Sleep Apnea Treatment

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If a sleep study shows that you have sleep apnea, your healthcare provider may talk to you about making lifelong heart-healthy lifestyle changes. You may also benefit from a breathing or oral device, or possibly other interventions to help keep your airways open while you sleep.

To help treat your sleep apnea, healthy lifestyle changes can be very effective. These include getting regular physical activity, maintaining healthy sleeping habits and a healthy weight, limiting alcohol and caffeine intake, and quitting smoking. Your provider may also recommend that you sleep on your side — not on your back — as this can help keep your airway open while you sleep.

A breathing device, such as a continuous positive airway pressure (CPAP) machine, is the most common treatment for sleep apnea. A CPAP machine provides constant air pressure throughout your upper airways to keep them open and help you breathe while you sleep.

Such breathing devices often work best when they are paired with healthy lifestyle changes. Side effects of CPAP treatment may include:

• Congestion
• Dry eyes
• Dry mouth
• Nosebleeds
• Runny nose

If you experience stomach discomfort or bloating, you should stop using your CPAP machine and contact your healthcare provider.

Depending on the type of sleep apnea you have, you may need another type of breathing device, such as an auto-adjusting positive airway pressure (APAP) machine or a bilevel positive airway pressure (BPAP) machine. It’s recommended that you discuss the most appropriate breathing device for you with your healthcare provider.

Living With Sleep Apnea has information about how to take care of your breathing device.

If you have sleep apnea, your provider may prescribe an oral device if you do not want to use or cannot tolerate CPAP. You may be referred to a dentist who custom-fits a device to your mouth so that it is comfortable and teaches you how to use it for best results.

Oral devices (also called oral appliances) are devices placed in the mouth to prevent blocked airways while you are asleep.

Two types of oral devices work differently to open the upper airway while you sleep.

• Mandibular repositioning mouthpieces are devices that cover the upper and lower teeth and hold the lower jaw in a position that prevents it from sliding backward and blocking the upper airway.
• Tongue-retaining devices are mouthpieces that hold the tongue in a forward position to prevent it from blocking the upper airway.

There are other devices that combine these features and/or use electrical stimulation to keep your upper airways open during sleep.

• Neuromuscular electrical stimulation (NMES) devices are removable devices that stimulate and tone the tongue and upper airway muscles to prevent them from collapsing and blocking the airway during sleep.

The U.S. Food and Drug Administration (FDA) has approved an NMES oral device for use while awake. The device delivers electrical muscle stimulation through a removable mouthpiece that sits around the tongue. You wear the mouthpiece once a day for 20 minutes at a time, for six weeks. This device is approved for people with mild obstructive sleep apnea.

The FDA has approved a device that can be surgically implanted in the mouth and upper chest region. The device uses hypoglossal nerve stimulation to activate specific nerves in the throat to keep the airways open during sleep.

Exercises for your mouth and facial muscles, called orofacial therapy, may also be an effective treatment for sleep apnea in children and adults. This therapy helps to strengthen and reposition the tongue and muscles that control your lips, tongue, upper airway, and face.

There are other surgical options available for sleep apnea. They include:

• Adenotonsillectomy to remove your tonsils and adenoids
• Surgery to remove some tissue from your mouth and throat, to help make your upper airway bigger
• Upper or lower jaw advancement to move your upper jaw (maxilla) and lower jaw (mandible) forward, to help make your upper airway bigger