There are three primary sleep apnea treatment options:

  1. Continuous Positive Airway Pressure (CPAP) therapy
  2. Dental appliances, such as an oral airway device (OAD)
  3. Surgery

This post is meant to shed light on the above sleep apnea treatment options, including their advantages and disadvantages, to help better inform your decision on sleep apnea treatment. 

Sleep Apnea Treatment Options

Sleep apnea (OSA) , a condition where breathing stops or becomes shallow during sleep, can have profound effects on your health and quality of life. Recognizing the condition and selecting the appropriate treatment is paramount to ensuring better sleep, reduced risk of health complications, and an overall improved well-being.

CPAP vs. OAD vs. Surgery

While the exact cause of BMS remains elusive, it can be classified into different types based on potential causes and triggers. BMS can be categorized into three primary types, each with its own set of potential causes:

1. Continuous Positive Airway Pressure (CPAP):

CPAP machines are the most commonly prescribed treatment for sleep apnea, especially for those with moderate to severe cases. The machine works by delivering a continuous stream of air through a mask to keep the airway open during sleep.

Advantages:

  • Effective: Numerous studies have shown that CPAP, when used consistently, is very effective in treating sleep apnea.
  • Immediate Relief: Many patients report improved sleep from the very first night of use.
  • Reduced Health Risks: Regular use can reduce the risk of heart problems, stroke, and other health issues associated with sleep apnea.

Drawbacks:

  • Adjustment Period: Some people find the mask uncomfortable or cumbersome and may need some time to get used to it.
  • Noise: The machine can be a bit noisy, potentially disturbing sleep initially.
  • Maintenance: Regular cleaning and maintenance are required.
  • Intolerance: Some individuals may be unable to adjust to the device resulting in discontinued use and failed treatment.

2. Oral Airway Devices (OAD)

Dental appliances, or oral airway devices (OAD), are an option suited for mild to moderate sleep apnea patients, especially those who cannot tolerate CPAP. They resemble mouth guards and work by repositioning the lower jaw and tongue to keep the airway open.

UnitedHealthcare OSA policy oral appliance

Advantages:

  • Comfortable: Many patients find dental appliances more comfortable than a CPAP mask.
  • Portable: Ideal for frequent travelers, as they are easier to carry than a CPAP machine.
  • Quiet: No noise as there’s no machinery involved.
  • Effective: While CPAP has traditionally been the gold standard of OSA treatment, OAD increasingly considered an equally effective and medically necessary treatment option for OSA.*

*A new UnitedHealthcare policy recognizes OAD as a viable and effective treatment option for those with CPAP intolerance, and will not cover the cost of surgery without “the failure of an adequate trial or oral appliance therapy.”

Drawbacks:

  • Potential Jaw Problems: Some users may experience temporomandibular joint (TMJ) problems or bite changes.
  • Regular Adjustments: Over time, dental appliances might require adjustments by a dental specialist.

3. Surgery:

For extreme cases of sleep apnea, surgical procedures are available. Because of the invasive nature of surgical procedures, this option should be considered as a last resort.

Types of Surgical Procedures:

Several surgical options are available, depending on the root cause of the sleep apnea. Some of the most common include:

  1. Uvulopalatopharyngoplasty (UPPP): Removes excess tissue from the throat.
  2. Trans Oral Robotic Surgery (TORS): Minimally invasive surgical approach that removes or reduces tissue in the throat to improve airway passage.
  3. Maxillomandibular advancement (MMA): Repositions the upper and lower jaw to enlarge the airway.
  4. Inspire Therapy: A device is implanted beneath the skin, which stimulates the nerve controlling tongue movement, preventing airway collapse.
  5. Tonsillectomy: Particularly effective for children where enlarged tonsils block the airway.

Advantages:

  • Permanent Solution: Surgery can offer a lasting solution, especially when anatomical issues cause sleep apnea.
  • No Need for Devices: Post-surgery, there’s no need to wear a device during sleep.

Drawbacks:

  • Invasive: Surgery comes with risks, including infections or complications.
  • Recovery Time: Patients require time to heal post-surgery.
  • Not Always Effective: Surgical interventions might not always cure sleep apnea. Some patients might still need CPAP or a dental appliance post-surgery.

When to Seek Treatment for Sleep Apnea  

Choosing the right treatment for sleep apnea is a decision that should be made collaboratively between you and your healthcare provider. It’s essential to weigh the advantages and drawbacks of each option, considering the severity of your condition, your lifestyle, and other individual factors.