Devices applying CPAP (Continuous Positive Airway Pressure), APAP (Automatic Positive Air Pressure) or Bi-Level pressure bring relief to patients by providing either a constant flow of air or forced air pressure into the airways via a mask. The most common treatment for sleep apnoea is CPAP. This involves a mask, worn over the nose at night, to apply air at a constant pressure. A machine connected to this mask blows air into the airways to prevent them from collapsing so that the individual is able to breathe normally.
The alternatives to CPAP are position therapy, lifestyle management, dental devices and surgery.
Position therapy, for example not sleeping on the back and raising the head off the bed, may reduce symptoms for patients with mild sleep apnoea.
Lifestyle management may involve helping people to lose weight, stop smoking and/or decrease alcohol consumption.
Dental devices are designed to keep the upper airway open during sleep. The efficacy of dental devices has been established in clinical trials1, but these devices are traditionally viewed as a treatment option only for mild and moderate sleep apnoea.
Surgery may be another option, whereby the size of the upper airway is increased to prevent collapse of the airway and make breathing easier. This involves, specifically, resection of the uvula and redundant retrolingual soft tissue. However, there is a lack of evidence of clinical effectiveness, and surgery is not routinely used in clinical practice.
The diagnosis and treatment of sleep apnoea as well as the monitoring of the patient response should be carried out by a physician or specialist.
1 Thicket EM, Hirani S, Williams A, Hodgkins J. Royal Bournemouth Hospital, Castle Lane East, Bournemouth, BH7 7DW. Eleanor.thickett@ . A prospective evaluation assessing the effectiveness of the '‘Dynamax'’ mandibular appliance in the management of obstructive sleep apnoea. Surgeon. 2009 Feb;7(1):14-7.