Positive airway pressure. If you have obstructive sleep apnea, you may benefit from positive airway pressure. In this treatment, a machine delivers air pressure through a piece that fits into your nose or is placed over your nose and mouth while you sleep.
Positive airway pressure reduces the number of times you stop breathing as you sleep. The therapy also reduces daytime sleepiness and improves your quality of life.
One of the most common types is called continuous positive airway pressure, also known as CPAP (SEE-pap). This treatment delivers continuous and constant pressure that is slightly stronger than the air pressure around you. The air pressure is just enough to keep your upper airway passages open so that you can breathe freely.
Although CPAP effectively treats obstructive sleep apnea, some people find the mask uncomfortable or loud. However, newer machines are smaller and less noisy than older machines. And there are a variety of mask designs for individual comfort.
Also, with some practice, most people learn to adjust the mask to obtain a comfortable and secure fit. You may need to try different types to find one that works well for you. Several options are available, such as nasal masks, nasal pillows or face masks.
If you're having trouble tolerating pressure, some machines have special adaptive pressure functions to improve comfort. You also might benefit from using a humidifier along with your CPAP system.
Another treatment option is autotitrating positive airway pressure, also called APAP. In CPAP, the pressure stays constant. The air pressure of an APAP varies, automatically adjusting when the device senses a change in airway resistance, such as the vibration of a snore. APAP can be helpful when the ideal fixed pressure for CPAP is difficult to identify — as is often the case during home sleep testing when no one is there to monitor your breathing patterns. There is less evidence supporting APAP compared with CPAP, but it seems to offer equivalent results.
Another type of positive airway pressure is bilevel positive airway pressure, also called BPAP. It's less commonly used than CPAP and APAP. BPAP delivers a preset amount of pressure when you breathe in and a different amount of pressure when you breathe out.
If you have stomach discomfort or bloating while using CPAP, check with your healthcare team to see what adjustments you can make to improve its comfort.
In addition, contact your healthcare team if you still snore or remain sleepy during the day despite treatment, if you begin snoring again, or if your weight changes by 10% or more.
Mouth devices. Also known as oral appliances, these are an alternative for some people with mild or moderate obstructive sleep apnea. They're also used for people with severe sleep apnea who can't use CPAP. The devices may reduce sleepiness and improve quality of life.
All these devices are designed to keep the throat open. Some devices keep the airway open by bringing the lower jaw forward, which can sometimes relieve snoring and improve obstructive sleep apnea. Other devices hold the tongue in a different position to keep the airway free.
If you decide to explore this option, see a dentist experienced in dental sleep medicine appliances for the fitting and follow-up therapy. Several devices are available. Close follow-up is needed to ensure successful treatment and that use of the device doesn't cause changes to your teeth.
A newer device uses electrical stimulation on the tongue. A small number of studies show the device may help people with very mild sleep apnea and snoring. This device isn't meant to be used in place of CPAP if you have moderate to severe obstructive sleep apnea. It also is not recommended for people who have a pacemaker or another implanted electrical device.