Sleep Apnea Treatment: What Works Best?

A story today on NPR’s “Morning Edition” discussed treatment options for obstructive sleep apnea and snoring.




What is the best treatment for OSA? In June the AASM released a clinical guideline for the evaluation and treatment of sleep apnea; it was published in the Journal of Clinical Sleep Medicine. Here is a summary of the AASM recommendations:

1. CPAP Therapy
CPAP therapy is the “treatment of choice” for OSA. It is effective for all severity levels of sleep apnea. CPAP should be the first treatment that a doctor offers to someone with OSA.

CPAP stands for “continuous positive airway pressure.” It provides a steady stream of air through a mask that you wear during sleep.

2. Oral Appliance Therapy
An oral appliance is an alternative treatment option for people with mild or moderate OSA; people with severe OSA should be treated with CPAP. Oral appliance therapy also can help a person who has primary snoring.

An oral appliance is a dental mouth piece that you wear during sleep. It fits much like a sports mouth guard or an orthodontic retainer. It either holds the tongue or supports the jaw in a forward position. An oral appliance should be customized to fit you by a dentist who has been trained in dental sleep medicine.

3. Surgery
A surgical procedure is an alternative treatment option for some people with OSA. It may be required to correct a physical abnormality; it also may be performed if you are unable to have success with CPAP or an oral appliance.

There are a variety of surgeries that can help correct a specific problem. Targeted areas include the throat, tonsils, jaw and nose. Surgery may not cure OSA; you may need to continue with another treatment such as CPAP. Positive results also may not be permanent; symptoms may reappear at a later time.

4. Behavioral Strategies
Weight loss is recommended for everyone with OSA who is overweight. But it rarely cures sleep apnea. It should be combined with another treatment. Positional therapy – side sleeping – may help some people with less severe OSA.

A board-certified sleep specialist can determine which treatment option is best for you. Contact an AASM-accredited sleep disorders center for help with sleep apnea.