical procedures, including laser surgery, may be used to treat OSA. Our in depth evaluation will identify possible surgical options that best fits your needs. Sometimes more than one procedure may be required along with other treatments in addition to the surgery. Dr. Patel can discuss these treatment options with you. Not all OSA sufferers will be good candidates for surgical treatment of their condition.
About 70 percent of people with obstructive sleep apnea are overweight or obese. Their health care professionals usually encourage them to lose weight. The vast majority of OSA cases can be improved, if not eliminated, with significant weight loss. The amount of weight a patient needs to lose to achieve these benefits varies. Some may need only a modest reduction in weight to gain improvement, while others require significant weight loss. It may not be necessary to slim down to “ideal body weight” to achieve these benefits.
In some situations, a physician may wish to prescribe weight loss medications to an overweight or obese patient with OSA, although this is usually rare.
Positional therapy can be used to treat patients whose OSA is related to body positioning during sleep. Most people with sleep apnea have worse symptoms if they lie flat on their back during sleep. Most bed partners can attest to this from experience and often try to make their partner move onto their side during the night to stop their snoring.
There are several strategies which can help patients who have mild apnea only when lying on their back. One is to sew or attach a sock filled with tennis balls, length-wise down the back of their pajama top or nightshirt. This makes it uncomfortable for the sleeper to lie on their back, and they usually will move onto their side. Another technique is to use positional pillows to assist in sleeping on the side.
Positional therapy has its limits, but it has been tried with success in some patients.
Smoking, drinking excessive alcohol or caffeine, or using muscle relaxants or sleeping pills can all have an effect on the airway or the brain’s control of the airway muscles during sleep. In some cases of mild OSA, eliminating these lifestyle factors may be the only treatment needed. Even people who require additional OSA treatment can improve by making these changes. Talk to your doctor about ways to manage the lifestyle factors that may be playing a role in your OSA.
If you have mild to moderate OSA, your condition may improve with a custom-made dental device that is worn in the mouth during sleep. These devices are designed to adjust the tongue or lower jaw position to keep the airway open. Their effectiveness in treating OSA varies and their cost may not be covered by all health insurance plans. Dr. Patel can help you decide whether this would be a good option for you.
Although some medications have been used to treat OSA, sleep experts today generally agree that other treatments are safer and more effective for long-term treatment. OSA may actually be caused or worsened by certain medications. Make sure to talk to Dr. Patel about all prescription or over the counter medications you use.
CPAP is the most common, most effective form of OSA treatment. Thousands of people use it every time they sleep. CPAP stands for Continuous Positive Airway Pressure.
CPAP is a continuous stream of air directed into the airway during sleep that holds the airway open and prevents apnea. Oxygen levels, blood pressure, heart function and sleep patterns are stabilized, resulting in a more restful sleep. About 1/2 of all patients who use CPAP do so on a nightly basis for more than 4 hours. The advantages of CPAP are that it is very safe and completely reversible. Generally, it is quite well tolerated, although some patients will require an adjustment period to become used to it. The main disadvantage is that it requires active participation every night, patient compliance is necessary for it to work.
Mask fitting is an essential element of a patient’s success with positive airway pressure therapy since it affects compliance and effectiveness of treatment. Higher pressures can result in air leaks and patient discomfort. Demands on mask stability increase as pressure increases. Higher pressures may also require tighter fitting head gear to maintain an adequate seal contributing to the discomfort.
Complications associated with CPAP include contact dermatitis, skin breakdown, mouth leaks, nasal congestion, runny nose, dry eyes, nose bleeds (rare), tympanic membrane rupture (very rare), chest pain, difficulty exhaling, pneumothorax (very rare), smothering sensation, and excessive swallowing of air.
Nasal congestion often can be reduced or eliminated with nasal steroid sprays and humidification placed onto the machine. Runny nose can be eliminated with nasal steroid sprays or ipratroprium bromide nasal sprays. Nose bleeds are usually due to dry mucosa and can be combated with humidification. Dry eyes are usually caused by mask leaks and can be eliminated by changing to a better fitting mask.