Obstructive Sleep Apnea: Treatments

Apr 03, 2020
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Obstructive sleep apnea (OBS) is the most common type of sleep apnea and is characterized by what causes the stop or pause on breathing, in this case, a muscle may be blocking the air path. It shows repeated episodes of complete or partial obstructions of the upper airway during sleep. Risk factors are age, male gender, obesity, upper airway abnormality, smoking, family history, pregnancy, diabetes, and other diseases. People with OBS commonly report daytime sleepiness, snoring, gasping, choking, snorting and interruptions in breathing.

Here are the list of treatment for OBS:

Hypoglossus Nerve Stimulation - is an implanted medical device that works to reduce the occurrence of obstructive sleep apnea by electrically stimulating the hypoglossal nerve to the tongue. This stimulation activates the muscles of the tongue, increasing the tone and moving it forward, away from the back of the airway.

Expiratory Positive Airway Pressure (EPAP) - mode of breathing support only applies positive pressure when you are exhaling. This is thought to work due to a belief that airway collapse and resulting sleep apnea are most likely to occur when you are breathing out.

Oral Pressure Therapy - This uses negative pressure in the mouth to shift the soft palate and tongue forward. The negative pressure is created by a bedside console connected by a small tube to a mouthpiece worn inside the mouth during sleep.

Surgery - This is for the severe cases of sleep apnea that needs a part of the muscle removed to give way to the normal passage of air. Whether surgery is a good choice depends on the anatomy of each person’s upper airway and the type of surgery performed.

Behavioral Treatments - Losing weight is known to improve OSA, as is limiting the consumption of alcohol and sedatives. If you only experience OSA when sleeping on your back, there are positioners that will help maintain a side sleeping position, to improve your breathing and promote continuous, healthy sleep.

Continuous Positive Airway Pressure Therapy - Accumulating evidence also suggests that successful treatment of OSA with continuous positive airway pressure (CPAP) can improve cardiovascular outcomes. This therapy is the most common form of treatment for moderate and severe obstructive sleep apnea. To use the CPAP system, the patient wears a nasal or full-face mask that delivers pressurized air to the upper airway, preventing the airway from collapsing during sleep. There are variations in how and at what level the pressure is delivered, including continuous, bilevel, and auto titrated systems.

After the screening and in-laboratory tests and the patient is diagnosed with OSA the doctor will decide if what therapy or treatment plan is best for the situation. Commonly if the patient doesn’t need surgery they always offer positive airway pressure (PAP) therapy as first-line therapy. The initiation of PAP therapy requires selection of a mode of PAP, device setting(s), and a patient-device interface.

PAP has two modes the continuous positive airway pressure (CPAP) and bilevel positive airway pressure (BPAP). BiPAP (also referred to as BPAP) stands for Bilevel Positive Airway Pressure, and is very similar in function and design to a CPAP machine (continuous positive airway pressure). Similar to a CPAP machine, A BiPAP machine is a non-invasive form of therapy for patients suffering from sleep apnea. Both machine types deliver pressurized air through a mask to the patient's airways. The air pressure keeps the throat muscles from collapsing and reducing obstructions by acting as a splint. Both CPAP and BiPAP machines allow patients to breathe easily and regularly throughout the night.

CPAP is generally preferred for most patients because it has been well studied, is simpler to use, and is less costly. Each of these modalities requires choosing between fixed or auto-titrating technology. You can discuss with your doctor what options are available for your OBS treatment. Nonetheless, we always suggest patients to keep track of their progress and maintenance to a certified healthcare practitioner to avoid any serious complications.

Resources:

https://www.uptodate.com

https://www.sleephealth.org/

https://www.sleepfoundation.org/

www.vastmedic.com