Sleep Apnea Treatments Without CPAP

A sleep disorder, sleep apnea is characterized by repeated breathing pauses during sleep. The hypopnea and apnea episodes can last from a few seconds to a minute at a time and can occur many times during a night. 

Obstructive Sleep apnea happens when the throat muscles relax and the tongue falls back into the throat, partially blocking the airway. That in turn leads to improper breathing as the airflow is blocked. If you ignore the snoring and sleep apnea, it can lead to multiple health issues such as hypertension, cardiovascular issues and even Type 2 diabetes. 

Usually, the gold standard in sleep apnea treatment is CPAP therapy or Continuous Positive Airway Pressure therapy, which helps eliminate the pauses in breathing, as it provides a steady stream of air to your airways, with the use of a facial mask. However, not everyone is comfortable wearing the mask at night and sleeping. 

For those that cannot adapt and use CPAP therapy as a means of sleep apnea treatment, here are other ways that you can reduce the symptoms of sleep apnea. However, they vary in its effectiveness based on the severity of OSA and your health and medical conditions.  

Oral Appliance Therapy (OAT)

These are custom- fitted devices that are worn when you are asleep. An example is, Mandibular Advancement Device (MAD) which works to reposition the jaw so that the nasal airway is kept open. These can be customized by a dental expert and works well for mild to moderate sleep apnea individuals. However, as compared to CPAP, it is less effective when used in severe OSA cases. 

Weight loss

One of the key factors for sleep apnea is weight gain. With fat deposits around the neck and the throat, it narrows the airways and increases the likelihood of obstruction when you are asleep. Even if you are able to lose 10% excess weight, it will lower the severity of sleep apnea. Sometimes, it reverses mild sleep apnea completely. 

Lifestyle changes

From quitting smoking to reducing the consumption of alcohol, there are some lifestyle changes that you need to make to ensure that sleep apnea symptoms such as snoring are reduced. You need to increase physical activity, adopt anti-inflammatory diet, and reduce inflammation in the airways by stop smoking. 

Positional therapy

If you are looking to breathe better and snore less, positional therapy is one of the ways to achieve that. It is better to sleep on your side than on your back or stomach as that puts pressure on your chest. It is known as positional obstruction sleep apnea. By intentionally sleeping on your side, you can reduce snoring with use of positional therapy. You can use positional anti-snoring pillows that can help you sleep on your side, while the vibrating positional therapy devices can be worn around your neck that will buzz, if you roll back on your back. 

Orofacial or Myofunctional Exercises

These are set of exercises which helps strengthen the muscles of the throat, tongue and mouth to ensure that there is reduced risk of airway collapse. Some of the exercises include:

• Lifting soft palate
• Muscle training for jaw and cheeks
• Nasal breathing exercises so that mouth breathing is reduced
• Tongue positioning and strengthening exercises 

With these exercises, there is a marked reduction of AHI or apnea-hypopnea index, daytime drowsiness and snoring.  

Surgical options

You can consider surgery for those people that do not respond to other treatments. There are many procedures that aim to reposition or reduce extra tissue that blocks the nasal passages and airway. Some of these surgeries include:

• Uvulopalatopharyngoplasty: It reduces and eliminates extra soft tissues from the palate and uvula. This ensures that the partial blockage is removed and the airways remain open. Additionally, tonsils and adenoids maybe surgically removed if there is swelling in it and cause partial blockage in the throat. 
• Genioglossus advancement: This surgery is done to reposition the muscles of the tongue so that there is no airway collapse.
• Maxillomandibular advancement (MMA): These move the lower and upper jaw forward to enhance the airway and ensure smooth breathing. 
• Nasal surgeries: These surgeries are done to remove nasal polyps and correct deviated septum to enhance your breathing and airflow. 

FDA approved Inspire therapy

This is an FDA-approved surgery that implants a device to stimulate the hypoglossal nerve to control the movement of the tongue. It helps to keep the tongue in place when asleep. It is usually implanted in the chest area, under the skin. It assists in monitoring your breathing and send out electrical impulses to ensure that the muscles in the airway are toned. It is usually advised to individuals that cannot use CPAP therapy and have a BMI under 35. 

Expiratory Positive Airway Pressure (EPAP) device

These are adhesive backed, disposable and small devices that are placed over the nostrils to exert pressure when exhaling. That assists in ensuring that the airway is open. These are easy to carry, non-invasive and do not require any electricity for operating.  One of the common devices is Provent. It helps those with mild to moderate sleep apnea. 

Alternative Therapies

There are alternate therapies and less conventional methods to stop snoring and reduce sleep apnea. Acupuncture improves muscle tone and enhance respiratory control. While essential oils are used to ease nasal decongestion and relaxation. The chiropractic adjustments help with improving your breathing by correcting your posture. However, these methods might provide relief but it cannot cure sleep apnea. 

Treatment for best results

Usually, the individuals try to combine multiple non- CPAP treatments to get the best results. Whether you try weight loss with using oral appliances or positional therapy with myofunctional exercises, there are a multitude of options you have. However, it helps to consult an ENT or a sleep specialist that is trained in sleep disorders to help you choose the right combination of treatment. Thus, if you cannot use CPAP device, don’t lose hope. There are many other methods that can bring relief.