Treatment for Sleep Apnoea

In this post, let us understand about Treatment for sleep apnoea. Before you read about treatment procedures, do read Know About Central Sleep Apnoea   and Obstructive Sleep Apnoea

Treatment for Sleep Apnoea basically include three aspects:

• Behavioural changes

• Medical treatment

• Surgical treatment

Behavioural change:

• Lose weight if you are overweight. But remember that sleep apnoea occurs in thin people as well; the airway can close during sleep for a number of reasons, not just excess weight.

• Sleep on your side and not your back.

• Change sleep positions to promote regular breathing.

• Avoid alcohol and medicines such as sedatives before bed.

• Stop smoking. Smoking can increase the swelling in the upper airway which may worsen both snoring and apnoea.

If you have moderate to severe sleep apnea, you may be able to use a machine that helps you breathe while you sleep. Treatment is called continuous positive airway pressure. (CPAP).

Medical treatment:

CPAP:

• Continuous positive airway pressure (CPAP) is nearly always the first medical treatment for sleep apnea.

• CPAP works by gently blowing pressurized room air through the airway at a pressure high enough to keep the throat open. This pressurized air acts as a "splint." The pressure is set according to the patient's needs at a level that eliminates the apnoeas and hypopnoeas that cause awakenings and sleep fragmentation. Pressure that is too low will not be as effective in eliminating the apneas and hypopnoeas.

Oral appliances:

• Oral appliances, also called dental appliances, are intended to treat apnea by keeping the airway open in one of three ways:

• By pushing the lower jaw forward (a mandibular advancement device or MAD),

• By preventing the tongue from falling back over the airway (a tongue-retaining device)

• By combining both mechanisms.

Oral appliances are more effective in mild sleep apnea and for non-obese people but can, for some, be effective for moderate and severe sleep apnea.

The most common type of oral appliance, a MAD is often adjustable so that the dentist can move the jaw further or reduce the advancement as necessary. The goal is to find the most comfortable and effective position for the patient. On occasion oral appliances may worsen the apnea. Not all dentists have the necessary knowledge of sleep apnea, so if you wish to pursue this therapy, ask your sleep doctor to refer you to a dentist who is familiar with apnoea and who works with oral appliances.

Surgical Treatment:

Uvulopalatopharyngoplasty, by this surgery excess tissue in the throat is removed to make the airway wider. It is the most common surgery to treat sleep apnoea in adults.

Tonsillectomy and/or adenoidectomy, which removes the tonsils and/or the adenoids. It may be used if person has enlarged tonsils and/ or adenoids that are blocking the airway during sleep. This is often the first treatment option for children because enlarged tonsils and adenoids are usually the cause of their sleep apnoea.

Other surgical procedures, which are used to repair bone and tissue problems in the mouth and throat.

Tracheostomy, which creates a hole in the windpipe (trachea). A tube is then put in the hole to bring air in. this surgery is rarely used because of complications. But when other techniques have failed to cure sleep apnoea, almost all people who are treated with tracheostomy will be cured of their sleep apnoea.

Bariatric surgery is useful for extremely overweight patient and in whom the excess weight is making sleep apnea worse. Bariatric surgery can promote weight loss that improves sleep apnoea. This surgery is done only for people who cannot lose weight with diet and exercise.

Laser-assisted uvulopalatoplasty may be used to treat snoring. It is sometimes used to treat mild to moderate sleep apnea, though it does not benefit all people.

Newer Pillar Palatal Implant can reduce snoring and improve sleep for people suffering from snoring and sleep apnea. 

The implants work by reducing the movement or vibration of the soft palate with implants designed to stiffen it. 

Using a special needle, three pieces of polyester mesh are inserted into the soft palate near where it meets the hard palate. It is a out patient procedure and takes only about 10 minutes and is done under local anesthesia.

Somnoplasty is an unique surgical method for reducing habitual snoring by removing tissues of the uvula and soft palate. 

Unlike other approaches (such as the laser), somnoplasty uses very low levels of radiofrequency heat energy to create finely controlled localized burn-areas beneath the lining (mucosa) of the soft tissues of the throat. 

These burn- areas are eventually resorbed by the body, shrinking the tissue volume, opening the passage way for air, and thereby reducing symptoms of snoring.

Somnoplasty is performed under local anesthesia in an outpatient setting and takes approximately 30 minutes. 

Thanks a lot for reading, hope you have understood about Apnoea (Sleep Apnea) disesase, symptoms and its treatments.

Please share your comments /suggestions below, as always stay fit and healthy