Lifestyle measures that may reduce sleep apnea include losing weight for people who are overweight or obese, avoiding alcohol and sedatives at bedtime, quitting smoking, and sleeping on your side or in a more upright position. For someone who has hypothyroidism, treating that condition may help reduce apnea.
If these measures do not help, continuous positive airway pressure (CPAP) may be necessary. CPAP, which involves wearing a nasal mask that delivers a steady stream of air to maintain airway pressure and keep the airways open, is effective in 80 to 90 percent of people.
However, the mask is cumbersome and can cause nasal dryness and congestion and skin irritation. Using a humidifier and making sure the mask fits properly can alleviate some of these problems. Some people benefit from a dental appliance that helps maintain an open airway by keeping the jaw and tongue in a forward position during sleep.
Carefully selected people who cannot tolerate CPAP may benefit from uvulopalatopharyngoplasty, a surgical procedure that increases the size of the upper airway by removing the uvula (the tag-like structure that hangs down from the back of the throat) and any excessive tissue surrounding it. The procedure is successful in only about 40 to 50 percent of people, typically those with mild cases of sleep apnea.
Tonsillectomy, surgical treatment of other upper airway obstructions, and facial reconstructive procedures may help in some cases.
Some physicians may attempt to relieve sleep apnea using a variety of medications known to affect the sleep cycle, but the only drug approved by the U.S. Food and Drug Administration (FDA) for use in sleep apnea, as an adjunct to other treatments, is modafinil (Provigil).
Originally approved to treat narcolepsy, Provigil can help people with sleep apnea to stay awake during the day. The most common side effects are
- stuffy nose
- back pain
- trouble sleeping at night
- upset stomach
A newer option is the Pillar Palatal Implant System. With this system, three polyester braids, each less than 1 inch long, are implanted in the back of the throat to stiffen the soft palate and reduce the vibration that causes snoring.
While the device is approved by the FDA to treat snoring and mild to moderate sleep apnea, the jury is still out on its effectiveness as a sleep apnea treatment.