Sleep Apnea - Treatment - Treatment

To help control or treat your sleep apnea, your doctor may recommend that you adopt lifelong healthy lifestyle changes.

• Make heart-healthy eating choices. This also includes limiting your alcohol intake, especially before bedtime.
• Get regular physical activity.
• Aim for a healthy weight. Research has shown that losing weight can reduce sleep apnea in people who were also diagnosed with obesity.
• Develop healthy sleeping habits. Your doctor may recommend general healthy sleep habits, which include getting the recommended amount of sleep based on your age.
• Quit smoking. Visit Smoking and Your Heart and the National Heart, Lung, and Blood Institute’s Your Guide to a Healthy Heart [PDF 2.9MB]. Although these resources focus on heart health, they include basic information about how to quit smoking. For free help and support to quit smoking, call the National Cancer Institute’s Smoking Quitline at 1-877-44U-QUIT (1-877-448-7848).

A breathing device, such as a CPAP machine, is the most commonly recommended treatment for patients with sleep apnea. If your doctor prescribes a CPAP or other breathing device, be sure to continue your doctor-recommended healthy lifestyle changes. Read Living With to learn more about properly caring for your breathing device.

Oral devices, also called oral appliances, are custom-fit devices that you typically wear while you sleep. There are two types of oral devices that work differently to open the upper airway while you sleep. Some hybrid devices have features of both types.

• Mandibular repositioning mouthpieces are devices that cover the upper and lower teeth and hold the jaw in a position that prevents it from blocking the upper airway.
• Tongue retaining devices are mouthpieces that hold the tongue in a forward position to prevent it from blocking the upper airway.

A new type of oral device was recently approved by the FDA for use while awake. The device delivers electrical muscle stimulation through a removable mouthpiece that sits around the tongue. You wear the mouthpiece once a day for 20 minutes at a time, for 6 weeks. The device stimulates the tongue muscle while awake to help prevent the tongue from collapsing backward and obstructing the airway during sleep. 

If you have sleep apnea, your doctor may prescribe an oral device if you do not want to use CPAP or cannot tolerate CPAP. Your doctor will recommend that you visit a dentist who will custom-make an appliance for you, make sure that it is comfortable, and teach you how to use it to get the best results.

Implants can benefit some people with sleep apnea. Some devices treat both obstructive and central sleep apnea. You must have surgery to place an implant in your body. The Food and Drug Administration has approved one implant as a treatment for sleep apnea. The device senses breathing patterns and delivers mild stimulation to certain muscles that open the airways during sleep. More research is needed to determine how effective the implant is in treating central sleep apnea.

A nerve stimulator can also treat sleep apnea. This treatment also involves surgery. A surgeon will insert a stimulator for the hypoglossal nerve, which controls tongue movement. Increasing stimulation of this nerve helps position the tongue to keep the upper airway open.

Children and adults with sleep apnea may benefit from therapy for mouth and facial muscles, known as orofacial therapy. This therapy helps improve tongue positioning and strengthen muscles that control the lips, tongue, soft palate, lateral pharyngeal wall, and face.

You may need surgery if you have severe obstructive sleep apnea that does not respond to breathing devices such as a CPAP machine, or that is caused by visible obstruction to the upper airway, perhaps due to large tonsils. Possible surgical procedures include:

• Tonsillectomy: a surgery to remove the tonsils, which are organs at the back of your throat
• Maxillary or jaw advancement: a surgery to move the upper jaw (maxilla) and lower jaw (mandible) forward, to enlarge the upper airway
• Tracheostomy: a surgery to make a hole through the front of your neck into your trachea, or windpipe. A breathing tube, called a trach tube, is placed through the hole and directly into your windpipe to help you breathe.

If surgery is considered as a possible treatment, talk to your doctor about the different types of surgical procedures, the risks and benefits of the procedures, potential discomfort, and the recovery time you will need after surgery.

• Living With will explain what your doctor may recommend, including lifelong lifestyle changes and medical care to prevent your condition from recurring, getting worse, or causing complications.
• Research for Your Health will discuss how we are using current research and advancing research to treat people with sleep apnea.
• Participate in NHLBI Clinical Trials will discuss our ongoing clinical studies that are investigating treatments for sleep apnea.