How Is Sleep Apnea Treated?

Sleep apnea is a condition that affects your breathing when you sleep, causing your airway to collapse or narrow. As a result, your breathing stops and restarts several times throughout the night.

The most common type of treatment is wearing a special machine—called a CPAP machine—which helps keep your airways open. Other sleep apnea treatments include wearing special oral appliances, practicing positional therapy, or getting surgery. Sleep apnea treatments can help you sleep more soundly at night as well as reduce risks for complications, such as irregular heart rhythms.

Your primary care provider can assemble a care team, which may include a neurologist or sleep medicine expert, to help you manage your condition. While there is no outright cure for sleep apnea, the goal of treatment is to improve your sleep quality and overall health. 

Continuous Positive Airway Pressure (CPAP) Machine

The American Academy of Sleep Medicine Clinical Practice Guidelines suggest using positive airway pressure to treat adults with sleep apnea. The most common approach is wearing a continuous positive airway pressure (CPAP) mask. The mask is attached to a special hose and motor that delivers constant pressure to keep your airways from collapsing while you sleep.

To wear a CPAP mask, you must participate in an overnight sleep study so your care team can determine what the best pressure settings are for your CPAP mask. Wearing a CPAP mask when you have sleep apnea has been shown to reduce daytime sleepiness, lower blood pressure, and improve overall quality of life.

However, some CPAP users report difficulties wearing a CPAP mask, including:

• Problems tolerating the airway pressure
• Difficult wearing a mask when sleeping 
• Feeling claustrophobic when wearing a mask
• Nasal congestion and dry mouth from the dry air 

An alternative to a CPAP machine is automatic positive airway pressure (APAP). This approach is slightly different from CPAP and instead changes the pressure of the machine breath to breath instead of delivering a consistent pressure to your airways. If you are using a CPAP machine and are finding discomfort, you may want to talk to your care team about APAP. 

Positional Therapy 

Some people experience positional sleep apnea, meaning they have pauses in their breathing when they are lying flat on their back. If you have sleep apnea, you may find that sleeping on your side or stomach can help you reduce your symptoms.

You can try different methods to practice positional therapy. You might sew a pocket on the back of your shirt and place a tennis ball inside to train you to stop sleeping on your back—as this position can cause pain. You can also try using pillows or special body positioners to prevent yourself from rolling on your back.

Oral Appliances 

You may also try wearing mandibular repositioning devices—a type of oral appliance that you can mimic the feel of a retainer. These devices help bring your jaw and tongue forward and open up your airways. 

If you can’t wear a machine that provides positive airway pressure, wearing an oral appliance may help. Your care team will likely refer you to a dentist who specializes in making these appliances to create a device that fits your mouth.

However, oral appliances don’t usually work as well as positive airway pressure, especially if you have a more severe type of sleep apnea. They also may cause jaw pain.

Surgeries and Procedures 

Surgery is a rare, but possible treatment for sleep apnea. Different surgical approaches and goals exist to treat sleep apnea. These include:

• Uvulopalatopharyngoplasty (UPPP): This procedure involves removing a portion of the soft palate or excess tissue in the mouth. However, the procedure isn’t usually as effective as positive airway pressure and can cause more pain and discomfort after surgery. 
• Maxillomandibular advancement: This is a complex surgical procedure that involves making changes to your jaw to bring it forward to help reduce the narrowing of your airways. The procedure has a long recovery time (2 to 10 weeks) and may affect the cosmetic appearance of your face. 
• Hypoglossal nerve stimulation: Hypoglossal nerve stimulation involves implanting a special device that stimulates the hypoglossal nerve—a part of the nervous system that controls the tongue. However, the procedure can be costly and result in tongue discomfort and soreness. 
• Tracheostomy: A tracheostomy is a rare, but possible surgery to treat the most severe sleep apnea cases. The procedure involves placing an airway in the neck through the trachea so you no longer need to breathe through your mouth. However, the procedure can require long-term care and may affect your appearance, speech, and ability to eat. 
• Bariatric surgery: Bariatric surgery is weight-loss surgery that may restrict the size of the stomach. An estimated 75% of people who have sleep apnea and undergo bariatric surgery report an improvement in their sleep apnea symptoms. However, the surgery does not come without risks. You must also be willing to change your eating habits to support a smaller-sized stomach. 

Living With and Managing Sleep Apnea 

You may find that certain lifestyle changes improve your sleep apnea symptoms. Examples of these changes include:

• Reducing your alcohol intake 
• Avoiding sleeping on your back 
• Engaging in exercise most days a week for at least 30 minutes 
• Eating a diet full of lean meats, whole grains, fruits, and vegetables to promote maintaining a healthy weight and reduce inflammation in your airways and body

If you use treatments such as a CPAP mask or oral appliance, wearing them most nights while you sleep will also help you better manage your sleep apnea. Your healthcare provider can help you find a CPAP machine that is right for you or support you in figuring out alternatives if you have discomfort. 

A Quick Review 

The gold standard of treatment for sleep apnea is using a positive airway pressure machine (e.g., CPAP or APAP) to prevent your airways from closing. You might also try an oral appliance and positional therapy, if positive airway pressure treatment feels uncomfortable. 

In rare cases, surgeries and procedures can also help your condition. However, healthcare providers will recommend practice lifestyle changes along with other methods of treatment before recommending surgery.