Treatment for Snoring and Sleep Apnea
To discuss treatment, we must know the cause for the problem. Both Snoring and Sleep Apnea are caused by the same thing – airway collapse. The illustration at the left shows the partially collapsed causing snoring, while the totally collapsed airway causes Obstructive Sleep Apnea. It is easy to see how untreated snoring can become Obstructive Sleep Apnea over time. The constant vibration of the tissues causes the snoring sound and results in inflammation and swelling of the tissues that ultimately close off the airway.
The obvious treatment for Snoring and Sleep Apnea is to open the airway – But How? There are many options for treatment that boil down to 3 main categories: Surgical – Soft Tissue, Surgical – Hard Tissue, and Non-surgical.
This is a somewhat lengthy discussion of Treatment Options for Obstructive Sleep Apnea. The treatment alternative offered by Dr. Hair is Oral Appliance Therapy. [button link=”#OAT” color=”#AAAAAA” size=”3″ style=”1″ dark=”0″ radius=”auto” target=”self”]Click Here[/button] to go directly to the Oral Appliance Option if you do not want to read about all of the options.
Surgical – Soft Tissue
There are procedures to place plastic inserts (or rods) into the soft palate to stiffen it and stop snoring. Other procedures remove your soft palate (or most of it) in an effort to open the airway. Dr. Hair has been unimpressed by either of these types of procedures, but all he sees are the failures.
One of the newest procedures involves removing the back part of your tongue to remove tissue thickness in your airway. Several problems with this: it is very expensive, not covered by insurance, and, worst of all, the tongue grows back.
Surgical – Hard Tissues
Of the surgical choices, these are the most predictable in actually treating Obstructive Sleep Apnea. However, these are major surgeries with associated risks, mortalities and morbidities. Two of there surgeries are Tracheostemy and Bi-Maxillary Advancement. A tracheostemy is produced by making a hole in your throat below your larynx or voice box. This bypasses all soft tissue and produces an open airway, but who wants that hole in your neck? The Bi-Maxillary advancement is achieved by detaching your upper and lower jaws from your head, moving them forward, and reattaching the jaws to your skull. This does open the airway area behind your jaws and in your throat, but, again, it is MAJOR surgery and reserved for the most difficult and non-responsive cases.
Non – Surgical
The most commonly prescribed non-surgical treatment for Obstructive Sleep Apnea is a PAP – CPAP, Bi-PAP, or AutoPAP. The PAP is Positive Airway Pressure; C is continuous, Bi has 2 levels, and Auto adjusts automatically. They all use air pressure to keep the airway open. CPAP is a very effective treatment; however, as much as 70% of people prescribed CPAP are CPAP intolerant – they simply cannot wear the CPAP for a variety of reasons. Some of the reasons are Claustrophobia, Leaking Mask, Noise of Machine (compressor), Limited Sleeping Positions, etc.
Oral Appliances are listed as a first line choice of treatment for mild and moderate Obstructive Sleep Apnea by the American Academy of Sleep Medicine (AASM) in Practice Parameters for the Treatment of Snoring and Obstructive Sleep Apnea with Oral Appliances. In this statement, the AASM also states that Oral Appliance Therapy is indicated for patients who are CPAP Intolerant and patients who refuse to wear CPAP.
Why do our patients like Oral Appliances?
Patients who do not tolerate CPAP can thrive on Oral Appliance Therapy (OAT). They can sleep in any position they choose. OAT does not have masks with attached straps and hoses. Oral Appliance therapy is quiet; therefore, OAT will not disturb your bed partner. Travel is much easier with an Oral Appliance; no one takes it from you to inspect it at the airport – you never know what the TSA was handling just prior to your CPAP. You may use your Oral Appliance anywhere because it does not require electricity.
What do we like about Oral Appliance Therapy (OAT)?
We have a few additional points we like about OAT:
- OAT does not have the complications that are associated with any surgery.
- Scarring (following surgery) could further constrict the airway.
- The patient may adjust the appliance to his comfort level.
- Surgery can make permanent changes to the patient; however, if patient is unhappy with OAT, he may discontinue OAT and go back to CPAP without changes to his body.
The Best News is the CPAP Alternative Treatment Can be Held in the Palm of Your Hand!
Do We Recomend Oral Appliances for Everyone?
There are many options for treatment; no one treatment can satisfy everyone’s treatment needs. We work in close contact with Primary Care Physicians, Sleep Physicians, and Sleep Centers here in Douglasville, Smyrna, Atlanta, and West Georgia making sure that you get the treatment that is best for you regardless of what that treatment may be. Simply stated: We want you to sleep better. “A well-rested patient is a much happier patient.”