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TREATING SLEEP APNEA

There are three ways to treat Obstructive Sleep Apnea (OSA), each has benefits and drawbacks. Choosing the treatment method for your condition should be done after appropriate testing and with the advice of a trained professional.

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Surgery

 

Surgical treatment is often reserved for only the most severe cases of the sleep apnea, typically to address specific anatomic issues contributing to the condition. These options include processes like nasal airway surgery, palate and pharyngeal surgery, and tongue reduction surgery. Surgery is typically a last resort for several reasons:

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  • Expensive compared to other, less-invasive treatment options

  • Surgery carries inherent risk which can lead to 2-3 weeks of painful recovery

  • Recovery often requires patients to take time off of work

  • After all that, surgery is not guaranteed to relieve sleep apnea or address the associated comorbidities 
     

CPAP

 

CPAP stands for Continuous Positive Airway Pressure. Treatment involves wearing a mask over the nose and/or mouth while sleeping. The mask is attached to an air-compressor which pumps air through the mask into the airway, keeping it open. CPAP is considered the "gold standard" for the management of sleep apnea because they are highly effective in a lab setting. For severe cases they can be the only effective treatment. But many CPAP users are “non-compliant” within 6 months of beginning therapy. Some studies estimate that as many as 80% of CPAP users do not wear the device more than 4 hours per night, resulting in inconsistent treatment. 

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CPAP treatment can be an expensive and time-consuming process:

  • Initial consultation with a primary care physician

  • Referral and consultation with specialists

  • Overnight stay in a sleep lab for testing

  • Consultation and diagnostic

  • Purchase of a cumbersome CPAP mask and machine

  • Wearing a bulky and noisy mask every night while sleeping

  • Follow up overnight test at a sleep lab

  • The patient is responsible for maintenance and replacement of pump every 3-5 years

  • Patient is responsible replacement of pump parts (tubes, filters, etc.)

  • Additional sleep lab visits with every replacement pump

  • Additional visits adjustment/titration with every replacement pump
     

Oral Appliance Therapy


Oral Appliance Therapy (OAT) uses a custom fitted dental appliance, similar to a retainer, to ensure unrestricted airflow during sleep. The device positions the lower jaw forward, which moves the base of the tongue slightly to ensure the airway remains open during sleep. The appliance fits in the palm of your hand, uses no power and has no hoses or pumps. Oral Appliance Therapy consists of four steps:
 

  • Screening and home sleep test schedule on first visit

  • Home sleep test results are reviewed by a board-certified sleep physician who makes a diagnosis and therapy suggestion

  • Delivery of custom-made oral appliance

  • Easy follow-up maintenance once or twice a year
     

Do not mistake OAT with a drugstore snoreguard, which is not FDA cleared for treating OSA. Attempting to treat OSA with an unapproved device and not under the care of a trained professional could exacerbate the condition leading to potentially serious complications.

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