Sleep apnea is a common sleep disorder affecting many people across the globe. Obstructive sleep apnea is the commonest type, affecting most people. Sleep apnea can have long term effects and hence must be cured. In this article, we will discuss the latest treatment for sleep apnea.
Treatment for Sleep Apnea
Sleep apnea can result in several complications affecting your health in many ways. While sleep deprivation can affect memory and cognition, it can also increase your risk of cardiovascular disorders, stroke, high blood pressure, metabolic disorders and inadequate oxygen supply to the tissues. Proper diagnosis and timely treatment for sleep apnea are necessary to prevent complications and reduce the risk of long term effects of sleep apnea.
Diagnosis not only helps to confirm obstructive sleep apnea but also determine the severity of it. Along with the evaluation of complaints, sleep studies enable experts to determine the severity of sleep apnea. It can be then classified into mild, moderate and severe categories, which can guide the protocol of treatment for sleep apnea.
Treatment for sleep apnea varies from person to person depending on the severity of the condition.
Lifestyle Modifications – For people with mild obstructive sleep apnea treatment options like positional therapy, weight loss and the oral appliance may be recommended.1 Changing sleep habits and adopting better sleep positions can help. As sleeping on the back can cause more snoring and worsen sleep apnea, it is best to sleep on the sides. This can improve your breathing and help maintain continuous sleep.2
Oral Appliances – For people with mild to moderate obstructive sleep apnea, dental appliances, oral appliances are recommended. Oral appliances help the proper movement of the tongue and the lower jaw to provide enough space in the airways, which facilitates proper breathing. These are effective in people who snore and do not respond well to other treatment options.
Surgery – Treatment for sleep apnea may involve surgery in some cases, where sleep apnea is related to facial abnormalities. The upper airway needs to be maintained for breathing, hence, surgery is decided based on the type of defect and the way it affects breathing during sleep and results in sleep apnea. Also, for people who are severely obese and do not respond to conventional measures for weight loss, bariatric surgery may be recommended.2
Continuous Positive Airway Pressure (CPAP) Therapy – Treatment for sleep apnea in moderate and severe cases require to focus on maintaining proper space in the upper airways to enable effective breathing. The most common treatment method is continuous positive airway pressure (CPAP) therapy. In this, the patient wears a mask that distributes pressurized air to the upper airways. This prevents the airways from getting obstructed during sleep and thus, the airways are maintained t facilitate proper breathing.
Oral Pressure Therapy (OPT) Therapy – Another way treatment for sleep apnea includes oral pressure therapy (OPT). In this, a mouthpiece is used, which connects to a small vacuum console with a tube. When the person sleeps, the vacuum helps reposition oral structures like the tongue and soft palate. This prevents them from falling and obstructing the airways, which facilitates proper breathing.
What is the Latest Treatment for Sleep Apnea?
Apart from the above-mentioned treatments for sleep apnea, there are certain advancements too.
Some latest treatment for sleep apnea include:
Improved CPAP Tolerability –CPAP treatment, which stabilizes the airways, is considered as the ‘gold standard’ treatment. But as it has some side effects, it is not well tolerated by patients. Hence, improving CPAP tolerability and adherence through patient interventions is also a part of the latest treatment for sleep apnea.3
Improved Mandibular Advancement Devices (MADs) – Appliances like mandibular advancement devices (MADs) are also considered useful as the latest treatment for sleep apnea.
Nasal Expiratory Positive Airway Pressure (EPAP) – In this, positive airways pressure is maintained through a device connected to the nose. Nasal EPAP comprises a disposable one-way resistor valve that is placed over the nostril with an adhesive tape. Due to the patient’s breathing, the valves operate and create positive end-expiratory pressure with minimal inspiratory resistance. This causes dilation of the upper airways and making way for proper breathing. The results and efficacy of EPAP are recorded on polysomnography and questionnaires, which show an improvement in symptoms of sleep apnea.4 It is particularly beneficial for patients who are unable to tolerate CPAP therapy, those with difficulty using the CPAP while traveling and those with mild or position-dependent sleep apnea with no chronic medical problems.4
Hypoglossal Nerve Stimulation – One of the latest treatments for sleep apnea includes hypoglossal nerve stimulation. It is an effective treatment option for sleep apnea patients who cannot tolerate CPAP therapy. Studies have shown that this latest treatment can show significant improvement in sleep apnea severity, daytime sleepiness, and overall quality of life.5 The treatment outcomes may depend on age, body mass index and apnea-hypopnea index.
Adaptive Servo-Ventilation For Central Sleep Apnea – Central sleep apnea is associated with greater mortality in patients with heart failure. In such cases, positive airway pressure therapy in the form of auto-servo ventilation therapy proves useful. It can not only suppress abnormal breathing patterns but also improve cardiac function in heart failure patients having central sleep apnea.6 Although this may need more study, presently it proves as an option in the latest treatment for sleep apnea.
Advanced Surgeries – The latest treatment for sleep apnea also include the use of recent advancement in surgical interventions. These include laser-assisted uvulopalatoplasty, radio frequency ablation, palatal implants and electrical stimulation of the upper airway muscles.7
Drug Therapy – While drugs have not been able to treat sleep apnea, certain potential drug therapies focus on increasing ventilatory drive altering the arousal threshold or preventing airway collapse by affecting surface tension. One of the latest approaches is the application of cannabinoids to improve the upper airway tone.7
Combination Therapy – Combination therapy involves combining two or more of the standard therapies as well as the latest treatment for sleep apnea.3
While it is important to get timely treatment, it is also necessary to get the most appropriate treatment. Various factors decide which treatment suits a person and the potential benefits and risks. These are some of the latest treatments for sleep apnea. You can decide the best treatment by discussing with your treating physician. While some prefer to continue with the standard treatments for sleep apnea, some may consider the latest options. Hence, it is necessary to stay informed and follow medical advice.
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