Alternative Treatments to PAP

• Through the use of air pressure, CPAP treats sleep apnea most effectively and generally the first step in treatment.
• Some individuals cannot tolerate CPAP and may benefit from alternative treatments such as dental devices, surgery, behavioral therapy, medication,  and some simple changes to your everyday practices.

While there are a number of different treatments for sleep apnea, CPAP is the most effective, and one of the least invasive, of the therapies.  CPAP allows air pressure to act as a splint for your airway, keeping your airway open to allow you to breathe normally and keep your oxygen levels up without the use of an oxygen canister or concentrator.  Oxygen is generally NOT used as a stand-alone treatment for sleep apnea.  Sleep apnea is the closing-off of your airway, and while oxygen will keep your oxygen levels up, it will not prevent your airway from closing off, and many symptoms of sleep apnea (high blood pressure, snoring, excessive sleepiness) may persist.

Outlined below are other forms of therapy that can be utilized, depending on the severity of your sleep apnea.

Dental Device –

Your sleep physician may refer you to a dentist to be fitted for a dental device.  A dental device is worn at night and pulls your lower jaw forward to open up your airway.

Surgery –

Different surgical techniques can be used to increase the size of the airway, alleviating sleep apnea.  These surgeries include those that can reduce the size of your airway (uvulopalatopharyngoplasty, or UPPP; Laser Assisted UP); reduce the size of your tongue (somnoplasty); create a direct opening in the airway below the obstruction site (tracheotomy); and reposition the bones of the upper jaw (bimaxillary advancement).

Behavioral Therapy –

Physicians may suggest changing certain behaviors to alleviate sleep apnea.  Some suggestions may include:  limiting alcohol intake; avoiding smoking; losing weight; sleeping on your side or stomach; and avoiding the use of sleeping pills.

Medication –

Very few studies have been performed on the effectiveness of anti-snore medications, and you should discuss these with your physician before starting.  Decongestants may be used to reduce swelling in the airway.  Some other medications, such as Provigil and Nuvigil, promote wakefulness during the day, but they should not be used as a replacement for CPAP therapy.  Again, you will need to discuss any course of action with your physician before starting.        

After receiving a diagnosis of sleep apnea, you will want to speak with your physician about which therapy is right for you.  Generally, your physician will want you to try CPAP before any other therapy, as CPAP has the highest success rate for correcting sleep apnea.  If your physician deems CPAP ineffective, he or she may suggest one of the therapies outlined above.

Key Words:

sleep apnea, CPAP, treatment, snoring, oxygen, alternative