Alternatives to CPAP Devices for Sleep Apnea Treatment

illustration of a woman having difficult sleep
If you are one of the millions of people who suffer from sleep apnea, you may be wondering if there are any alternatives to CPAP therapy. CPAP therapy is the most common treatment for sleep apnea, but not everyone can tolerate it. If you find that the mask makes you feel claustrophobic, that it doesn't fit properly while you sleep, or even that the machine is too loud, you may not tolerate a CPAP device. If this is your experience, don't worry, there are plenty of other treatment options available to you. In this article, we will discuss some of the best alternatives to CPAP therapy for sleep apnea so you and your doctor can find the right one for you.

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Sleep Apnea 101 | Symptoms | What is CPAP

If you are one of the millions of people who suffer from sleep apnea, you may be wondering if there are any alternatives to CPAP therapy.

CPAP therapy is the most common treatment for sleep apnea, but not everyone can tolerate it.

If you find that the mask makes you feel claustrophobic, that it doesn’t fit properly while you sleep, or even that the machine is too loud, you may not tolerate a CPAP device.

If this is your experience, don’t worry, there are plenty of other treatment options available to you.

In this article, we will discuss some of the best alternatives to CPAP therapy for sleep apnea so you and your doctor can find the right one for you.

What is sleep apnea?

Sleep apnea is a sleep disorder that occurs when the upper airway becomes blocked during sleep, causing disruptions in your breathing that can lead to a number of complications like heart attack, high blood pressure, and stroke.

These pauses in breathing can last from a few seconds to over a minute, and they may occur 30 times or more an hour.

Therefore, sleep apnea prevents you from getting the quality sleep your body needs. Sometimes with sleep apnea you may stop breathing hundreds of times during your sleep each night without even realizing it.

There are three types of sleep apnea with some being more common than others.

Obstructive sleep apnea (OSA) is caused by an obstruction in the throat or nose area, such as when the soft tissues in the back of the throat collapse and block the airway.

Central sleep apnea (CSA) is a less common type of sleep apnea that occurs when the brain fails to send proper signals to the muscles that control breathing while complex sleep apnea syndrome, also called mixed sleep apnea (MSA), is a combination of obstructive and central sleep apnea.

sleep apnea treatment without CPAP
Obstructive Sleep Apnea

What are the symptoms of sleep apnea?

There are a number of symptoms associated with sleep apnea, although if you have sleep apnea you may not experience all of them. The most common symptoms of sleep apnea are:

  • Loud snoring
  • Pauses in breathing as you sleep
  • Choking or gasping during sleep
  • Fatigue and excessive daytime sleepiness (EDS)
  • Difficulty concentrating
  • Mood swings or irritability
  • Morning headaches
  • Dry mouth
  • Sore throat
  • Trouble staying asleep which is also known as insomnia

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What is CPAP therapy?

CPAP, or continuous positive airway pressure, therapy is the most common treatment for sleep apnea.

A CPAP machine uses a mask to deliver pressurized air into your mouth or nose to keep your upper airway open while you sleep. This helps prevent the pauses in breathing that are known as apneas.

Why would you not want to use CPAP therapy?

There are a number of reasons why you might not want to use CPAP therapy. If you find the mask uncomfortable and difficult to sleep with, or if you feel claustrophobic wearing the mask, you may not like wearing the CPAP mask.

Sometimes the noise from the machine can be bothersome or you find that you have trouble tolerating the air pressure from the machine. Additionally, using CPAP therapy you may find that it does not help you sleep better or feel more rested.

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What are the alternatives to CPAP therapy for sleep apnea?

There are a number of alternatives to CPAP therapy available if you live with sleep apnea. It should be noted there are other positive airway devices such as BiPAP or bilevel positive airway pressure, and APAP, or automatic positive airway pressure, machines but we will not focus on these as the same problems you have with CPAP machines are likely to occur with these too.

Some of the other alternative treatments include:

Oral devices

Oral devices, also called oral appliances or dental devices, are worn in the mouth during sleep and work to keep the airway open.

There are a number of different types of oral devices available but they all work by holding the lower jaw slightly forward during sleep.

The two most popular are the mandibular advancement device (MAD) and the tongue retaining device (TRD).

MADs push your jaw forward which opens up your upper airway while TRDs prevent your tongue from collapsing into the back of your throat.

Oral devices are often recommended for sleep apnea if you have mild to moderate sleep apnea or if your sleep apnea is caused by a blocked airway.

Additionally, these devices may be used as an alternative to CPAP therapy if you have trouble tolerating the sleep mask.

However, oral devices are not recommended for if you have sleep apnea with severe sleep apnea or in those whose sleep apnea is caused by obesity.

These devices can sometimes cause dental problems including tooth pain and jaw ache as well as excessive salivation.

Surgery

There are a number of surgical procedures available to treat sleep apnea. One of the most common is called UPPP, or uvulopalatopharyngoplasty, which is surgery to remove excess tissue in the throat and soft palate. Other surgeries that may be used to treat sleep apnea include:

  • Nasal surgery to improve airflow
  • Tongue surgery to keep the tongue from falling back into the throat by moving it forward which is also called genioglossus advancement or GGA
  • Laser-assisted uvulopalatoplasty (LAUP), which is a procedure to remove excess tissue in the palate using a laser
  • Tonsillectomy, which is the surgical removal of the tonsils
  • Tracheostomy, which is a surgery to create an opening in the windpipe to allow air to enter the lungs directly and is usually a last resort
  • Adenoidectomy, which is the surgical removal of the adenoids or soft tissue in the back of your throat
  • Maxillomandibular advancement surgery, which is a surgery to move the jaw forward in order to open up your airway
  • Implantable treatment options are also available where a device is implanted in the chest that is similar to a pacemaker that stimulates muscles to help with breathing

Positional sleep therapy

You may find that sleep therapy works for you. This includes sleeping on your side instead of your back or using a device to prevent you from sleeping on your back such as a special pillow with a tennis ball attached at the neck, alarm systems, or sleep apps that will alert you if you roll onto your back during sleep, or sleep apnea devices that are designed to help you sleep on their side.

Weight loss

Weight loss and healthier lifestyle choices may also be recommended for sleep apnea patients who are overweight.

Stopping smoking and drinking alcohol

Smoking and drinking alcohol may also increase your risk for sleep apnea. If you smoke, quitting smoking can help improve your sleep apnea symptoms. Alcohol consumption should be limited to no more than two drinks per day if you have sleep apnea and not before bedtime as alcohol can relax the muscles used for breathing.

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Summary

Sleep apnea is a disorder that pauses your breathing as you sleep and can lead to a number of medical problems.

CPAP therapy is the most common sleep apnea treatment, but it isn’t for everyone. Thankfully, there are alternative treatment options such as oral appliance therapy, surgical procedures to remove tissue in the throat or palate, sleep therapy, weight loss, and quitting smoking and drinking alcohol.

If you have any other questions, please talk to your doctor or healthcare provider about the best sleep apnea treatment for you.

References and Sources:

Sleep Foundation 

Harvard Health Publishing 

American Sleep Association

medically reviewed and fact checked
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