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Sleep apnea treatment options

A range of sleep apnea treatment options is available to meet diverse patient needs and may help patients, including those with severe sleep apnea, improve their sleep patterns.

Positive airway pressure (PAP) therapy

PAP therapy is widely regarded as the most effective way to treat obstructive sleep apnea (OSA) and certain types of central sleep apnea (CSA).1 It works by creating a “pneumatic splint” for the upper airway, preventing the soft tissues of the upper airway from narrowing and collapsing. Pressurised air is sent from a device through to the upper airway via air tubing and a mask worn over the face.

pap-therapy

CPAP, APAP and bilevel therapy

Positive airway pressure therapy can be delivered in a number of modes:

  • Continuous positive airway pressure (CPAP): delivers air at a fixed pressure.
  • Automatic positive airway pressure (APAP): automatically adjusts pressure levels based on a patient's breathing. APAP may be suitable for patients with REM-related sleep apnea, positional apnea or those who experience non-compliance with standard CPAP therapy.
  • Bilevel therapy: provides higher inspiratory pressure (IPAP) and lower expiratory pressure (EPAP). It can also be effective for certain OSA patients who are non-compliant, and used to treat a wide range of sleep and respiratory disordered breathing other than OSA, such as CSA, overlap syndrome, COPD and more.
all-therapy
Positive airway pressure (PAP) therapy

Positive airway pressure therapy is widely regarded as the most effective way to treat OSA.1 It works by creating a "pneumatic splint" for the upper airway, preventing the soft tissues of the upper airway from narrowing and collapsing. Pressurised air is sent from a therapy device through air tubing and a mask that patients wear over their nose or mouth, through to the upper airway.

As a result of positive airway pressure therapy, a patient with severe sleep apnea may experience a return to a normal sleep pattern once his or her sleep debt resolves.

Resmed's AirSense and AirCurve series of devices have helped patients sleep through the four hour compliance threshold. AirSense and AirCurve devices are stylish and quiet, and provide a variety of unique features that are designed to deliver a more comfortable sleeping experience for your patients.

CPAP, APAP and bilevel therapy

Positive airway pressure therapy can be delivered in a number of modes:

  • Continuous positive airway pressure (CPAP) - which delivers pressurised air at one fixed pressure.
  • Automatic positive airway pressure (APAP) therapy - which automatically adjusts pressure levels based on a patient's breathing patterns. This may be particularly suited to patients with REM-related sleep apnea, positional apnea or those who are non-compliant with standard CPAP therapy.
  • Bilevel therapy - which provides higher inspiratory pressure (IPAP) and lower expiratory pressure (EPAP) - can also be effective for certain patients who are non-compliant, and used to treat a wide-range of respiratory disorders.
Oral appliance therapy

An oral appliance, often called a mandibular repositioning device (MRD), can be a second line therapy option and can be considered for patients with mild to moderate sleep apnea. It is a custom-made, adjustable oral appliance available from a dentist that holds the lower jaw in a forward position during sleep. This mechanical protrusion expands the space behind the tongue, puts tension on the pharyngeal walls to reduce collapse of the airway and diminishes palate vibration. 

Alternative treatment options

Surgery is also an option for treating sleep apnea, but as with all surgeries there are associated risks.

Uvulopalatopharyngoplastry (UPPP) has been widely used to treat snoring or OSA, but is not recommended as the first choice treatment option2. This surgical procedure involves the removal of the tonsils, soft palate/uvula and closure of the tonsillar pillars and certain risks are involved3.

Oral appliance therapy and surgery

Also called a mandibular repositioning device (MRD), oral appliances can be an effective therapy option for patients with mild to moderate sleep apnea. These are custom-made, adjustable oral appliances that hold the lower jaw in a forward position during sleep, with a mechanical protrusion that expands the space behind the tongue and puts tension on the pharyngeal walls to reduce collapse of the airway and diminish palate vibration.

Surgery is also an option for treating sleep apnea, but as with all surgeries there are associated risks.

Uvulopalatopharyngoplastry (UPPP) has been widely used to treat snoring or OSA, but is not recommended as the first choice treatment option1. This surgical procedure involves the removal of the tonsils, soft palate/uvula and closure of the tonsillar pillars and certain risks are involved.2

Patient outcomes and comorbidities

Helping patients start and continue therapy can support better symptom control and quality of life. Effective treatment has been shown to reverse the effects of daytime sleepiness, fatigue, moodiness and depression.3 And studies have shown that when patients are successful with their therapy, their long-term health care costs are at least 40% lower overall.4

There are also a variety of serious comorbidities such as cardiovascular disease, diabetes and stroke that have a strong connection to sleep apnea.

patient-outcomes

More about treatment options for sleep-disordered breathing

Treatment options for CSA
Read more
References
1

Epstein L.J., et al. 2009 ‘Clinical Guidance for the Evaluation, management and long-term Care of Obstructive Sleep Apnea in Adults” Journal of Clinical Sleep Medicine, vol. 5, no. 3 pp. 263-276. 

2

Franklin KA, et al. Effects and side-effects of surgery for snoring and obstructive sleep apnea--a systematic review. Sleep. 2009 Jan;32(1):27-36.

3

Bhat S, et al., The relationships between improvements in daytime sleepiness, fatigue and depression and psychomotor vigilance task testing with CPAP use in patients with obstructive sleep apnea, Sleep Medicine,
Volume 49, 2018, Pages 81-89, ISSN 1389-9457, https://doi.org/10.1016/j.sleep.2018.06.012. 

4

Bock JM, et al. Continuous Positive Airway Pressure Adherence and Treatment Cost in Patients With Obstructive Sleep Apnea and Cardiovascular Disease. Mayo Clin Proc Innov Qual Outcomes. 2022 Apr 4;6(2):166-175. doi: 10.1016/j.mayocpiqo.2022.01.002. 

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