Sleep Apnea Treatments

For mild and some moderate cases of sleep apnea, doctors may recommend only lifestyle changes, such as losing weight or quitting smoking if applicable. Another suggestion may be be using supports to help you sleep in your side. If these suggestions don't improve your signs and symptoms then you may be required to use the equipment for moderate to severe sleep apnea. As a last resort, you will be assessed for different types of surgery.

Treatments for moderate to severe sleep apnea include:

Continuous positive airway pressure (CPAP). If you have moderate to severe sleep apnea, you may benefit from a machine that delivers air pressure through a mask placed over your nose while you sleep. With CPAP (SEE-pap), the air pressure is somewhat greater than that of the surrounding air, and is just enough to keep your upper airway passages open, preventing apnea and snoring.

Although CPAP is the most common and reliable method of treating sleep apnea, some people find it cumbersome or uncomfortable. Many people give up on CPAP, but with some practice, most people learn to adjust the tension of the straps to obtain a comfortable and secure fit. You may need to try more than one type of mask to find one that's comfortable. Some people benefit from also using a humidifier along with their CPAP system. Also see my blog here for an accessory that will help prevent air leaks and allow for slightly less strap tension.

Don't just stop using the CPAP machine if you experience problems. Check with your doctor to see what modifications can be made to make you more comfortable. Additionally, contact your doctor if you are still snoring despite treatment or begin snoring again. If your weight changes, the pressure settings may need to be adjusted.

There are other equipment options.

Adjustable airway pressure devices. If CPAP continues to be a problem for you, you may be able to use a different type of airway pressure device that automatically adjusts the pressure while you're sleeping. For example, units that supply bilevel positive airway pressure (BPAP BiPAP) are available. These provide more pressure when you inhale and less when you exhale.

The other types of positive airway pressure machines are:

CPAP – Continuous Positive Airway Pressure
APAP – Auto Adjust Positive Airway Pressure
BiPAP – Bi-level Positive Airway Pressure
VPAP – Variable Positive Airway Pressure
Auto-titrating Continuous Positive Airway Pressure

Expiratory positive airway pressure (EPAP). This is the most recent treatment approved by the Food and Drug Administration (FDA). These small, single-use devices are placed over each nostril before you go to sleep. The device is a valve that allows air to move freely in, but when you exhale, air must go through small holes in the valve. This increases pressure in the airway and keeps it open. The device helped reduce snoring and daytime sleepiness when compared to a sham device And, it may be an option for some who can't tolerate CPAP. Read this for further explanation = http://www.directhomemedical.com/30-DAY-PROVENT-therapy-sleep-apnea-treatment.html#.U9bW6bH8DFE .

Oral appliances. Another option is wearing an oral appliance designed to keep your throat open. CPAP is more reliably effective than oral appliances, but oral appliances may be easier to use. Some are designed to open your throat by bringing your jaw forward, which can sometimes relieve snoring and mild obstructive sleep apnea.

A number of devices are available from your dentist. You may need to try different devices before finding one that works for you. Once you find the right fit, you'll still need to follow up with your dentist at least every six months during the first year and then at least once a year after that to ensure that the fit is still good and to reassess your signs and symptoms.

One option not found in any of the medical articles is this device. Now that you have digested all of this, consider if you want a mask and check out this site. https://www.nomask.com/index.cfm This needs to be considered by some people. Not everything works for every person. There could be medical reasons making this more important than the masks.

Information for CPAP Users

I admit that I love my sleep apnea machine. It is a BiPAP and this means that two settings are input into the machine. The first is the lowest reading allowed and the second is the maximum reading allowed. Then the machine adjusts automatically between the two and provides the correct pressure. The minimum on mine is 10 and the maximum is 15. The average on the last printout obtained over 18 months ago was 12.5, with rare excursions to 10 and 15 and the majority of readings between 11 and 13.5. The data recorded includes sleeping time on a daily basis and averages.

There are different types of CPAP (continuous positive airway pressure) machines. Most insurance companies have a strict schedule of what they will cover and what they will replace and when. Do not try to get fancy, as they will not as a rule, allow exceptions to policy. Do talk to your insurance company and ask for the schedule.

Also, Federal law requires that sellers of sleep apnea equipment have a valid prescription on file before they ship or supply you with your machine or appliance. Yet there are many suppliers that are bypassing this having their own specialists ask some questions and prescribing internally. Not the wisest choice as then you will not know what pressure settings to use. Plus insurance may not reimburse you. Many of the internet advertising companies do not accept insurance or Medicare.

Because of the above, I would urge you to talk to your insurance company and find out what machines they will reimburse and cover. They may even be able to suggest the suppliers they prefer to use. I used a local supplier and Medicare reimburses the same supplier.

Speaking of Medicare, they will require another sleep study to determine your eligibility for equipment and supplies. I was required to have a sleep study in a facility separate from the hospital and I admit I was not happy with the schedule. Once the study was complete, Medicare received the results and authorized the equipment they would cover. I had three choices and no more. My supplier only carried two of the authorized machines.

The different types of machines are:

CPAP – Continuous Positive Airway Pressure

APAP – Auto Adjust Positive Airway Pressure

BiPAP – Bi-level Positive Airway Pressure

VPAP – Variable Positive Airway Pressure

Auto-titrating Continuous Positive Airway Pressure (To determine the concentration of (a solution) by titration or perform the operation of titration.) In this case, by pressure is titrated. This is the most complicated of the machines and possibly one I would be cautious about having.

After having an auto-titrating machine during the sleep study lab, I would still urge caution, but would not hesitate to consider having one. The one used for me was very quiet.

Then in addition to the above types, a determination needs to be made if you need a humidifier. This is where full disclosure to the prescribing doctor is very important. If you have allergies, sinus infections, regular colds or cold like flare-ups, sleep with mouth open and have many dry mouth mornings – discuss this information with your doctor to get the right machine and mask for you.

Next is the type of mask which will be best for you. Types are nasal masks, full-face masks, nasal pillow masks, and other headgear and chinstraps. The biggest problem is getting the correct one for you. Whoever is setting up the order should cover this and you should verify that you are getting the correct size of mask. Masks are normally small, medium, and large. There is not a standard and a medium in one type of mask may require a large in a different mask. They should also discuss with you whether you have seasonal or chronic allergies, whether you have a deviated septum, do you awaken with a dry mouth, do you need heated humidification, and they should measure your nasal bridge – average, tall, wide, narrow, or flat.

I cannot emphasize how important the two paragraphs above are. This is how you obtain the right equipment and the equipment that fits you and your needs. The next blog will cover an important accessory.