How Is Sleep Apnea Treated?
Reviewed by: HU Medical Review Board | Last reviewed: March 2023 | Last updated: April 2023
Sleep apnea is one of the most common sleep disorders. If a person has sleep apnea, they have shallow breathing or stop breathing for 10 seconds or longer while asleep. They also tend to snore loudly. They may make snorting or choking noises during sleep.1,2
The good news is that sleep apnea can be treated. The type of treatment you need depends on which type of sleep apnea you have.
Types of sleep apnea
There are a few types of sleep apnea, including:3
- Obstructive sleep apnea (OSA) – a temporary stop in breathing during sleep caused by tissue blocking the airway. This causes heavy snoring, choking, and gasps while sleeping. It is the most common sleep-related breathing disorder. While snoring is common, not all people with OSA snore.
- Central sleep apnea (CSA) – a short stop in breathing during sleep caused when the brain does not send a signal to the body to breathe. It is not caused by an airway blockage.
- Sleep-related hypoventilation disorders (SRHD) – low blood oxygen and high carbon dioxide levels during sleep
Treatments for obstructive sleep apnea
Obstructive sleep apnea (OSA) can be treated with a combination of lifestyle changes, devices to help with breathing, and sometimes surgery.
Lifestyle changes for obstructive sleep apnea
A variety of lifestyle changes can help reduce or eliminate sleep apnea. Weight loss and exercise are often recommended to treat sleep apnea. Studies have found that weight loss reduces daytime sleepiness, improves sleep quality, and reduces high blood pressure. Exercise alone can improve sleep apnea symptoms, even without weight loss.4
Other lifestyle changes that can improve sleep apnea include:4
- Changing sleep positions from sleeping on the back to sleeping on the side
- Avoiding alcohol
- Avoiding sedating drugs such as benzodiazepines, barbiturates, antiepileptics, antihistamines, opioids, and certain antidepressants
CPAP machines for obstructive sleep apnea
Continuous positive airway pressure (CPAP) machines are highly effective in treating sleep apnea. A CPAP machine works by gently forcing air through a mask and into your airway. Studies show that when used consistently, CPAP machines improve sleep quality and reduce daytime sleepiness, blood pressure, number of car wrecks, and depression.4
There are other types of positive airway pressure machines, but CPAP is the one most often used.4,5
Dental appliances for obstructive sleep apnea
Dental, or oral, appliances may be prescribed for people with mild to moderate obstructive sleep apnea (OSA) who do not want to sleep with a CPAP machine. These devices fit in the mouth and keep the airway open during sleep. They work by holding the chin forward or the tongue down. Oral appliances are not recommended for people with severe OSA.4,6
Surgery for obstructive sleep apnea
Surgery may be recommended if a person has a lesion, tonsils, adenoids, or birth defect that partly blocks the airway. Surgery is generally only done on people with moderate to severe OSA if a CPAP machine did not provide enough relief.4
There is a nerve stimulation device that may work for certain people with moderate to severe OSA. The device is placed under the skin of the neck and chest through 2 small incisions. It stimulates the hypoglossal nerve, which activates the genioglossus muscle and keeps the upper airway open. This device is sold under the brand name Inspire. To qualify for Inspire, you must:4
- Have struggled with CPAP or been unable to get consistent benefits from it
- Be 18 years or older
- Have a body mass index (BMI) below 32 (Medicare looks for a BMI below 35)
- Be diagnosed with moderate to severe obstructive sleep apnea with an apnea-hypopnea index (AHI) between 15 and 65
Medicines for obstructive sleep apnea
While many drugs have been tested, none have been found to improve sleep apnea better than the CPAP machine, mouth appliances, surgery, or weight loss. But there are drugs currently being studied that seem to improve OSA without the use of a machine or dental appliance. The drug Sunosi® may be prescribed to help treat excessive daytime sleepiness caused by sleep apnea. Provigil and Nuvigil can also help to treat sleepiness that persists even when the sleep apnea is fully treated.4,7
Getting treated for sleep apnea is important for long-term health. Left untreated, sleep apnea can cause high blood pressure, heart disease, diabetes, kidney disease, depression, kidney disease, and more.8
Treatment for central sleep apnea
Central sleep apnea (CSA) is not common. Most cases are caused by other health conditions such as heart failure, stroke, or use of narcotic substances. CSA may occur when living at high altitudes. It is normally treated by addressing the underlying health condition causing it. But it can also be treated with positive air pressure (PAP) machines.9
Treatment for sleep-related hypoventilation disorders
Sleep-related hypoventilation disorders are often treated using a CPAP or a BPAP machine. BPAP stands for bi-level positive airway pressure. It delivers one pressure when you inhale and a lower pressure when you exhale, which helps improve oxygen levels in the blood.8