The treatment of choice for obstructive sleep apnea is a positive airway pressure device (PAP). The treatment consists of a mask that fits over the nose and/or mouth, and gently blows air into the airway to help keep it open during sleep. This method of treatment is highly effective and referred to as the “Gold Standard” treatment for Sleep Apnea.
This method of treatment is highly effective and has enormous health benefits when the PAP device is used consistently and as recommended. This therapy dramatically improves the quality of sleep, reduces Excessive Daytime Sleepiness (EDS), improves mood and function and decreases the incidence of motor vehicle accidents.
Continuous positive airway pressure (CPAP) devices deliver a single fixed pressure during both inhalation and exhalation.
In patients with positional OSA (for whom OSA is only present when the person sleeps on his/her back in a supine position), devices may be used to help the person reposition him or herself and minimize the OSA. For example, there are several types of wearable sensors, such as the Night Shift neckband, that use vibrations to train the individual not to sleep on his or her back, thereby minimizing OSAS symptoms.
There are also wearable inflatable bumper belts designed to comfortably hold you on your side and prevent you from rolling on your back.
Positional therapy can be used by itself or in conjunction with PAP therapy to reduce treatment pressures by reducing or eliminating supine sleep.
Mandibular Advancement Device
Mandibular Advancement Devices or Oral Appliances, are devices used to treat obstructive sleep apnea that move the tongue or lower jaw forward to increase the size of the upper airway, and facilitate breathing. These devices look like mouth guards, and should always be fitted by a dentist who is trained in sleep medicine.
These devices are mainly used for the treatment of patients with snoring or mild to moderate OSAS, and for some in conjunction with or as an alternative to PAP therapy.
In the milder forms of OSAS, behavioral treatment may be successful and primarily involve such lifestyle modifications as weight loss and limiting the use of alcohol or sedatives.
Another treatment development uses nasal Expiratory Positive Airway Pressure (EPAP) to treat OSAS. The nostrils are covered with a disposable adhesive valve. During inhalation, the valve opens and facilitates unobstructed airflow; during exhalation, the airflow is directed into small channels, which increases resistance and creates pressure in the airway, keeping it open and minimizing OSA.
In a randomized controlled trial, EPAP users demonstrated significantly lower Apnea-Hypopnea Index (AHI) and Epworth Sleepiness Scale (ESS) outcomes, as well as improved reports of daytime sleepiness. Adherence was excellent and no negative outcomes were reported.