Medicines and products for sleep apnea

There is no tablet that cures sleep apnea. The main treatments are devices and procedures, with medicines used to treat related problems. A sleep specialist recommends the best option based on the type and severity.

CPAP (continuous positive airway pressure) The most effective treatment for moderate to severe obstructive sleep apnea. A mask worn during sleep delivers air at steady pressure to keep the airway open. It reduces snoring, daytime sleepiness and heart risks when used every night. Modern machines can be adjusted, and masks come in several types.

• Variants include auto-adjusting CPAP (APAP) and bilevel (BiPAP) machines.
• Common problems are dry mouth, nasal irritation and mask leaks, which can be fixed by changing the mask, adding a humidifier or adjusting pressure.

Oral appliances Custom-fitted mouthpieces (mandibular advancement devices) move the lower jaw forward to open the airway. They suit mild to moderate apnea or people who cannot tolerate CPAP, and are made by a trained dentist.

Surgery and implants Options include removal of tonsils and adenoids (very common in children), nasal surgery, upper airway surgery, jaw advancement surgery, and a hypoglossal nerve stimulator implant in selected adults. These are considered when other treatments fail.

Medicines

• Treatment of nasal allergy with steroid nasal sprays or antihistamines.
• Treatment of reflux, thyroid disease and high blood pressure, when present.
• Certain medicines may be prescribed for severe daytime sleepiness despite good treatment (such as modafinil), by a specialist.
• Newer weight-loss medicines may be used for obesity under specialist guidance.

Medicines to avoid or use with care Sleeping pills, sedatives, opioids and alcohol can worsen sleep apnea. Tell your doctor before taking any sedating medicine.

Oxygen Used in some central sleep apnea or lung disease, often with other therapy.

Ayurvedic view (interpretive) Herbal products may be used traditionally for weight and congestion, but they do not treat sleep apnea and must not replace CPAP.

Remember Use CPAP every night as advised, and return to the sleep clinic if the mask is uncomfortable instead of stopping.