Treatment for obstructive sleep apnoea (OSA)
OSA is a long-term condition and you may need lifelong treatment to control the symptoms. There are effective treatments and changes you can make to improve your wellbeing.
Treatment focuses on reducing the number of breathing pauses you have when you’re asleep. You should feel less sleepy during the day, have a better quality of life and reduce your risk of getting health complications and having accidents.
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People react differently to treatment, but you’re likely to benefit a lot. For example:
- you’ll have more energy and be less sleepy so you feel better physically and mentally
- you’ll start to enjoy things you were finding difficult, such as staying awake to watch a film
- if your driving was affected by excessive sleepiness, you’ll be safe to drive if you can satisfy DVLA your sleepiness is under control
Your partner will also benefit from your treatment. They’ll sleep better too as you will not be snoring and you will move less in bed. You’ll be more alert during the day, so you can enjoy more quality time together.
You can help to manage the symptoms of OSA yourself by making some changes to the way you live. Reducing the amount of alcohol you drink, maintaining a healthy weight and having good bedtime habits can make a big difference. If you smoke, try to quit.
Estimates vary, but more than 60% of people with OSA are overweight. Being overweight can affect your breathing. As your body weight increases, so do the number of breathing pauses when you’re asleep.
Your doctor can help you work out what your healthy weight should be and give you advice about how to lose weight if you need to.
Research has suggested that smoking can damage your airways and make them more likely to collapse while you’re asleep. So it’s a good idea to quit.
As soon as you start to do more, the risks to your health reduce, so increasing your activity levels will be very good for you. Research has shown that exercise can improve OSA symptoms.
Aim to do at least 30 minutes’ moderate-intensity activity five times a week. This means activity that makes you breathe more heavily and raises your body temperature, while leaving you able to talk at the same time. And avoid sitting still for long periods.
It’s also a good idea to do physical activity that strengthens your muscles twice a week. Try activities that involve stepping and jumping, such as dancing. Carrying or moving heavy loads such as groceries counts too.
Small changes that can help you get active:
- If you use public transport, try to get off a stop early and walk the rest of the way
- If you drive, park the car further away and walk the rest of the way
- Walk or cycle to the shops, to work or to social events
- Take the stairs instead of the lift
- Exercise with a friend
- Join a gym or exercise programme or go swimming with family or friends
Get better quality sleep
Good sleeping habits and sleep patterns are important to feeling well and happy, and are a supplement to other sleep treatments.
Try to go to bed and get up at the same time every day. Keep your bedroom dark and quiet and get seven to eight hours sleep a night.
If you sleep on your back, try sleeping on your side instead to relieve your symptoms.
For a good night’s sleep:
- exercise every day - in the morning is best
- go outdoors during the day and into sunlight or bright light
- keep your bedroom at a comfortable temperature for you
- use your bed for sleep and sex only
- do something to relax just before you go to bed, such as having a warm bath
- if you find yourself always worrying at bedtime, try to find a time in the day to write down your worries and get them out of your system
What to avoid:
- exercise late in the day
- going to bed too hungry or too full
- eating heavy, spicy or sugary foods close to bedtime
- coffee or tea in the evening
- drinking alcohol within four to six hours of your bedtime
- looking at a bright screen (such as a laptop, tablet or smart phone) within 30 minutes of bedtime. Their light interferes with your body’s sleepiness cues
- taking a nap during the day
You’re likely to need another treatment as well as making lifestyle changes. Mandibular advancement devices (MADs) and continuous positive airway pressure (CPAP) machines are common.
Mandibular advancement devices (MADs)
MADs are devices you wear in your mouth as you sleep. They bring your lower jaw forward to help keep your upper airway open. They’re also called intra-oral devices, mandibular repositioning devices and mouth guards. They’re effective if you have mild or moderate OSA.
A trained health care professional working alongside the sleep service can custom-make an MAD for you. They’ll make impressions of your upper and lower teeth to make it.
Getting used to mandibular advancement devices (MADs)
MADs are designed to keep your airway open as you sleep. There are many different devices available but it’s best to have one made for you by a trained health care professional. If you live in an area that prescribes these devices on the NHS, you’ll be referred to a specialist to make your device. If not, you may have to buy your own.
If the device feels uncomfortable on your teeth, get advice from your sleep clinic to make sure it is not causing any damage. You may also find your jaw aches in the morning, but this usually wears off after a while. Oral devices take a little getting used to, so persevere. The device should last about 2 years.
Continuous positive airway pressure (CPAP)
CPAP is a simple machine that blows air through a mask you wear at night. It’s designed to hold your airway open while you’re asleep. It sends air at pressure into your upper airway to stop it collapsing or narrowing. Your sleep clinic or the machine itself will set the pressure for you.
Surgery may sometimes be an option. If you are severely obese (with a BMI over 40), an operation to help you lose weight, called bariatric surgery, can be very effective.
There are very few randomised control trials to support other kinds of surgery. Operations might be helpful in a very small number of cases, such as for people with enlarged tonsils, adenoids and nasal polyps. But surgery on the soft tissues at the back of the mouth and top of the airway is used less and less as it is not usually effective.
Getting used to your OSA treatment
You may take some time to adjust to living with OSA and your equipment. Some people find this easier than others. If you’re struggling with treatment, or if you’re feeling anxious or depressed, talk to your sleep clinic or ring our helpline on 03000 030 555.