Sleep Solutions by Severity of Sleep Apnea (2024)

You’ve been diagnosed with sleep apnea, and effective treatment is crucial for achieving better sleep that improves overall health. We know that sleep apnea exacerbates detrimental complications like high blood pressure, diabetes, and cognitive decline. Addressing your sleep apnea will help mitigate these conditions along with reducing the likelihood of daytime accidents caused by extreme fatigue.

Treatment for sleep apnea can also enhance mental health. You’ll get the quality sleep you need to show up like you want to at home, work, and in the community. Not to mention, your bed partner will appreciate more restful nights and may decide to no longer abandon the bedroom.

You’re not alone on the journey toward healthy sleep. Our Sleep Care team is here to support you with guidance and resources. If you’re not exactly sure whether your snoring is sleep apnea, take a Home Sleep Test and get some answers.

Treating Mild Sleep Apnea

If your sleep apnea is mild, common symptoms include loud snoring that may be interrupted by choking and pauses in breathing due to blocked airways. You may wake up in the morning with a headache, or even feel short of breath. While nighttime symptoms interfere with healthy sleep, the resulting daytime side effects of mild sleep apnea can drag you down. Excessive daytime sleepiness, irritability, depression, and difficulty concentrating on regular tasks can negatively impact your quality of life.

With mild sleep apnea, lifestyle changes can be a good first line of treatment but Positive Airway Pressure (PAP) therapy is often more effective and is therefore our primary treatment recommendation.

PAP Therapy

PAP machines deliver a stream of pressurized air through a face mask you wear while sleeping. Air pressure can be consistent or adjusted throughout the night, taking cues from your breathing patterns. The oxygen helps keep the airway open to stop obstructions that cause snoring and pauses in breathing. There are several types of PAP therapy to accommodate your comfort level and needs based on sleep apnea severity.

Auto-titrating positive airway pressure (APAP): APAP operates at a range of pressure levels based on your breathing needs during sleep.

Continuous positive airway pressure (CPAP): This is the simplest PAP therapy with a machine that delivers constant air pressure throughout the night. Pressure is adjusted based on your titration sleep study, where the pressure is adjusted based on your breathing patterns throughout the night.

Bilevel positive airway pressure (BiPAP): If CPAP’s consistent air pressure is uncomfortable, BiPAP is an alternative that alternates between two different pressure levels for inhaling (higher) and exhaling (lower).

Expiratory positive airway pressure (EPAP): Unlike CPAP, EPAP works only during exhalation and relies on your breath to create positive pressure through mechanical valves placed in your nose. These devices are typically less invasive, more portable, and don’t require electricity.

Lifestyle Changes

There are a number of behavioral modifications you can make to try and improve sleep apnea symptoms. These can work especially well when paired with other forms of treatment (like PAP therapy).

Weight loss: Maintaining a healthy weight will improve your health overall, and it can reduce some symptoms of sleep apnea, especially if you’re carrying extra weight around the neck that can obstruct airways.

Avoid substances: Alcohol before bedtime, along with certain pain medications and sleep aids that tend to relax airways and exacerbate snoring and breathing pauses.

Sleep on your side: Changing your sleep position if you typically nod off on your back can help open up airways, reduce snoring and minimize sleep apnea symptoms.

Positional Therapy

While lifestyle modifications can reduce mild sleep apnea symptoms, many people require positional therapy. There are a variety of options, from pillows to oral appliances to wearables. Positional therapy tools are CPAP alternatives that encourage side sleeping.

Adjustable beds and wedge pillows: Sleeping on an incline at a 30 to 40-degree angle can improve airway flow. With adjustable beds and wedge pillows, you can customize your sleep position and angle.

Pillows: Contour pillows for sleep apnea help maintain a side-sleeping position during sleep for optimal breathing and reduced snoring.

Wearables: Wearable technology allows for tracking sleep apnea — collecting data that can help inform therapy with the help of a doctor and Sleep Care advisor.

