Other Treatments for Sleep ApneaEn Español (Spanish Version)
Managing Breathing Interruptions During Sleep
There are several different systems available that deliver air and pressure through the nose or mouth. The continuous delivery of pressurized air helps to keep the tissues in the throat open. Some continuous positive airflow pressure (CPAP) masks fit over the mouth and nose; others fit over only the nose. Some devices simply deliver a preset amount of air at a preset unit of pressure. Other devices are very sophisticated, delivering more pressure with every inhalation and a bit less with every exhalation. Others monitor breathing and only add pressure if the machine senses a breathing abnormality.
Unfortunately, many of the devices are uncomfortable to wear if not fitted properly. They often dry out the nose and/or mouth, irritate the skin, leave you with a headache, and are bulky and tight to wear. However, CPAP devices provide clear benefits to patients with sleep apnea that ranges from mild to severe.
Dental and Orthodontic Devices
Several dental devices are available for the treatment of sleep apnea. These devices may hold the tongue down, thrust it forward, or thrust the lower jaw forward. These devices seem to be less frustrating to use than CPAP devices, although they’re only effective as a treatment for mild to moderate sleep apnea.
Pillar Palatal Implants
This is a new procedure that allows stiffening of the palate by implanting permanent pieces of silastic, a silicone elastomer. This procedure is more effective for snoring; however, there are no studies to show benefits for sleep apnea. This procedure is done in the office under local anesthesia
Radiofrequency Ablation of the Palate and Base of Tongue
Radiofrequency heating of the palate and the base of tongue can cause shrinkage of the tissue, widening the airway. This procedure is quite successful in the treatment of snoring, but studies do not show adequate effectiveness in the treatment of sleep apnea.
American Sleep Apnea Association website. Available at: http://www.sleepapnea.org/resources/pubs/evaluated.html. Published May 2005. Accessed September 17, 2008.
Cecil R, Goldman L, Benett JC. Cecil Textbook of Medicine. 21st ed. Philadelphia, PA: WB Saunders Company; 2000.
Fischer Y, Khan M, Mann WJ. Multilevel temperature-controlled radiofrequency therapy of soft palate, base of tongue, and tonsils in adults with obstructive sleep apnea. Laryngoscope. 2003;113:1786-1791.
Questions about the pillar procedure? American Sleep Apnea Association website. Available at: http://www.sleepapnea.org/news/pillar.html .
Snoring. American Academy of Otolaryngology-Head and Neck Surgery website. Available at: http://www.entnet.org/HealthInformation/snoring.cfm. Accessed September 17, 2008.
Steward, DL. Effectiveness of multilevel (tongue and palate) radiofrequency tissue ablation for patients with obstructive sleep apnea syndrome. Laryngoscope. 2004;114:2073-2084.
What is sleep apnea? National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/dci/Diseases/SleepApnea/SleepApnea_WhatIs.html. Updated February 2008. Accessed September 17, 2008.
Last reviewed August 2008 by Elie Edmond Rebeiz, MD, FACS
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