Depending on the severity of your OSA and your response to various types of treatment, your doctor will customize a treatment plan tailored to your condition. Fortunately, there are many treatment options available for treating OSA, ranging from lifestyle changes to therapy and even surgery. Furthermore, many of the treatments for OSA are also used to treat simple snoring.
In milder cases of OSA and simple snoring, lifestyle changes will first be recommended:
- Lose excess weight
- Don’t sleep on your back – lie on your side
- Avoid smoking
- Avoid drinking alcohol
- Use nasal decongestants to clear nasal congestion
- Get treated for allergies
Should your OSA and snoring be moderate to severe, and did not completely resolve with lifestyle changes alone, then certain therapies and devices will be recommended:
The preferred treatment for OSA, it requires patients to wear a fitted mask over their nose and/or mouth. Through the mask, an air blower gently pushes air through the nose and/or mouth, with the air pressure adjusted to the optimal level where the upper airway tissues remain open while the patient is asleep. This is typically set at a fixed pressure.
Autotitrating occurs in a CPAP machine when the device’s sensor and algorithm adjust air pressure on a breath by breath basis, providing the user with the least amount of pressure to support the airway.
While the purpose remains essentially the same as the CPAP, in the BiPAP, you receive higher air pressure when you inhale and lower air pressure when you exhale.
These devices are oral supports designed to keep your throat open. For instance, some devices keep your airway open by bringing your lower jaw forward, which can sometimes relieve snoring and OSA. Other devices hold your tongue in a certain position so that it doesn’t block the airway. Your sleep doctor will work with a dental specialist to determine if this is a viable option for you.
In severe cases of OSA and snoring that do not respond well to conservative treatments and
CPAP, surgery may be considered. Surgery is most commonly required for patients with too
much abnormal tissue that blocks airflow, such as a deviated septum, a large tongue or a
small lower jaw that resulted in the throat being unusually narrow.
While not all patients are suitable for surgery, common types of surgery include:
With the nose being crucial to breathing, particularly in patients intending to use the CPAP machine, nose surgery is performed to remove obstructions in the nose, such as nasal polyps. Nose surgery can also be performed to correct a deviated septum.
The removal of excess tissue at the back of throat, such as enlarged tonsils, can remove obstructions to the airway. Another type of palate surgery also involves the insertion of small polyester rods in the soft palate. These inserts support the soft palate, preventing the upper airway from collapsing.
A tiny and thin impulse generator (also known as a hypoglossal nerve stimulator) is placed under the skin of the right side of the chest. This device senses your breathing patterns, and stimulates the nerve that controls tongue movement when necessary, moving the tongue forward and out of the airway.
Depending on severity, jaw surgery and tongue surgery may be performed to create more space in the mouth and reduce obstruction to the airways.
For more than 20 years, Dr Paul Mok is a Ministry of Health-accredited ENT specialist in Singapore with a sub-specialty in Obstructive Sleep Apnoea (OSA), Voice and Swallowing. To that end, Dr Mok was responsible for setting up the Voice, Swallowing & Obstructive Sleep Apnoea Service at Tan Tock Seng Hospital and headed the Sleep Clinic at Khoo Teck Puat Hospital. Apart from his clinical contributions, Dr Mok is also regularly invited to present at local and international ENT conferences, perform live surgery and remains actively involved in medical missions.
Dr Lau Hung Tuan is an accredited, international fellowship-trained Ear, Nose and Throat (ENT) specialist in Singapore. Dr Lau is experienced in treating a wide array of ENT conditions, such as sinus infection, nasal allergy, ear and hearing problems, as well as swellings in the head and neck region. Besides these common ENT conditions, Dr Lau has special interest in the sub-specialty field of Snoring and Obstructive Sleep Apnoea (OSA). He is highly passionate about treating these conditions with holistic, tailored and individualised solutions for his patients.