Man trying to sleep on a white bed

How to Treat Obstructive Sleep Apnea without CPAP

March 9, 2022

Are your dental patients complaining about a dry mouth or sore throat? Are they also experiencing loud snoring, morning headaches, daytime sleepiness, or high blood pressure? These are common symptoms of obstructive sleep apnea (OSA), which may be the root of their issues.

Currently, the most common way to treat OSA is with continuous positive airway pressure (CPAP) machines. However, there are many disadvantages to using a CPAP machine that might irritate your patients and discourage them from treating the condition.

The good news is that there are other treatment alternatives that you can implement into your dental practice. Here is what you need to know about the causes of OSA, the pros and cons of CPAP machines, and alternative treatment options available.

 

What Causes Obstructive Sleep Apnea?

Obstructive sleep apnea (OSA) is usually a result of the throat muscles relaxing too much. When the muscles that support the roof of the mouth, uvula, tonsils, and tongue relax, they can block the airway and make it difficult to breathe. Pauses in breathing can last 10 seconds or longer, which can lower the blood oxygen levels and increase carbon dioxide in the bloodstream.

When your brain recognizes this is happening, it jolts the body awake, often accompanied by snorting, choking, or gasping. Further, this can repeat as many as 30 times per hour, sometimes more. Not only is this extremely disruptive to sleep, but severe cases can also be associated with many other long-term complications, including dementia, mood disorders, stroke, and diabetes.

Oftentimes, those with OSA don’t even know they have it. That’s why it is important for you as their dentist to screen for these symptoms in patients and educate them on their treatment options.

 

Is CPAP the Best Treatment for OSA?

CPAP machines function by sending a steady flow of pressurized oxygen into a mask covering the individual’s mouth and nose. While CPAP is the most common form of treatment for OSA, it’s important to be aware of both the advantages and disadvantages of using a CPAP machine. On the positive side, CPAP machines effectively deliver oxygen and stop breathing interruptions. This in turn reduces other symptoms associated with OSA.

On the other hand, there are some drawbacks associated with CPAP machines. The biggest complaint is that it is uncomfortable and hard to get used to. Sleeping with a mask strapped to the face is quite an adjustment and can irritate the skin and even cause some people to feel claustrophobic or anxious. The machine is also noisy, making it difficult for some to relax and fall asleep. In addition, since the machines blow air into your mouth all night, they cause many to experience dry mouth. Further, swallowing the air during the night can cause bloating and gas.

While CPAP machines are useful and effective, especially for severe cases of OSA, there are other, perhaps more comfortable, options for treating the condition that you may want to consider implementing into your dental practice.

 

What Are Alternative Treatment Options?

There are a variety of options for treating obstructive sleep apnea, ranging from lifestyle changes to surgery, depending on the severity of the condition and the unique needs of the patient.

Lifestyle Changes 

For mild cases of sleep apnea, lifestyle changes might help. Here are a few you can recommend to your patients:

  • Reduce obesity
  • Exercise regularly
  • Avoid drinking alcohol, especially at night
  • Quit smoking
  • Reduce allergies with a nasal decongestant or medication

Changing Sleeping Position 

Some people only experience sleep apnea when they sleep on their back. If this is the case for your patient, consider recommending a sleeping product to prevent them from rolling onto their back.

Oral Appliances

Oral devices, such as a mouthguard, mandibular advancement device (MAD), or orthodontic retainer, can help reposition the jaw, open the throat, and relieve symptoms of OSA. This is especially useful for those with mild to moderate sleep apnea or who are unable to use a CPAP machine. Plus, it can be a lot more comfortable than having the CPAP mask strapped to the face.

Surgery

This is usually a last-resort option for severe cases of sleep apnea if other treatment options have failed. Surgical options can include tissue removal, tissue shrinkage, jaw repositioning, implants, nerve stimulation, and tracheostomy (creating a new air passageway).

Hypoglossal Nerve Stimulation 

This is a surgical option in which an implanted device stimulates the nerves in the airway, which improves the muscle tone and helps keep the airways open.

Neural Stimulation

Similarly, for certain types of sleep apnea, a similar surgically implanted device can stimulate your diaphragm through the phrenic nerve, which helps initiate breathing during sleep.

If you are looking for effective treatment recommendations for your dental patients with sleep apnea, CPAP machines are not your only option. There are multiple other effective treatment options, such as oral appliances, that are especially beneficial for those with mild sleep apnea. As a dentist, it is important for you to understand the different treatment options available so you can recommend the best possible approach for your patients.