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Treatment Options

OSA and excessive sleepiness (ES) associated with OSA can interfere with your daily life and relationships with others, but there are a number of approaches to help keep the airway open and prevent lapses in breathing during sleep.

Depending on the severity of your condition, your health care provider may first recommend lifestyle changes that can relieve OSA in some patients. These include:

• Weight loss and management
• Avoiding alcohol and medications that relax the central nervous system (e.g., sedatives and muscle relaxants)
• Quitting smoking
• Changing sleeping positions (sleep apnea is often worse while lying on the back)

If you are overweight, even a slight reduction in weight may help improve your symptoms. Be sure to adopt a healthful, low-fat diet and exercise program to help you reach your goals. Drinking alcohol or taking sleeping pills at bedtime relaxes the muscles in the back of your throat, making it harder for you to breathe and prolonging apneic periods. Sometimes in mild sleep apnea, breathing pauses occur only when you sleep on your back; if this is the case, you may want to use a pillow to help you sleep on your side.

Continuous positive airway pressure (CPAP) is the most common and effective treatment for OSA. With this treatment, you wear a special mask that fits over your nose and/or mouth while you sleep. A machine gently blows air through your nasal passages to prevent your throat from collapsing during sleep. The device must be worn every night to be effective.

Studies show that with regular use of CPAP, patients may be more alert. CPAP may also reduce problems with heart rhythms, high blood pressure and depression. The optimal CPAP level for each patient is usually best determined during the sleep study. Some people find it cumbersome and uncomfortable. If this is the case, ask your provider what adjustments can be made, since many complaints can be successfully remedied.

If there is an anatomical reason(s) for your sleep apnea, surgery may be recommended to remove tissue and enlarge the airway. Possible surgeries may include:

• UPPP (removal of excess tissue at the back of the throat)
• Tonsillectomy (removal of enlarged tonsils or adenoids)
• Tracheostomy (creation of an opening into the windpipe to bypass the obstructed airway)
• Repositioning of your jaw

Other possible remedies for OSA include mouthpieces that look like sports mouth guards, which can be fitted by dentists trained in sleep medicine to reposition the jaw, tongue and other parts of the mouth to clear the airway. These appliances are typically used in patients with relatively mild OSA.

Despite treatment for the underlying obstruction, some people continue to experience ES associated with OSA. For those people, there is an FDA-approved prescription medicine used to improve wakefulness in adults who experience ES due to OSA. For more information, ask your doctor, or click here