Treatment for Sleep Apnea

Treatment and management
The goals of treating obstructive sleep apnea are to:
• Restore regular breathing during sleep
• Relieve symptoms such as loud snoring and daytime sleepiness
- Lifestyle changes is only for mild OSA
Lifestyle Changes
If you have mild sleep apnea, some changes in daily activities or habits may be all that you need.
• Avoid alcohol and medicines that make you sleepy. They make it harder for your throat to stay open while you sleep. (alcohol causes URT muscle to relax)
• Lose weight if you're overweight or obese. Even a little weight loss can improve your symptoms.
• Sleep on your side instead of your back to help keep your throat open. You can sleep with special pillows or shirts that prevent you from sleeping on your back.
• Keep your nasal passages open at night with nose sprays or allergy medicines, if needed. Talk to your doctor about whether these treatments might help you.
• Stop smoking.
• Gargle with salt water (without swallowing) to shrink your tonsils.
• Develop regular sleep habits, and make sure you get enough sleep at night.
• Use an air humidifier at night.
Mouthpiece/oral appliance
- Help with mild OSA or snoring
- Customize to fit different patients, plastic made.
- It adjust your lower jaw and your tongue to help keep your airways open while asleep.
- Make sure it is comfortable, adjustable.
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Breathing Devices
CPAP – continuous positive airway pressure for moderate to severe sleep apnea in adults.
- It’s a mask that fits over mouth and nose and blows air into the throat.
- Air pressure adjusted to avoid airway being narrowed or blocked during sleep
- Sleep apnea returns if CPAP stops or not used correctly
- Machine set up by a technician with doctor’s orders
- May cause side effects, dry or stuffy nose, irritated skin on face, sore eyes, and headaches, stomach bloating and discomfort.
- Nasal spray and adding moisture to air is helped to relieve SE.
There is no drug that completely treats sleep apnea. Some of the drugs used in combination with CPAP include:
• Medroxyprogesterone -- side effects may include nausea, depression, excess hair growth, breast tenderness, and fluid retention.
• Protriptyline -- this medication is used rarely. Side effects may include dry mouth, constipation, frequent urination, impotence, and confusion (in the elderly).
• Modafinil -- sometimes prescribed in combination with CPAP to treat excessive daytime sleepiness.

Surgery
- To widen breathing passage, involves removing, shrinking or stiffening excess tissue in the mouth and throat or resetting the lower jaw.
- Shots to shrink tissue or plastic pieces inserted to stiffen loose tissue.
- Surgery to remove tonsils maybe helpful for children. Or wait for tissues to shrink by itself.
Uvulopalatopharyngoplasty (UPPP) -- The operation involves the removal of the uvula and back of the soft palate, often accompanied by tonsillectomy.
In UPPP, soft tissue on the back of the throat and soft palate (the uvula) is removed.
UPPP does not address apnea or snoring caused by obstructions at the base of tongue.
• First patient undergoes soft tissues surgeries, UPPP together with genioglossus advancement or hyoid suspension and usually fails
• Then a maxillomandibular advancement surgery to move the top jaw and bottom jaw forward. (pulling tongue forward)
• High rates of complication
Surgeons usually use either conventional scalpel techniques or newer laser methods (LAUP, or Laser-Assisted Uvulopalatoplasty). LAUP may have a higher rate of success than UPPP, but it also requires the expertise of a surgeon highly skilled in laser procedures.
LAUP Treatment Procedure
A laser beam to remove and tighten floppy soft palate tissue in the back of the mouth, thereby reducing the amount that these tissues contribute to snoring.
LAUP causes mild discomfort after surgery. Local anesthestic.
LAUP needs up to five treatments spaced four to eight weeks apart (although one to three are usual).

Tracheostomy -- to create an opening in the windpipe to bypass the blocked airway if there are anatomical problems (rarely done)
General anesthesia, exposure of the tracheal cartilage rings. The surgeon then creates an opening into the trachea and inserts a tracheostomy tube.
Complementary and Alternative Therapies
Useful in treating sleep apnea caused by allergies.
Homeopathy and nutrition are most likely to have a positive effect.
Nutrition and Supplements
• Diet: Try eliminating mucus-producing foods (such as bananas) for 2 weeks, then reintroducing them to see if you notice any difference in sleepiness or other symptoms.
• Essential fatty acids (EFAs) moderate inflammatory response and decrease allergic response. EFAs are low in obese people. Fish oil, evening primrose oil, flaxseed oil, and borage oil all contains essential fatty acids.
Acupuncture
Some evidence suggests that a type of acupuncture called auriculotherapy acupoint pressure may help treat sleep apnea.


http://www.umm.edu/altmed/articles/sleep-apnea-000156.htm
http://www.nhlbi.nih.gov/health/dci/Diseases/SleepApnea/SleepApnea_Treatments.html
http://www.nlm.nih.gov/medlineplus/ency/article/000811.htm
http://www.sleepdisordersguide.com/topics/laup.html
http://www.nlm.nih.gov/medlineplus/ency/article/002955.htm