Many people with sleep apnea are diagnosed and prescribed CPAP devices to treat their condition. However, some patients are unable to adhere to this treatment. These difficulties lead them to look for cpap alternatives. One common alternative to cpap is oral appliance therapy. The dentist can prescribe an oral appliance to help with snoring and mild sleep apnea.
1. Sleep Apnea Masks
A good-fitting mask can make CPAP therapy comfortable, which can increase compliance and the effectiveness of treatment over time. Masks fit over or under the nose, mouth, or both and are typically clear. They come with mechanisms to deliver pressurized air and attachments to fit securely onto the face during sleep.
Many people with obstructive sleep apnea snore and a CPAP machine can decrease or eliminate snoring. The mask can also help alleviate symptoms such as bloating, gas, and dry mouth that are sometimes experienced when using a CPAP machine.
Patients can find a comfortable fit by practicing with the mask and adjusting it to their face while awake, following the manufacturer’s product instructions. They can also ask their sleep coach or a CPAP supplier for advice. Increased adherence to CPAP therapy can lead to better self-reported and objectively measured daytime functioning, as well as improved long-term health. Consistent, high-quality sleep is fundamental to mental and physical health and wellness.
2. Nasal Pillows
Nasal pillows rest at your patient’s nostril entrance, forming a seal that directs pressurized air into their nasal passages. They’re a minimal contact CPAP mask option that can alleviate feelings of claustrophobia and discomfort that may occur with larger, more obtrusive CPAP mask designs.
A recent study found that nasal pillows perform comparably to nasal masks at high CPAP pressures, and are more comfortable and less obtrusive for many users. They may not be ideal for patients who are mouth-breathers or have enlarged turbinates that could be irritated by the direct airflow of this style of mask.
Like all CPAP masks, a CPAP nasal pillow can be uncomfortable or itchy after prolonged use. Regular cleaning and replacement can help to prevent this.
3. Chin Straps
Chin straps are making waves on social media and beauty blogs as a way to reduce mouth breathing, slim the jawline, and improve skin elasticity. However, it’s best to avoid chin tape or straps and instead consult a sleep doctor or plastic surgeon for a more informed approach to these issues. According to King and Dasgupta, chin straps are not effective as a stand-alone treatment for obstructive sleep apnea or for reducing snoring.
However, if used as part of a CPAP mask and prescribed by a sleep specialist, they can help with the dreaded air leak problem that plagues many PAP users. A recent study found that adding a chin strap to a patient’s CPAP therapy positively impacts the rate of air leak and PAP compliance, even among difficult apnea patients who experience snoring and high levels of residual apnea. A chin strap is also useful for preventing the CPAP mask from slipping. A chin strap fits under the chin and around the head, typically on top of your CPAP headgear.
4. Nasal Expiratory Pressure (EPAP)
In contrast to CPAP, which maintains a pressure throughout the respiratory cycle, EPAP devices generate a high negative pressure during expiration (end-expiratory pressure or EPP). These devices are relatively small, portable, easy to use and are often associated with fewer side effects. They improve polysomnography and questionnaire-based quality of life measures in patients with OSA.
EPAP has been shown to reduce apneas and hypopneas, decrease nocturnal oxygen desaturation and enhance arousal frequency. However, it has not been proven to be efficacious in the long-term and further clinical trials are warranted.
The primary limitation of EPAP is that it does not eliminate the underlying structural abnormality of the upper airway. Moreover, not all EPAP devices produce identical expiratory pressure profiles with different valve designs, which may impact tolerance, adherence and the time required for acclimatization. Consequently, clinicians should carefully evaluate patient physiology and anatomy prior to prescribing this device. Nevertheless, it is recommended that all patients with OSA gain exposure to PAP before proceeding to surgical therapy.