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Obstructive sleep apnea - Treatment

Alternative Names

Sleep apnea - obstructive; Apnea - obstructive sleep apnea syndrome

Treatment:

The goal is to keep the airway open so that breathing does not stop during sleep.

The following may relieve symptoms of sleep apnea in some individuals:

Avoiding alcohol or sedatives at bedtime
Dental devices inserted into the mouth at night to keep the jaw forward
Weight management or weight loss

If these measures do not help, your doctor may recommend continuous positive airway pressure (CPAP) therapy. CPAP is the first-line treatment for obstructive sleep apnea. For information on this treatment, see:CPAP

Surgery may be an option in some cases. This may involve:

Uvulopalatopharyngoplasty (UPPP) to removing excess tissue at the back of the throat
Tracheostomy to create an opening in the windpipe to bypass the blocked airway if anatomical causes are present (rarely done)

Surgery to remove the tonsills and adenoids may cure the condition in children; it does not seem to help most adults.

Expectations (prognosis):

When treated correctly, obstructive sleep apnea may be controlled. However, many patients are unable or unwilling to tolerate CPAP therapy.

Complications:

During the nonbreathing episodes, blood oxygen levels falls. Persistent low levels of oxygen (hypoxia) may cause many of the daytime symptoms. If the condition is severe enough, pulmonary hypertension may develop, leading to right-sided heart failure or cor pulmonale.

Other complications include:

Abnormal heart rhythm (arrhythmia)
Excessive carbon dioxide levels in the blood
Heart disease
High blood pressure
Sleep deprivation
Stroke

Calling your health care provider:

Call your health care provider if you have excessive daytime sleepiness, or if you or your family notice symptoms of obstructive sleep apnea.

If you have this condition, call if symptoms do not improve with treatment or if new symptoms develop.

Decreased consciousness, extreme sleepiness, hallucinations, personality changes, and persistent confusion can be a sign of a medical emergency. Seek immediate medical attention or call your local emergency number, such as 911.

Obstructive sleep apnea

Reviewed last on: 9/11/2008
Allen J. Blaivas, DO, Pulmonary, Critical Care, and Sleep Medicine, Department of Veteran Affairs, VA New Jersey Health Care System, East Orange , NJ . Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Patel NP, Ahmed M, Rosen I. Split-night polysomnography. Chest. 2007 Nov;132(5):1664-71.

Basner RC. Continuous positive airway pressure for obstructive sleep apnea. N Engl J Med. 2007 Apr 26;356(17):1751-8.

Patil SP, Schneider H, Schwartz AR, Smith PL. Adult obstructive sleep apnea: pathophysiology and diagnosis. Chest. 2007 Jul;132(1):325-37.

Darrow DH. Surgery for pediatric sleep apnea. Otolaryngol Clin North Am. 2007 Aug;40(4):855-75.

Friedman M, Schalch P. Surgery of the palate and oropharynx. Otolaryngol Clin North Am. 2007 Aug;40(4):829-43.

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