Mild cases of obstructive sleep apnoea (OSA) can usually be treated by making lifestyle changes, such as losing weight (if you are obese). More serious cases may require the use of a type of breathing apparatus known as continuous positive airway pressure (CPAP) to assist with breathing during sleep.
Lifestyle changes
Some cases of mild to moderate OSA can be successfully treated by making changes to your lifestyle. These include:
- losing weight, if you are obese,
- avoiding alcohol during the evening,
- quitting smoking, if you are a smoker, and
- avoiding the use of sleeping tablets and tranquillisers.
Sleeping on your side, rather than on your back, may also help to relieve symptoms of OSA.
Continuous positive airway pressure (CPAP)
If your OSA is moderate to severe or does not respond to the changes suggested above, the use of continuous positive airway pressure (CPAP) is recommended.
CPAP has a mask that is placed over your nose which delivers a continuous supply of compressed air. The compressed air prevents the airway in your throat from closing. You will need to use CPAP at night when you sleep.
Earlier generations of CPAP often cause nasal dryness, nose bleeds and sore throat. However, newer types of CPAP include a humidifier which should help to reduce these side effects.
To start with, using CPAP may feel peculiar and you may be tempted to abandon the treatment. However, people who persevere with CPAP tend to find that they get used to wearing the mask and their symptoms dramatically improve.
If using CPAP causes you discomfort, you should inform your treatment staff because modifications can be made to the device that may make it more comfortable.
Inter-oral devices (IODs)
Inter-oral devices (IODs) are small devices that you place in your mouth that are designed to keep your throat open while you sleep. IODs are not as effective as CPAP, but they may be recommended for mild OSA or for people who cannot tolerate using CPAP.
Side effects of IOD can include:
- increased saliva in your mouth, and
- tooth and gum pain.
However, these side effects should improve over time.
Stimulants
If your symptoms of daytime sleepiness are particularly severe, you may be given a short-term dose of a medicine known as a stimulant. Stimulants work by increasing the activity within your nervous system in order to make you feel more alert and awake.
If you are experiencing severe symptoms of sleepiness during the daytime a medicine called modafanil may be recommended for you. Side effects of modfanil can include:
- dizziness, and
- blurred vision.
You should not drive or operate heavy machinery if you are experiencing severe symptoms of daytime sleepiness, especially as the side effects listed above will further affect your ability and judgement. See the 'complications' section for more information about driving.
In rare situations, modafanil can cause depression and make people think suicidal thoughts. If this occurs, you should stop taking the medicine and see your GP.
The long-term use of stimulants is not recommended because they can become addictive.
Surgery
The use of surgery to treat OSA is usually not recommended because evidence shows that does not tend to be as effective as CPAP in controlling symptoms.
Surgery is usually only considered as a last resort when all other treatment options have failed, and OSA is severely affecting your quality of life.
The preferred surgical treatment for OSA is a tracheostomy. A tracheostomy involves a tube being inserted directly into your neck to allow you to breathe freely, even if the airways in your upper throat are blocked.
Alternative treatment
As unusual as it sounds, there is evidence that regularly playing the Australian wind instrument, the didgeridoo, can help to reduce the symptoms of mild to moderate OSA.
A study found that people who attended regular didgeridoo lessons and practiced everyday for four months experienced a significant reduction in daytime sleepiness.
This may be because regularly playing the didgeridoo strengthens the muscles in your upper airways.
