Sleep apnea is a condition that causes your breathing to periodically stop or become excessively shallow at night. This can happen repeatedly—up to hundreds of times per night, in short intervals lasting anywhere from 10 to 30 seconds. Many people are unaware that their breathing is stopping and restarting while they sleep. However, sleep apnea is very common and an estimated 25% of people between the ages of 30 and 70 live with the condition.
Because sleep apnea deprives your body of consistent oxygen, it can have serious effects on your health if left untreated. People with sleep apnea have a higher risk of hypertension (high blood pressure), depression, heart disease, stroke, and diabetes. It's also common to feel extremely fatigued during the day due to poor quality of rest at night.
Fortunately, there are several treatment options including lifestyle changes, medications, and devices. In particular, specialized devices for sleep apnea can help keep your airways open at night to keep symptoms at bay, improve your condition, and support you in getting the rest you need.
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How Devices Help Sleep Apnea
Obstructive sleep apnea (OSA): Occurs when something blocks your airway at night while you try to breathe during sleep. Most people with sleep apnea have OSA.
Central sleep apnea: This happens when there's a problem with your central nervous system (e.g., brain and spinal cord). Your brain doesn't correctly send signals to the muscles that help you breathe during sleep which can cause you to repeatedly stop and start breathing. This is a much less common type of sleep apnea.
Sleep apnea devices can help both types of the condition. Depending on the exact device you're using, devices can help support sleep apnea in the following ways:
Keeping your airway open while you sleep
Preventing your tongue or jaw from slipping into positions that block your airway
Improving the muscle tone of the tongue during the day so the tongue is less likely to block your airway at night
Monitoring your breathing at night while you sleep to ensure that your airway stays open
Types of Devices
Depending on what type of sleep apnea you have, you may be a candidate for one or more of the following sleep apnea machines. It’s important to work with your healthcare provider when choosing a machine that's safest and most effective for you.
Positive Airway Pressure (PAP) Machines
PAP machines use light pressure and forced air that pumps into your airway to ensure that your airway stays open while you sleep. There are three main types of PAP machines that your provider may recommend:
Continuous positive airway pressure (CPAP): Maintains a steady flow of air throughout the night
Adjustable positive airway pressure (APAP): Adjusts the amount of airflow it delivers based on your breathing patterns
Bilevel positive airway pressure (BiPAP): Delivers different air pressure amounts based on whether you are breathing in or out
For all of these devices, you’ll need to wear a mask over your nose and/or mouth that’s connected with a tube to the machine that pumps the air. You and your provider will need to work together to find the settings that work best for you, taking into account what machine is most comfortable and suitable for your needs.
Oral appliances are non-electrical devices that hold your tongue or jaw in a fixed position while you sleep. These appliances prevent your tongue and jaw from sliding backward and blocking your airway. There are two types of oral appliances: mandibular repositioning mouthpieces which hold your jaw in place and tongue retaining devices which hold your tongue in place.
It's important to note that if the positioning of your tongue or jaw isn't the cause of your sleep apnea concerns, these devices will likely not work for you. If you believe these devices are a good fit for your needs, however, you will need to consult with a dental sleep medicine specialist to ensure the devices properly fits in your mouth and that you're using the device correctly.
There are two types of electrical stimulation devices that have been approved by the FDA for use in treating sleep apnea:
The eXciteOSA® mouthpiece: Delivers electrical pulses above and below your tongue to improve muscle function. This prevents your tongue from slipping back while you sleep and blocking your airway. You can use this mouthpiece for 20 minutes per day for six weeks while you are awake. This is not intended for use while you're sleeping.
The Inspire® upper airway stimulation (UAS) device: Monitors your breathing patterns while you sleep and delivers mild nerve stimulation to your airway to keep it open during rest. It's important to note that a healthcare provider will have to surgically implant this device inside you.
Positional Therapy Devices
Many people experience sleep apnea symptoms only when they sleep on their backs, so devices that keep you in a side-sleeping position can sometimes help improve symptoms. You can wear positional devices around your waist, back, or the back of the neck. These devices can help prevent you from rolling over in your sleep or use small vibrations to wake you up at night if you do roll over on your back.