Oral devices: Oral appliances work by positioning the lower jaw slightly forward during sleep.

Nasal dilators: Minimally invasive nasal dilators fit into your nostrils and gently expand them to improve breathing, reduce snoring and ease congestion. Many are customizable to fit your nose.

Breathing strips: Snoring strips are adhesives that stick to the outside of your nose, opening nostrils to increase airflow.

Treating Moderate Sleep Apnea

Loud snoring, restless sleep and frequent pauses in breathing — generally up to 30 times per hour — are some symptoms of moderate sleep apnea. Left untreated, moderate cases of sleep apnea can steamroll into more serious health problems including heart disease and diabetes. If your sleep apnea has advanced from a mild case, treating it will require more than lifestyle change.

PAP therapy is still the gold standard for moderate OSA, but positional therapy can also help reduce pauses in breathing at night. A Home Sleep Test can help you identify if your sleep apnea is more than a light case and your doctor can suggest other interventions.

Oral Appliances

Oral devices help keep your airways open during sleep and can help mitigate sleep apnea symptoms. Mandibular advancement devices (MAD) look like mouth guards and secure to your teeth. MADs reposition the lower jaw and pull the tongue forward, out of your airway.

Tongue-retaining devices (TRDs) are customized to fit your mouth and stabilize the tongue to keep your airway open during sleep.

The latest oral appliance is a tongue muscle stimulation device with an electronic mouthpiece that gently clamps the tongue and emits electrical pulses. These pulses stimulate the tongue muscles to tone and strengthen them, helping to keep the tongue positioned forward and preventing it from collapsing into the airway.

Humidifiers

Adding extra moisture to your sleeping environment with a humidifier will reduce dryness that can irritate nasal passages and alleviate sleep apnea side effects like sore throat, sinus inflammation, and blocked airways. Some PAP therapy machines have built-in humidifiers to encourage clearer breathing at night.

Treating Severe Sleep Apnea

Loud, persistent snoring, choking, and pauses in breathing that occur 30 or more times per hour during a sleep study or Home Sleep Test are indications of severe sleep apnea that can cause serious health problems if not treated. If you’re suffering from severe sleep apnea, gasping and choking triggers frequent awakenings — continuous disruptions that prevent you from getting the restorative sleep you need to get through the day. If your sleep apnea is severe, a doctor will advise assertive treatment, ranging from PAP therapy to surgery or implants.

PAP Therapy

More complex sleep apnea breathing cases may call for APAP, which delivers a range of air pressure levels based on your breathing needs during sleep. However, CPAP is the most common and simplest form of PAP therapy to treat severe sleep apnea and delivers constant air pressure through a mask. BiPAP is an alternative to CPAP if constant air pressure is uncomfortable. BiPAP has two programmable pressure levels — one for inhalation (higher pressure) and another for exhalation (lower pressure), making it easier to breathe out. Adaptive Servo-Ventilation (ASV) PAP machines are designed specifically for central sleep apnea and some cases of mixed sleep apnea. These devices detect and respond to changes in your breathing patterns in real-time, providing pressure support as needed. ASV may include features like a backup-breath option to deliver assistance if breathing becomes too shallow or stops.

Sleep Apnea Surgery

If PAP therapy is not successfully managing your sleep apnea, your doctor may suggest surgery. There are a range of procedures that address anatomical issues that cause sleep apnea, such as a soft palate or tongue size and position. These procedures ultimately stabilize structures around your airway. A surgical evaluation will determine the most promising procedure that addresses the root cause of your sleep apnea.

Implants for Sleep Apnea

An implantable device is designed to stimulate the hypoglossal nerve, which controls tongue movement, to treat moderate to severe obstructive sleep apnea. If you are struggling to tolerate PAP therapy and do not have an upper airway blockage, you could be a candidate for this device. Three parts are surgically implanted in the neck and chest. You activate the device before sleep and control it with a remote. When on, gentle signals move the tongue forward to create space for better breathing.