Treatment
Mild Sleep Apnoea
While the best treatment for OSA depends on the severity of the condition, a number of lifestyle changes have proven to improve symptoms of OSA. Such changes include:
• Losing weight if BMI > 35
• Reducing alcohol consumption, especially 4-6 hours before bed
• Decreasing sedative ustilisation
• Smoking cessation.
• Sleeping on your side or in a semi-propped position.
Lifestyle Modifications
Mandibular Advancement Devices
Provent Therapy
The mandible is the lower jaw. There are devices that you can wear inside your mouth when you sleep. They work by pulling the mandible forward a little so that your throat may not narrow as much in the night. These devices look a bit like gum shields that sports-people wear. Although you can buy these devices without a prescription, it is best to get one properly fitted by a dentist if one is recommended. These devices can work well in some cases. They tend to be used in mild OSA or in people who are unable to tolerate CPAP treatment. However, the evidence to support their effectiveness is very limited.
Provent Therapy (Nasal EPEP), is another proven treatment for OSA. The treatment utilises nasal expiratory positive airway pressure in order to treat individuals who suffer from OSA who has rejected or are non-compliant with the CPAP treatment.
Moderate Sleep Apnoea
Continuous Positive Airway Pressure - CPAP
This is the most effective treatment for moderate or severe OSA. It may be used to treat mild OSA if other treatments are not successful. This treatment involves wearing a mask when you sleep. A quiet electrical pump is connected to the mask to pump room air into your nose at a slight pressure.
The slightly increased air pressure keeps the throat open when you are breathing at night and so prevents the blockage of airflow. The improvement with this treatment is often very good, if not dramatic.
If CPAP works, (as it does in most cases) then there is an immediate improvement in sleep. Also, there is an improvement in daytime well-being, as daytime sleepiness is abolished the next day. Snoring is also reduced or stopped.
The device may be cumbersome to wear at night, but the benefits are usually well worth it. Comments like “I haven’t slept as well for years” have been reported from some people after starting treatment with CPAP.
Lifelong treatment is needed. Sometimes you can have problems with throat irritation or dryness or bleeding inside your nose. However, newer CPAP machines tend to have a humidifier fitted which helps to reduce these problems.
Severe Sleep Apnoea
Continuous Positive Airway Pressure - CPAP
This is the most effective treatment for Moderate or Severe OSA. CPAP Therapy is the Gold Standard for Sleep Apnoea treatment because it delivers pressurised air into the upper airway to relieve obstruction during sleep.
Surgery
Surgery is not often used to treat OSA in adults. However, sometimes an operation may be helpful to increase the airflow into your airway. For example, if you have large tonsils or adenoids, it may help if these are removed. This is more commonly done in children with OSA. If you have any nasal blockages, an operation may help to clear the blockage.