There are a number of treatment options for Obstructive Sleep Apnea. CPAP is generally the most effective treatment but depending on the individual and the severity of their sleep apnea, other treatments may be as effective and sometimes easier to use or more comfortable. There are oral appliances such as a Mandibular Advancement Device (Somnodent, Snore Owl) or a Tongue Retaining Device (MPOWRx). For those with sleep apnea that is primarily when they sleep on their back, there are body re-positional devices (Night Shift, Rematee). There are also adhesive patches for the nostrils that generate increased pressure in the airway that helps to hold the airway open (Provent, Theravent).
Good Sleep Health Inc. has offices at the Kelowna Sleep Clinic as well as Vernon and Penticton.
Continuous Positive Airway Pressure (CPAP) opens up the obstruction at the back of the throat by applying positive pressure to the airway through a mask over the nose or sometimes the nose and mouth. The settings for CPAP are determined in the sleep lab or through Auto-CPAP. Auto-CPAP senses snoring or pauses in breathing and automatically increases the pressure accordingly.
Bi-level Positive Airway Pressure (BiPAP) provides two pressures. One pressure to breathe in and a lower pressure to breathe out. The lower pressure makes it easier to exhale for those patients requiring high CPAP pressures. The higher inspiratory pressure assists the patient in taking a bigger breath in those with chronically low oxygen levels at night. A more sophisticated BiPAP called BiPAP S/T can provide a backup rate to automatically ventilate the patients with Central Sleep Apnea. BiPAP S/T also has a setting called AVAPS (Average Volume Assured Pressure Support). This setting helps patients with obesity or neuromuscular diseases take a big enough breath to maintain their oxygen levels when they sleep.
The Adaptive Servo Ventilator (ASV) is an even more sophisticated type of BiPAP. It is essentially a type of ventilator used in patient with Central Sleep Apnea. It is particularly helpful in patients with Cheyne-Stokes type Central Sleep Apnea. It reacts more accurately to the gradual waxing and waning of Cheyne-Stokes breathing than the BiPAP S/T. This helps to stop the waxing and waning cycles that disturb the sleep in these patients generally resulting in a more restful sleep than they could obtain on BiPAP S/T.
PROVENT therapy consists of a pair of adhesive patches containing "one-way" valves affixed over the nostrils. The large opening on the valve allows unrestricted airflow into the nose. On expiration, the valve partially closes resulting in a build up of air pressure that effectively holds the airway open and prevents snoring or obstructive apnea from happening. PROVENT is usually quite effective for patients with snoring or mild sleep apnea. It is moderately effective for patients with moderate sleep apnea. Anyone with significant sleep apnea will be tested in the lab while using the device to document it's effectiveness.
The Somnodent is a custom made mandibular advancement device that holds the lower jaw forward during sleep. This brings the tongue forward which helps to hold the airway open at the back of the throat relieving snoring and mild to moderate obstructive sleep apnea. This device is custom fitted and adjusted by a dentist trained in sleep disorders medicine. It tends to be slimmer, more comfortable and made from much more durable materials than a "boil & bite" type of device.
The Snore Owl is a "boil & bite" type of mandibular advancement device that holds the lower jaw forward during sleep. This brings the tongue forward which helps to hold the airway open at the back of the throat relieving snoring and mild obstructive sleep apnea. The device comes with instructions on how to heat and mold the upper and lower pieces to your teeth. The upper and lower pieces are snapped together in one of two positions and then inserted into the mouth. The first position is neutral and helps to prevent the lower jaw from sliding back especially when you turn onto your back. The second position provides 5 mm of lower jaw advancement. This device is primarily for patients with snoring or mild obstructive sleep apnea. It includes a 30 day money back guarantee.
MPowRx is a type of "tongue retaining device". It is very useful for snoring and mild obstructive sleep apnea. It is also an alternative for patients with dentures who cannot use a dental appliance. It is made of a soft, flexible silicon that fits comfortably behind the lips in front of the teeth or denture. It has on open bulb in the middle that you stick your tongue in. The suction in the bulb holds the tongue forward. This gives you more space at the back of the throat to breath. It is very simple to use.
The Night Shift is a rubber collar with a magnetic clasp on the front and a small, light-weight position sensor and data logger on the back. This device is for patients who have sleep apnea primarily when they sleep on their back. The device records body position and vibrates when you turn on your back. This motivates you to wake up and turn over. The device records your body position as well as how often it has to remind you to turn over. It also records snoring and body movement. Movement helps to determine how often you are awake in the night. The device comes with a USB cable that you can plug into your computer to download the information from the data logger and view in chart format. The charts will show how successful you are at avoiding sleeping on your back. They will also show if there is residual snoring and if you are spending less time awake during the night as time goes on.
The Rematee consists of a comfortable, wide belt with pouches on the back for plastic, inflatable cylinders. This device is used in patients who have sleep apnea primarily when they sleep on their back. The cylinders create soft bumps that help to keep you from rolling over onto your back.