CPAP Machines and Other Sleep Apnea Treatments: Which Is Right for You?

If you’ve been diagnosed with sleep apnea, you and your doctor will likely discuss a number of treatment options to help you manage the common sleep disorder.

Sleep apnea can be a potentially serious condition with harmful effects on health, especially when it is not diagnosed or treated correctly. But the good news is that there are a lot of solutions and therapies that can help you manage sleep apnea symptoms and avoid complications, explains Neeraj Kaplish, MD, a clinical associate professor of neurology at the University of Michigan in Ann Arbor. With the right sleep apnea treatment, he says, “most patients have resolution of symptoms.”

Here’s a primer on what types of treatments your doctor might suggest, as well as some new and promising therapies that are being investigated.

If you have mild sleep apnea, making some important lifestyle changes may alleviate your symptoms, says Ronald Chervin, MD, a professor of sleep medicine and neurology at the University of Michigan in Ann Arbor. And even if you do require further treatment (like a breathing machine or surgery) for your sleep apnea, your doctor will likely recommend taking some or all of these steps.

• Lose weight. Research has shown that weight loss can improve sleep apnea in people who have obesity.

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   Getting rid of excess weight can reduce the amount of excess fat in your neck and relieve the constriction in your airway, Dr. Chervin explains.
• Sleep on your side. When you sleep on your back, your tongue and soft palate naturally fall back into your throat and can block the airway, causing obstructive apnea. Sleeping on your side (either with or without a special pillow to prevent you from rolling over) or, in some cases, on your stomach, can reduce sleep apnea.

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• Avoid alcohol late in the day and certain drugs. Alcohol and some medications — like sleeping pills, tranquilizers, opioids, or benzodiazepines — make you stay asleep and prevent you from waking up easily when you experience sleep apnea, says Chervin. Not only that, they can relax the muscles in the back of your throat, which can cause your airway to collapse and increase snoring and sleep apnea.
• Quit smoking. Evidence suggests that smoking may make obstructive sleep apnea worse by increasing upper airway inflammation and reducing function. While there is limited evidence that quitting smoking can alleviate sleep apnea symptoms, experts suspect this is indeed the case.

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• Exercise. Research has shown that regular physical activity can reduce the severity of sleep apnea and daytime sleepiness, improve sleep, decrease the body’s inflammatory response, and help reduce body weight.

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   Even if you’re overweight or have obesity, research published in 2021 suggested regular exercise can reduce sleep apnea risk.

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   Regular moderate physical activity — such as 30 minutes of brisk walking at least five days a week — can help some people with sleep apnea even before any weight is lost. Exercise improves muscle tone in the throat and airways, which can ease symptoms in some cases. It’s not only an important part of treating mild cases of sleep apnea but also in treating moderate to severe sleep apnea in individuals who may not be able to tolerate using a breathing machine. Also, exercise helps thwart cardiovascular problems, such as hypertension and stroke.

If your doctor has prescribed a CPAP machine to help you manage sleep apnea and you are having problems with it, let your doctor know. A different type of face mask may solve the problem. In other cases, using a humidifier along with a CPAP machine can help with mouth dryness.

If used correctly and well tolerated, a CPAP machine can effectively manage sleep apnea and is one of the most effective solutions available. But there are other types of breathing machines that can be more effective depending on the type of sleep apnea you have, as well as how well you tolerate a CPAP. Alternatives include the following:

• Auto-CPAP Machines These devices automatically adjust the pressure while you sleep.

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• Bilevel Positive Airway Pressure Machines These units deliver more pressure when you inhale and less pressure when you exhale. These devices, which can be particularly helpful in strengthening the weak breathing pattern in individuals with central sleep apnea, can be set to automatically deliver air if the machine detects that you haven’t taken a breath after a set number of seconds.

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• Adaptive Servo-Ventilation This breathing machine is similar to a CPAP in that it delivers positive air pressure to your airways, but it’s a smart machine. It learns your normal breathing pattern during sleep and stores that information so that the device can then use air pressure to normalize your breathing and prevent pauses in airflow while you sleep.

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If other sleep apnea treatments don’t work and your symptoms are severe, your doctor may advise you to consider surgery. Surgery is typically performed to either make more room in the throat or to adjust your jaw to open up the airway. “Sometimes it’s making a small house larger, and sometimes it’s taking furniture out of the house,” says Robson Capasso, MD, a professor of otolaryngology and head and neck surgery at Stanford University School of Medicine in California. These procedures are some of the possible types of surgery that may be done to treat sleep apnea.

• Removal of Extra Tissue From the Back of Your Mouth and Top of Your Throat Called uvulopalatopharyngoplasty, the surgery involves the removal of part or all of your tonsils, adenoids, uvula, and other tissue from this area.

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• Repositioning the Jaw or Correcting the Facial Structure to Open the Airway Doctors may move your jaw forward to enlarge the space behind the tongue and soft palate and help prevent airway obstruction.

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• Tracheostomy This procedure is usually considered for people with severe, life-threatening sleep apnea who haven’t had success with a CPAP or other treatments.

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   For the procedure, surgeons create an opening in the neck and insert a breathing tube directly into the trachea. The tube is kept closed during the day but is uncovered at night to allow unobstructed breathing during sleep.
• Implantation of a Neurostimulation Device One of the newest additions to the roster of sleep apnea treatment options is a pulse generator device. Similar to a pacemaker, it is surgically implanted underneath the skin of the neck and chest.

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  The device continuously monitors your breathing patterns while you sleep and delivers mild stimulation to key respiratory tract muscles in the upper airways to help keep the airway open as needed while you sleep.

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   Such devices have only been available in the last few years.
• Other Types of Surgery In some cases, weight loss surgery, such as gastric bypass, or nasal surgery to remove polyps or straighten a deviated septum may be useful in treating sleep apnea.

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Treating the causes of conditions that are related to sleep apnea, such as cardiovascular disease or neuromuscular disorders, can also help sleep apnea symptoms.

• There are many causes of sleep apnea and symptoms that range from mild to severe. A doctor can help figure out a sleep apnea treatment plan that suits your body.
• One of the most common treatments for sleep apnea is a CPAP machine, but this may not be the best treatment for everyone, as some may find it uncomfortable.
• If other forms of treatment are not enough, a doctor may suggest surgery to open up the airway.
• For those who have both obesity and obstructive sleep apnea, the first FDA-approved drug for obstructive sleep apnea can help adults lose weight, which also reduces the airway obstruction that causes the sleep apnea.