Alternative Treatments for Sleep Apnea
In sleep apnea, the upper airway becomes blocked, and people stop breathing during sleep, usually in 10- to 20-second bouts that can occur 30 or more times an hour. The problem is usually treated with a device that increases air pressure in the throat, keeping the airway open. Called continuous positive airway pressure, or CPAP, the therapy involves wearing a mask attached to a machine.
The success rate of CPAP therapy is more than 90%. Though effective, many people find it uncomfortable and cannot tolerate the appliance.
A surgery, called transpalatal advancement pharyngoplasty, enlarges the space behind the roof of the mouth. The lead author of a study that tested this treatment, Dr. Neville Patrick Shine, of St. Johns Hospital in Edinburgh, Scotland, found better than 60% success with this procedure .
Another alternative is an appliance called a mandibular advancement device, designed to prevent the airway obstruction of sleep apnea. It does this by moving the lower jaw forward. A research team led by Dr. Chul Hee Lee, from Seoul National University Bundang Hospital and Seoul National University College of Medicine, evaluated 50 people with sleep apnea who used the device. Based on reductions in shallow or stopped breathing, the device worked in 37 of the participants, including a mix of people with mild, moderate and severe sleep apnea, the researchers found.
However, Dr. Shirin Shafazand, an assistant professor of medicine in the Division of Pulmonary and Critical Care Medicine at the University of Miami Miller School of Medicine, said that devices such as the one tested in the Korean study, are really for people with mild sleep apnea and should be prescribed only after people have undergone sleep studies to determine the severity of their condition.
SOURCES: Neville Patrick Shine, F.R.C.S., St. Johns Hospital, Edinburgh, Scotland; Shirin Shafazand, M.D., assistant professor, medicine, Division of Pulmonary and Critical Care Medicine, University of Miami Miller School of Medicine, Miami; Jose W. Ruiz, M.D., assistant professor, otolaryngology, University of Miami Miller School of Medicine, Miami; May 2009, Archives of Otolaryngology, Head & Neck Surgery.
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