Changes in lifestyle may be sufficient to control sleep apnea in mild cases and should be included in the treatment plan even in more severe cases.
Generally, surgery is not recommended for the treatment of obstructive sleep apnea unless there is an obvious and significant anatomical cause of upper airway obstruction such as enlarged tonsils and/or enlarged adenoids (mainly in children). These sources of upper airway obstruction can be removed by tonsillectomy and adenoidectomy.
Prior to the development of mechanical treatment in the 1980’s (see below), tracheostomy was used in severe cases. This is very rarely necessary now. Other surgical treatments that have been used for the treatment of OSA are:
This operation involves the straightening of the division (called the nasal septum) between the nostrils. This may become crooked, often after an injury to the nose, resulting in partial or complete obstruction of the nasal airway. Although surgical straightening of the nasal septum (called “septoplasty”) may make breathing more comfortable, it usually does not improve snoring or OSA.
This operation involves the removal of soft tissue in the back of the throat (called the soft palate and the uvula) in addition to removal of the tonsils, if they are present. This is done under a general anesthetic and requires admission to hospital. Potential adverse effects include pain, bleeding, infection, voice change and greater difficulty adjusting to CPAP if this is required later. Unfortunately, UPPP does not correct OSA in the majority of patients although it can improve snoring in up to 50% of cases. Consequently, it is not recommended for the treatment of OSA but may be considered for patients with severe snoring that do not have obstructive sleep apnea.
Laser-Assisted Uvulopalatoplasty (LAUP)
Is a modification of the UPPP and is usually performed in an out-patient facility under local anesthetic with a laser device. The limitations and potential side-effects are the same as those for UPPP.
There are several types of dental appliances. The principle objective of all dental appliances is to advance the lower jaw and hold it in that position while the patient sleeps. They usually consist of an upper and lower dental plate. They are joined by a hinge, which allows the lower plate, and therefore the lower jaw, to move forward. This pulls the muscles attached to the lower jaw, including the tongue, forward, thereby increasing the size of the upper airway and making it less likely to obstruct.
Although not as effective as CPAP (Continuous Positive Airway Pressure), a dental appliance is more convenient especially for patients who need to travel frequently.
CPAP therapy ( pronounced "see-pap") is currently the only treatment that is 100% effective in treating Obstructive Sleep Apnea (OSA).
The CPAP machine provides a positive pressure that will hold your airway open while you sleep. This prevents snoring and the airway collapse causing OSA.
The CPAP machine connects to a mask that you can wear over your nose and/or mouth.
How do I start CPAP therapy?
When a patient is first diagnosed with OSA they may undergo a trial of CPAP. This trial will usually last for a month.
During this trial you will be educated, by your CPAP Provider, about how to use your CPAP machine and all the accessories that come with it. You will also be fitted for a mask that is suited especially for you.
How will I know CPAP is working?
The trial of CPAP will let you know. You should:
Some people are comfortable with CPAP equipment after only one or two nights. Most people need a few weeks before they can sleep comfortably with the CPAP. A few people have problems that can take longer to sort out.
Keep trying and get the help you need!
Costs for CPAP Therapy
CPAP costs approximately $1,800 to $2,500 in Alberta including a mask.
If our physician diagnoses you with Obstructive Sleep Apnea we will refer you to one of the local companies that provide CPAP. They will contact you to start a 1 month trial of CPAP. During this trial the company will educate you, fit you with a mask that will work for you and provide any troubleshooting as required.
After this CPAP trial, you will likely have a follow-up appointment with the physician or our CPAP Clinic. At this appointment we will determine if you received a benefit from CPAP and make a long-term plan for treating your OSA.