There are three common treatment options for snoring and sleep apnea:

• Oral appliances (such as the TAP^®)
• Continuous positive airway pressure (CPAP)
• Surgery

Except for surgery, treatment for sleep apnea involves action every night on your part. You must use a medical device each and every time you sleep to treat your snoring or sleep apnea. Therefore, it’s important that you choose a treatment option that fits into your lifestyle.

Ask yourself: “Do I want a non-invasive, reversible therapy?
Oral appliances and CPAP are non-invasive treatment options for snoring and sleep apnea. A non-invasive solution is one that does not involve surgery or inserting foreign objects into your body. You are in control of your treatment at all times when you use an oral appliance or CPAP. Both treatments are reversible and you can remove the device at any time if there is a problem. Surgical treatments for snoring and sleep apnea are invasive, are not reversible, may be painful and can require recovery time.

Ask yourself: “What am I willing to do every night to treat my problem?”
If you do not wear your oral appliance or CPAP, you will continue to have symptoms of the disease. Studies have shown that both of these therapies can work extremely well.
The catch is that you have to use your chosen device regularly to get relief from your snoring and sleep apnea. The therapy you choose will only be effective if you follow the doctor’s orders and sleep with your oral appliance or CPAP.

Ask yourself: “What type of therapy will fit into my lifestyle?”
Do you travel a lot? Would the sound of a CPAP machine disturb your bed partner? Do you suffer from claustrophobia? Do you get your hair styled every week?

An oral appliance is hidden in your mouth, so it is less obvious than a CPAP machine and mask. Unlike CPAP, an oral appliance does not make any sound while in your mouth. Oral appliances are small and can easily fit into your pocket, briefcase or purse.

CPAP machines are typically size of a shoebox and need electricity. Once it is turned on, the machine makes noise as it blows air to help you breathe. It requires you to wear a mask over your nose and/or mouth. A hose connects the mask to the CPAP machine. The mask is held on by straps that can make you feel like you are tied up. Women, in particular, complain that the straps mess up their hair at night.

These examples are just a few lifestyle issues to consider when you choose a therapy.

Ask yourself: “Is the treatment recommended by the American Academy of Sleep Medicine?”
There are many products and treatments that claim they get rid of snoring and sleep apnea. One way to know whether your treatment of choice is a “good” choice is to find out what a scientific or professional group recommends.

The American Academy of Sleep Medicine (AASM) is a professional group of clinicians involved in the treatment of snoring and sleep apnea. They have an advisory board that reviews the science and success of different treatments options.

Comparing Treatments

Use this chart to compare your treatment options for sleep disordered breathing.

Features of the comparison chart:

• Steps involved in treatment
• Pros and cons of each treatment
• Insurance coverage

AASM Recommendations for Treatment

The American Academy of Sleep Medicine (AASM) is a professional organization of clinicians involved with the diagnosis and treatment of sleep disorders.¹ The AASM Standards of Practice Committee has made the following treatment recommendations for those who suffer from obstructive sleep apnea. These recommendations are based on literature review, expert opinion, and consensus.

Optimal Treatment
According to the AASM, optimal treatment for snoring and sleep apnea is as follows.

For Mild to Moderate Obstructive Sleep Apnea
The American Academy of Sleep Medicine recommends oral appliances as a primary or first line of treatment for mild to moderate obstructive sleep apnea. Patients should always be offered the choice of an oral appliance if they have mild to moderate OSA.

Oral appliances (OAs) are indicated for use in patients with mild to moderate OSA who prefer OAs to Continuous Positive Airway Pressure (CPAP), or who do not respond to CPAP, are not appropriate candidates for CPAP, or who fail treatment attempts with CPAP or treatment with behavioral measures such as weight loss or sleep position change. ²

For Moderate to Severe Obstructive Sleep Apnea
The American Academy of Sleep Medicine recommends Continuous Positive Airway Pressure (CPAP) for the treatment of moderate to severe sleep apnea. If patients have tried and failed CPAP, they should be offered treatment with an oral appliance.

CPAP is indicated for the treatment of moderate to severe OSA.³

Patients with severe OSA should have an initial trial of nasal CPAP [prior to trying oral appliances]. ²

In some cases, surgery may be an appropriate treatment option. There are only three surgical procedures recommended by the AASM. These are surgery to remove the tonsils and adenoids, craniofacial surgery that involves breaking the upper and lower jaws to create a larger airway, and a tracheostomy – a surgical procedure that creates a new airway through a hole in the neck.

Upper airway surgery (including tonsillectomy and adenoidectomy, craniofacial operations and tracheostomy) may [be performed on] patients for whom these operations are predicted to be highly effective in treating sleep apnea.²

References:

1. American Academy of Sleep Medicine website http://www.aasmnet.org
2. Kushida CA; Morgenthaler TI; Littner MR et al. Practice parameters for the treatment of snoring and obstructive sleep apnea with oral appliances: An Update for 2005. SLEEP 2006;29(2): 240-243.
3. Kushida CA; Littner MR; Hirshkowitz M et al. Practice parameters for the use of continuous and bi-level positive airway pressure devices to treat adult patients with sleep-related breathing disorders. SLEEP 2006;29(3):375-380.