CPAP Therapy Most Effective for Sleep Apnea, Experts
MONDAY, Aug. 8 (HealthDay News) -- The most effective treatment
for the nighttime breathing disorder known as obstructive sleep
apnea is the continuous positive airway pressure (CPAP) machine,
according to a new report.
A CPAP machine pumps air through a mask while the patient
sleeps. This treatment is highly effective in improving sleep and
reducing symptoms of obstructive sleep apnea, according to the
review of available evidence.
However, side effects such as dry nose and mouth, nosebleeds,
chest discomfort and feeling trapped can cause patients to abandon
CPAP treatment, noted the authors of the report, which was funded
by the U.S. Agency for Healthcare Research and Quality (AHRQ).
One expert called the report's findings "valuable."
"CPAP is known to be the most effective way to treat sleep apnea, but compliance is a big issue," said Dr. Linda Dahl, an Ear, Nose & Throat specialist at Lenox Hill Hospital in New York City. "It can be uncomfortable and difficult to use. Also, younger patients do not want the stigma of using it. Oral appliances are very helpful for certain types of sleep apnea, but they can be costly and are usually not covered by insurance."
Dahl, who was not involved in the new report, added that "there
are also surgical treatments available. They are often not
curative, but they do play a role in sleep apnea treatment. For
example, if a patient has nasal obstruction and cannot tolerate
CPAP, nasal surgery can open the nose so they can tolerate the CPAP
The report also found that one other treatment -- a mouthpiece
called a mandibular advancement device -- can be highly effective
for sleep apnea patients. The device moves the jaw forward and
keeps the airway open.
This treatment is often used if patients can't tolerate the CPAP
machine, but potential side effects of the mandibular advancement
device include loose or damaged teeth, the report noted.
While weight loss and surgery to clear airway blockage may also
effectively treat sleep apnea, the evidence behind these treatments
isn't as strong, according to the team from the Tufts Medical
Center Evidence-Based Practice Center, which prepared the
"The bottom line is that every patient is an individual," Dahl said. "So it is important to know all of the possible treatment options when deciding what will work best. Unfortunately, sleep apnea is mutifactorial, so there is no magic treatment."
The new report, along with companion guides for consumers and
medical professionals that summarize the latest evidence for
treating obstructive sleep apnea, are available on the AHRQ
About 12 million Americans are known to have obstructive sleep
apnea, and it's likely that millions more are undiagnosed,
according to the AHRQ. The condition, caused by the repeated
collapse and blockage of the upper airway during sleep, stops
breathing many times through the night.
Obstructive sleep apnea can lead to high blood pressure, heart
disease, diabetes and increased risk of accidents because of
"Obstructive sleep apnea is a frustrating and debilitating condition for so many Americans, and millions of people don't even know they have it. The resultant poor sleep and daytime sleepiness can lead to work-related or driving accidents," AHRQ director Dr. Carolyn M. Clancy said in an agency news release. "These guides and this new report will help patients and their doctors understand what treatment options might be best for them."
The U.S. National Heart, Lung, and Blood Institute has more
sleep apnea treatments.
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