Proven Alternatives to PAP therapy for you
Looking for CPAP alternatives? You’re not alone. We’re here to help you investigate your options.
So, grab a pen and paper or cue up a new computer document file and let’s go.
Here is a list of twenty-plus alternatives to CPAP and in no particular order:
(1) Weight Reduction is a common assumption to partially solve sleep apnea. It improves breathing patterns during sleep. Even more, losing weight also improves the quality of sleep and reduces daytime sleepiness. However, it isn’t an end all solution. Remember, losing weight can reduce the intensity of other treatment options. In other words, it can only help one’s sleep by losing weight and maintaining a healthy weight with custom diet/lifestyle/exercise solutions, especially when combined with other sleep apnea treatment options.
(2) Positional therapy is another option which can lead to moderate reductions in sleep apnea events, especially when someone is younger, has a low AHI and is less obese. But this choice is clearly inferior to CPAP and, therefore, only works with carefully selected people who have met Long-term compliance with positional therapy is historically poor.
3) Apnea triggered muscle stimulation is not an effective treatment of OSAS in this moment in time. Electrical stimulation of muscle tissue in the throat (where lazy tissue predominantly resides) is impractical, surgical in nature and is largely unproven.it works based on your unique breathing patterns; the system delivers mild stimulation to the hypoglossal nerve which controls the movement of your tongue and other key airway muscles. By stimulating these muscles, the airway remains open during sleep.
The Inspire obstructive sleep apnea device uses a small handheld sleep remote. The remote allows you to turn Inspire therapy on before bed and off when you wake up, increase and decrease stimulation strength, and pause during the night if needed.
Proof of sleep apnea relief is largely undocumented to offer a definitive recommendation. Seek the assistance of an ENT specialist with this option.
4) Although tongue muscle training is good like exercise for the body is, it is not the go-to solution in the treatment of sleep apnea in general. This is because weak muscle tissue typically surrounds the tongue or is in the throat area (internally). Unfortunately, this tissue is not re-trainable to maintain any rigidity. Therefore this type of approach has a low return of benefit.
5) Mandibular advancement devices (MADs) reduce sleep apnoeas and subjective daytime sleepiness, improve quality of life compared with control treatments. They work for patients with mild to moderate obstructive sleep apnoea (OSA). There is emerging evidence on the beneficial cardiovascular effects of MADs. However, doctors rarely reccomend TRDs.
7) Drug therapy is not an effective treatment for OSA (i.e. mirtazapine and protryptilline). This is due to constant dosage adjustment, doctor visits, etc.
For Nose-Related Alternatives:
8) Nasal dilators are not recommended for reducing snoring, or for improving sleep disordered breathing or sleep architecture in OSA . They may be beneficial for nasal passage clearance and clear nostril breathing relief only.
9) Nasal surgery doesn’t always work. Get specific assessments by an Ear Throat Nose Doctor before this option is worth it.
10) Intranasal corticosteroids improves mild to moderate OSA in children with co-existing rhinitis and/or upper airway obstruction due to adenotonsillar hypertrophy. They may also show some benefit with respect to both symptoms and some sleep parameters. Intranasal corticosteroids can be recommended as concomitant therapy in these situations.
11) Tonsillectomy as a single therapy treats OSA in the presence of tonsillar hypertrophy in adults. Adenotonsillectomy can be recommended in the presence of adenotonsillar hypertrophy associated with paediatric OSA (C). Radiofrequency tonsil reduction is not recommended as a single procedure for the treatment of OSA (negative recommendation.
12) Uvulopalatopharyngoplasty (UPPP) is a single-level surgical procedure effective only in selected patients with obstruction limited to the oropharyngeal area. When proposing UPPP, potential benefits should be weighed against the risk of frequent long-term side-effects. These can include velopharyngeal insufficiency, dry throat and abnormal swallowing. UPPP works only in carefully selected patients.
There’s more alternatives
13) Laser assisted uvulopalatoplasty has not demonstrated any significant effect, either on OSA severity or in symptoms or quality of life domains, and is not recommended (negative recommendation.
15) Uvulopalatal flap as a single intervention can only be recommended in selected cases for treatment of OSA (C). Studies investigating the uvulopalatal flap with tonsillectomy for OSA show a significant improvement of the severity of OSA and quality of life, and this combined intervention can be recommended in selected patients (B).
16) Pillar1 implants may be considered in patients with mild to moderate OSA, who are suitable with regard to their overall physical condition (not or only moderately obese, no or small tonsils and no sign of retrolingual obstruction). But only if the patient declines conservative approaches. Pillar implants only work in carefully selected patients.
17) Due to insufficient evidence, radiofrequency surgery of the tongue base as an isolated or combined procedure may only work for selected patients intolerant to conservative treatment as long as the overall condition appears suitable (non- or only moderately obese patients with retrolingual obstruction.
18) Due to insufficient evidence, hyoid suspension only works for carefully selected patients (C).
19) Procedures such as laser midline glossectomy and tongue suspension (Repose1) somewhat help as a single treatment option for obese patients with moderate to severe OSA. There are at present no data about their role in patients with mild disease.
20) Genioglossus advancement doesn’t work as a single procedure for the surgical treatment of OSA.
And the final three
21) Maxillomandibular advancement (MMA) seems to be as efficient as CPAP in patients with OSA who refuse conservative treatment, particularly in a young OSA population who don’t have excessive body mass index (BMI) or other comorbidities.
22) Distraction osteogenesis (DOG) works only in congenital micrognathia or midface hypoplasia (mandibular lengthening: B; midface advancement.
23) And of course the APAP (Auto-positive airway pressure) unit gives variable air pressures. This is instead of one pressure (from a CPAP) to keep the airway open. APAP works for individuals who clearly cannot sleep with CPAP.
Please consult your Sleep Doctor for further details about the alternatives above.
Still have questions?
Call 1.877.430.2727
Last Updated: May 22nd, 2024
Edited by Bill Bistak B Sc.,SEO/SEM Spc, CRT
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