There are several positional therapy devices on the market, including the Zzoma pillow, the Night Shift Sleep Positioner, and the Philips NightBalance Positional Sleep Therapy Device. Ask your provider about which one may be best for you.
How Effective Are Sleep Apnea Devices?
The most common device that people with sleep apnea use are PAP machines. While these devices can sometimes have uncomfortable side effects such as dry throat and nasal congestion, PAP machines are widely considered to reduce many of the long-term complications of having sleep apnea like heart disease and stroke.
In fact, a 2019 review of studies published by the American Academy of Sleep Medicine suggests that all types of PAP machines significantly reduce sleepiness, blood pressure, and motor vehicle accidents, as well as the severity of sleep apnea symptoms.
Researchers also consider positional therapy devices to be effective for sleep apnea, as body position plays a large role in people with OSA. In early studies, these devices have shown to reduce sleep apnea symptoms both when used alone and in conjunction with other devices like PAP machines.
Electrical stimulation devices are still somewhat new, but early studies have yielded positive results. According to the FDA, the use of stimulation devices led to a 50% reduction in loss of breathing in one clinical trial. As these devices become more widely available, researchers will continue to better understand their effectiveness.
Finally, researchers deem oral appliance therapy a reasonably effective option for mild to moderate sleep apnea. It's recommended that people with more severe symptoms of sleep apnea use PAP machines. However, oral appliances are better than no treatment at all in people with milder symptoms. These devices aren’t as well-researched as others, but small studies have shown them to have a positive effect on improving sleep apnea.
How to Use Sleep Apnea Devices
All types of sleep apnea devices are used differently, so it’s important to learn how to use your specific product by reading any instruction manuals that come with it and talking to your healthcare provider about best practices for use. Here's what you should know about each type of device:
PAP machines: These often require an adjustment period, so you may need to gradually become more comfortable using your device and work with your provider to troubleshoot any concerns or problems you run into. If your machine includes a humidifier, be sure to only use distilled water in the machine to prevent inhaling potentially harmful toxins as you sleep.
Oral appliance: It's imperative to get these devices custom-fitted by a dental sleep medicine specialist. This helps optimize how safe and effective they are for you.
Stimulation devices: It's important to note that stimulation devices aren’t available over-the-counter. You'll either need a prescription or a surgical procedure to use one. That said, your provider will give you the proper instruction on how to use your specific device.
Positional therapy devices: Because you can buy these in-store, they should come with a set of instructions for use. You may also ask your healthcare provider for tips on incorporating them into your sleep apnea treatment routine.
Things To Consider
The most important things to consider when choosing a sleep apnea device are how comfortable, safe, and effective they are in treating your condition. If a device is too uncomfortable for you, it's good practice to talk to your provider and seek alternatives.
Other considerations you may want to think about when choosing a device include:
How portable the device is, especially if you travel frequently
The noise level of your device, particularly if you are a light sleeper or share a bed with a light sleeper
Size of the device, such as how much of your face your mask covers or how well an oral appliance fits inside your mouth
Any accessories that come with your device that may make your device easier or more comfortable to use
Your sleep position, which can affect the style of PAP machine mask you choose
If you aren’t sure which device would work best for you, talk to your healthcare provider about your options. They can help you figure out which device is best fit for your needs or help you find alternatives if the device you're currently using isn't improving symptoms.
A Quick Review
Sleep apnea is a sleep disorder that causes your breathing to stop or excessively slow down while you sleep. This often occurs because something is blocking your airway at night. As a result, there are a variety of devices on the market which aim to keep your airway open as you sleep to improve your symptoms and the quality of your rest.
There are several types of sleep apnea devices to choose from including positive airway pressure machines, oral appliances, stimulation devices, and positional therapy devices. Not all types of devices work for all types of sleep apnea. That said, knowing what type of sleep apnea you have and talking to your healthcare provider about your options can help you choose the device that is most effective for you.
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