Medical treatments

To date, there are no drugs to treat sleep apnea. However, very effective mechanical treatments exist:

• Continuous positive airway pressure therapy (CPAP or CPAP). It is the treatment of choice for sleep apnea. A device blows air continuously through the nose, thanks to a mask that is worn at night. Several models of devices and masks are available. To designate this device, the term CPAP, which comes from the English “Continuous Positive Airway Pressure”, is often used. The blown air keeps the airways open continuously, which suppresses apnea. Although this treatment is extremely effective, it takes time to get used to sleeping with the mask on. It may seem uncomfortable at first, but you have to be patient. The reduction in symptoms is felt after 4 to 6 weeks, provided the mask is worn every night. This treatment improves the quality of life vigilance and the mémoire sufferers, as well as lowering blood pressure in associated hypertension;

• Oral appliance. This is a dentist molded splint that is worn at night, also called a mandibular advancement orthosis. It keeps the lower jaw and the tongue forward (a few millimeters), which facilitates the passage of air. These devices are especially reserved for people with mild or moderate apnea. They are less effective than continuous positive pressure ventilation, but require less adaptation effort.

Medication

Although no drug does not allow to delete theapnea some sleep, some treatments can help reduce apnea by treating the cause.

Thus, if the apneas are due to allergic rhinitis, nasal corticosteroids can reduce the number of apneas.

Likewise, in patients with gastroesophageal reflux disease which can make apnea worse, taking an anti-reflux medicine (such as omeprazole) helps reduce apnea.

Finally, if the drowsiness is very important during the day despite treatment with CPAP, stimulant drugs may be prescribed. Talk to your doctor.

Others: surgery

In some cases, when CPAP ventilation therapy does not work or is not well tolerated, a surgery can be considered.

There are several types of operations designed to reduce snoring and apneas. However, their effectiveness is relatively low and apneas tend to reappear some time after the procedure. There is not enough evidence to recommend these interventions for people with mild to moderate sleep apnea.

• Uvulo-palato-pharyngoplastie (UPPP). This operation consists of removing the uvula and part of the soft palate, which vibrate during snoring, so as to clear the airways and facilitate the passage of air. It is performed under general anesthesia. It is effective in reducing snoring, but does not prevent the throat from sagging. It is only effective on apneas in 50% of cases;
• Tonsillectomy and adenoidectomy. These procedures involve surgery to remove tonsils and adenoids, lymph nodes located in the throat. If they are very swollen, which often happens in children, they can obstruct the passage of air and cause apnea. This operation is especially proposed in cases of obstructive sleep apnea syndrome in children;
• Nose and sinus surgery. It is useful if the apneas are related to an abnormality of the nasal septum or the sinuses which interferes with breathing;
• Tracheotomy. This “radical” operation is reserved for people with very serious apneas and for whom CPAP ventilation is not effective. It is therefore very rarely offered. It consists of creating an opening in the trachea, below the throat. This “hole” allows air to enter the lungs without passing through the throat at night. It can be blocked during the day to resume normal breathing;
• Surgery for weight loss. When sleep apnea is due to significant obesity, losing weight makes it possible to act effectively on apnea. Bariatric surgery, reserved for severe obesity, reduces the severity of apnea⁷.

  For more information, see our Obesity sheet.

Complementary approaches

Based on our research in the scientific literature, there is no validated complementary approach to treating sleep apnea.