How is sleep apnoea treated?

The treatment of sleep apnoea depends on the type and the severity of the condition. In this article, we will focus on the treatment of obstructive sleep apnoea (OSA), the most common type.

There are three broad treatment options for OSA:

1. Non-invasive ventilation: CPAP, APAP and BiPAP
2. Dental oral appliance therapy (OAT)
3. Surgery

1. Non-invasive ventilation: CPAP, APAP and BiPAP
Continuous positive airways pressure (CPAP), automatic positive airways pressure (APAP), and bi-level positive airways pressure (BiPAP) are different types of devices that enable the airway to remain open by blowing pressurised air into the airway while you’re asleep.

CPAP was the initial technology developed to keep the airway open during sleep. However, further development of technology and sensors enabled the developed of a device that automatically detects the pressure required to maintain an open airway and prevent collapse. This treatment is APAP.

Some people who have severe, complex OSA and those with central sleep apnoea require treatment with BiPAP. This regulates breathing in and breathing out.

CPAP and APAP are considered gold standard treatments for moderate to severe OSA.

2. Dental oral appliance therapy (OAT)
Dental OATs are mouth-guard-type devices that are worn during sleep. They should be made by a qualified dentist who has experience in sleep medicine and sleep apnoea. These devices work by holding the lower jaw and tongue forward during sleep.

Dental OAT devices are usually indicated for people with mild OSA or those with positional OSA (where the OSA is much worse when lying on your back).

3. Surgery for OSA
Some people have facial deformities that may be the cause of their sleep apnoea. It simply may be that their jaw is smaller than it should be or that they have a smaller opening at the back of the throat. Others have enlarged tonsils, a large tongue, or some other tissues that are partially blocking the airway.

Fixing a deviated septum may help to open the nasal passages. Removing the tonsils and adenoids or polyps may also help. Other surgical treatments include removing excess tissue to clear the airway, or moving the upper and lower jaw forward.

Success of treatment is measured by the reduction of respiratory disturbances. If untreated, the personal and professional life of someone who has sleep apnoea could suffer considerably. The risk of a heart attack or stroke also rises.

Course and prognosis of sleep apnoea
If treated correctly – whether through behavioural changes, continuous positive airway pressure (CPAP), or surgery – a person with sleep apnoea could be successfully treated.

Some people are even cured of this debilitating condition, and can once again enjoy a quality life thanks to quality sleep.

When to visit a doctor
When your partner starts complaining about your snoring, you keep waking up tired and groggy, and it’s detected that you gasp for air during sleep, you should see a doctor about your condition. If you wake up during the night with the sensation of being choked, you need to get medical advice.

Children should never snore at all. If a child snores, and there are complaints of attention problems at school, the tonsils should be examined and removed if they’re obstructing the airway. This is frequently more effective in treating inattention than using medications like methylphenidate (Ritalin).

Sleep apnoea is a potentially life-threatening condition that requires immediate medical attention. The risks of undiagnosed obstructive sleep apnoea include heart attack, stroke, impotence, irregular heartbeat, high blood pressure, and heart disease.

Obstructive sleep apnoea is associated with a 23 times raised risk for a heart attack. You’re uninsurable if you have it.

In addition, obstructive sleep apnoea causes daytime sleepiness that can result in accidents, lost productivity and interpersonal relationship problems.

Visit to find to a sleep clinic near you.

Reviewed by Dr Irshaad Ebrahim, specialist neuropsychiatrist in sleep disorders at The London Sleep Centre and The Constantia Sleep Centre. FRCPsych. April 2018.


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