Treating Sleep Apnea And Snoring
Sleep apnea may be treated with lifestyle changes such as losing weight, cutting down on alcohol consumption and quitting smoking. While we all know how beneficial this can be to all aspects of our health, we realize that it’s easier said than done.
The most commonly prescribed treatment for Sleep Apnea by physicians is a Continuous Positive Airway Pressure device, commonly known by its acronym, CPAP. This involves wearing a face mask over your nose and or mouth while you sleep. This mask is attached by a flexible hose to a bedside machine which forces pressurized air into your lungs all night. While this is the most effective treatment of severe sleep apnea, it is also the least complied with method of treatment. Most patients refuse to wear it from day 1, while others only wear it sporadically, and continue to suffer with their life-threatening sleep apnea. I only recommend this treatment to my most severe cases of sleep apnea. For those patients that can tolerate it, they experience the most restful night’s sleep they ever had and feel totally energized the next day, something they haven’t experienced in years! Our treatment plan recommends that patients combine the CPAP and an MRD to open up their airway. Studies at Harvard and the Mao Clinic have proven that combining the two therapies will yield the best results for living with Sleep Apnea when a patient tests out as severe Sleep Apnea.
My favored treatment for sleep apnea is a Mandibular Advancement Device, also known as a custom made, fully adjustable Oral Appliance. While they come in many different shapes and sizes, they all are discreetly hidden within your mouth at bedtime, and they function by bringing your lower jaw slightly forward, thereby opening your airway and stopping your snoring, and eliminating your sleep apnea. While your sleep apnea must be diagnosed by a medical doctor, these Oral Appliances can only be made by a licensed dentist that has been thoroughly trained in Sleep Medicine. Dr. Bittner Toohey has been practicing sleep medicine for well over 15 years. She is nationally recognized as a speaker, mentor, and innovator in the world of Sleep Medicine. Most mild and moderate Sleep Apnea patients are treated with an Oral Appliance as their 1st treatment choice. Severe patients are urged to try a Cpap, but if they cannot, or simply do not want to try it, they are also treated with an Oral Appliance. The compliancy rate of patients on Oral Appliance Therapy is so high, that even though the efficacy rate of Cpap is slightly higher, the Mean Disease Alleviation (MDA) of Oral Appliance Therapy is much better.
A third treatment option is surgery with an ENT or Oral Surgeon. The goal of most surgical procedures is to remove the excess tissue from the nose and/or throat and palate in order to open the upper air passages to facilitate breathing. Some common surgeries include T&A (Tonsils and Adenoids), UPPP (Uvulopalatopharyngoplasty), Septoplasty and G=Turbinate surgery, Genioglossus and Hyoid Advancement, and finally, the most drastic MMA (Maxillomandibular Advancement). All the above, except MMA are usually temporary fixes that require repeat surgeries. MMA, while extremely debilitating at first, usually works permanently. Dr. Bittner Toohey only believes in surgery as a last resort.
A new promising surgical approach called Inspire is now surfacing. It is currently limited to patients that have tried and failed with Cpap and Oral Appliance. It involves implanting a “pacemaker-like device” in your chest which sends signals to your tongue in rhythm with your chest movements during breathing. Those signals cause your tongue to jut forward out of the way of blocking your airway, There isn’t enough long term data yet to evaluate its long term efficacy.