Obstructive sleep apnea (OSA) is a serious condition. With the right treatment, however, the nocturnal breathing disorder can be effectively treated, so that those affected can enjoy their lives again. Every treatment option for sleep apnea is primarily aimed at preventing breathing interruptions during sleep, as these can have serious consequences and risks if left untreated. There are various treatments for OSA, including ventilators, special aids and surgical procedures. An overview of possibilities can be found on this page.
Therapy by severity & causes of obstructive sleep apnea syndrome
The selection of the treatment method is made individually for each affected person by the doctor and is based, among other things, on the severity of obstructive sleep apnea as well as on the individual causes, which can be anatomical, for example, but can also be found in lifestyle. Being overweight is one of the biggest risk factors for OSA.
The diagnosis of obstructive sleep apnea is based on tests in the sleep laboratory. The Apnea-Hypopnea Index (AHI), which quantifies the number of episodes of reduced respiratory flow per hour, distinguishes three degrees of severity:
- mild obstructive sleep apnea: more than 5 to 15 breathing interruptions per hour, AHI 5-15
- moderate obstructive sleep apnea: 15 to 30 breathing interruptions per hour, AHI 15-30
- severe obstructive sleep apnea: more than 30 breathing interruptions per hour, AHI > 304
In a mild form of obstructive sleep apnea, changing lifestyle and optimizing sleep hygiene can lead to significant improvements.
In addition, a so-called mandibular protrusion splint can be used, which is also a therapy option for moderate to severe sleep apnea syndrome. If obstructive sleep apnea is more treatment advanced, a changed lifestyle or a mandibular protrusion splint are often no longer sufficient. In this case, treatment with a CPAP mask, surgical intervention, or tongue pacemaker may promise success.
The standard treatment of moderate to severe sleep apnea is the CPAP mask, which, however, often has undesirable side effects.
For those affected who cannot tolerate the CPAP mask or cannot be treated with it, there is an innovative alternative. The tongue pacemaker ensures that the breathing interruptions do not occur.
Mandibular protrusion splint
The mandibular protrusion splint, also called anti-snoring splint, is individually made dental and is mainly used for mild to moderate sleep apnea. But not everyone is suitable for this form of therapy.
Surgery is a treatment option, especially for moderate to severe obstructive sleep apnea. However, the surgical procedure carries risks such as bleeding or lack of effectiveness.
What you can do yourself to prevent and treat sleep apnea
If you suffer from obstructive sleep apnea and are overweight, you should try to lose weight. Being overweight is a significant risk factor that affects the vast majority of sleep apnea sufferers.1 When you lose weight, fat deposits inside your body also disappear. In the upper respiratory tract, this creates more air. The throat area widens and the risk of airway blockages during sleep decreases.
There are structured weight loss programs that help you to persevere and successfully master typical stumbling blocks. It’s best to talk to your doctor about it.
In mild forms of obstructive sleep apnea, weight loss alone may sometimes be enough to stabilize respiratory function. In moderate and severe forms, however, targeted treatment with positive pressure ventilation or a tongue pacemaker is essential.
For obstructive sleep apnea, it is recommended to sleep in a lateral position.2 Back sleepers have been shown to snore more frequently and suffer from breathing problems more frequently. When sleeping in a supine position, the risk is particularly high that the sagging tongue muscle slips backwards and the airways collapse. Therefore, it can be helpful if back sleepers get used to it. The problem: During sleep, you will automatically turn from the side to your back if you are so used to it. A raised bedding of the head or a so-called “supine position avoidance” with the help of tennis balls or a backpack can facilitate relearning.
Furthermore, you should pay attention to good sleep hygiene. There are a number of measures that are conducive to healthy and restful sleep. Such measures cannot be used to combat obstructive sleep apnea, but they are very useful as supportive measures.
Four, better six hours before bedtime, you should not eat sumptuous meals and stimulating, caffeinated drinks. Alcohol consumption and smoking are also not conducive to healthy sleep. Alcohol promotes a relaxation of the muscles and can thus increase the risk of nocturnal breathing interruptions. The best conditions for a restful sleep can be created with a bedroom that is darkened, not heavily heated and free of noise.
If possible, you should avoid sleeping pills altogether. Some drugs can increase the symptoms of sleep apnoea.3 Please consult your doctor.
1 Deutscher Berufsverband der Ohren-Nasen-Ohrenärzte e.V. Available online at: www.hno-aerzte-im-netz.de/krankheiten/schnarchen-schlafapnoe/definition-und-haeufigkeit.html
2 Institute for Quality and Efficiency in Health Care (IQWiG). Available online at: www.gesundheitsinformation.de/behandlung-einer-obstruktiven-schlafapnoe.2120.de.html?part=behandlung-as
3 Ancoli-Israel, S. Sleep apnea in older adults–is it real and should age be the determining factor in the treatment decision matrix? Sleep Med Rev 11, 83-85, doi:10.1016/j.smrv.2006.11.002 (2007).
4 Mayer G, physician M, Braumann B et al. S3 guideline Non-restful sleep/sleep disorders, chapter “Sleep-disordered breathing in adults”. Somnology 2017; 20 (Suppl s2): 97-180
For reasons of readability, the generic masculine is generally used in the text. This formulation applies equally to all persons and is not intended to constitute discrimination.
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