Types of Sleep Apnea Products

There are so many products that claim to stop snoring and obstructive sleep apnea (OSA). Treating sleep disorders is a very competitive market, with products ranging from sprays and nasal pillows to mouth guards and CPAP machines. How do you know which products are the best for you?

In this article, we discuss treatment options that have been scientifically and clinically proven to treat snoring and sleep apnea, as well as how to use them, the cost of each product, and a few things to be aware of when using each one.

Oral Sprays

There are both nasal and oral sprays on the market that claim to eliminate snoring and apneas. But buyer beware: Nasal sprays usually work by clearing your nasal passage, while oral sprays lubricate the soft muscle tissues at the back of your throat to prevent vibrations of soft tissue and reduce snoring. 

Nasal sprays are generally not used to treat sleep apnea because they don’t prevent the collapse of soft tissue at the back of the throat. They do, however, help expand and clear your nasal airway, which is effective for people who suffer from hay fever, flu, or allergies. They may also help to silence snorers.

Oral sprays primarily help with snoring, though some may help people with mild cases of sleep apnea. 

Below are two oral sprays on the market for people with mild sleep apnea.

Nasal Dilators

Nasal dilators are small devices that mechanically open your nasal passages to allow more air to flow into the nose and, as a result, decrease snoring. They consist of two small rings, usually made of plastic, that you place into your nostrils. Nasal dilators are simple, surprisingly not uncomfortable, and also noninvasive. 

Like nasal sprays, nasal dilators don’t work for everyone. In many cases, snoring is caused by vibrations of the relaxed muscle tissue in your soft palate and throat, and unfortunately, nasal dilators cannot always solve this problem.

Let’s discuss the two most popular nasal dilators on the market designed to tame snoring.

Tongue Stabilizing Device

Tongue stabilizing devices (TSDs) use suction to pull the tongue forward and lift the soft muscles away from your airway. They prevent the tongue from over relaxing and compressing the airways, which causes most episodes of snoring and sleep apnea.   

Let’s discuss two of the most popular tongue stabilizing devices currently on the market.

Sleep Positioning Device

People who suffer from sleep apnea benefit from sleeping either on their left or right side because it alleviates any direct force of relaxed soft muscle tissues on the airway. Most of us do not even realize we are tossing and turning at night, so how do we make sure we are constantly sleeping on our sides at night?

Sleep positioners are designed to help you stay asleep on your side. Let’s discuss two of the most popular products on the market today.

Expiratory Positive Airway Pressure (EPAP)

EPAP, short for expiratory positive airway pressure, is a type of therapy that draws more air into the nostrils, but prevents some of it from being exhaled. This creates a positive air pressure in your airways, and also prevents your airways from collapsing. One downfall is that you may feel it is hard to exhale while on this therapy.

Unlike a bulky CPAP machine, which pushes air into the airway, an EPAP uses natural pressure when you exhale to help keep your airway open while you breathe. 

Let’s discuss the two of the most popular EPAP products currently on the market.

What is Sleep Apnea? 

Sleep apnea is a sleep disorder that occurs when breathing is briefly and repeatedly interrupted during sleep. Obstructive sleep apnea, or OSA, occurs when the muscles in the back of the throat close. It’s similar to what happens when you snore, but with episodes of obstructive sleep apnea, you stop breathing because your airway has collapsed. This causes you to choke, cough, or gasp, and often jolts you awake, preventing you from getting a restful sleep. 

OSA can cause low blood oxygen, which can be life threatening. This dangerous combination of fragmented sleep and oxygen starvation can lead to high blood pressure, heart disease, and memory problems, as well as increase the risk of recurrent heart attacks and sudden cardiac death. 

Types of Sleep Apnea Treatments

• Oral sprays — Oral sprays are designed to lubricate the soft muscle tissues in the back of the throat to prevent vibrations. They are more often used to reduce snoring but are sometimes used to treat very mild cases of sleep apnea. 
• Nasal Dilators — These devices consist of two small rings that are placed inside the nostrils and open your nasal passages. They can reduce snoring and improve sleep, but don’t effectively treat sleep apnea.  
• Tongue stabilizing device (TSD) — These devices sit at the lips and use suction to pull the tongue forward and lift the soft tissues away from the back of your throat, which can reduce sleep apnea symptoms.
• Mandibular advancement device (MAD) — Mandibular advancement devices are the most widely used mouthpiece used to treat sleep apnea. MAD devices are like mouth guards with metal hinges that allow the lower jaw to gently slide forward, opening the airway.  
• Sleep positioning device — Episodes of sleep apnea are reduced when you sleep on your side as opposed to your back. Sleep positioners prevent you from rolling from your side onto your back while you sleep.
• Positive airway pressure (PAP) — Positive airway pressure, or PAP, is the most effective and widely used method for treating obstructive sleep apnea. It uses a small device or machine with a face mask to introduce pressurized air into the throat in order to prevent the soft tissues from collapsing. There are several different PAP devices or sleep apnea machines available to treat moderate to severe cases of sleep apnea.

Oral Sprays

Oral sprays lubricate the soft muscle tissues in the back of the throat in order to prevent the tissues from vibrating. Some work to tone up the tissues at the back of the throat to prevent it from obstructing the airway. Oral sprays are more effective at reducing snoring rather than treating sleep apnea. 

Pros: 

• Less expensive
• No prescription needed 
• Non invasive

Cons: 

• Not considered an effective treatment for sleep apnea
• Side effects include tingling in the throat

Nasal Dilators

Nasal Dilators are made up of two small rings that fit into the nostrils and open the nasal cavity. While they are great for increasing airflow, reducing snoring, and improving sleep quality, they aren’t an effective sleep apnea treatment. 

Pros: 

• Can reduce snoring
• Can improve sleep quality 

Cons: 

• Not considered an effective treatment for sleep apnea
• Can be painful to remove

Oral Appliances

Oral appliances are often used to treat snoring and mild to moderate sleep apnea. They are usually more easily tolerated than bulky sleep machines like CPAPs. 

Tongue stabilizing device (TSD) 

Tongue stabilizing devices sit at the lips and look somewhat like a pacifier. They use suction to pull the tongue forward and lift the soft tissues away from the back of your throat.

Pros: 

• Less expensive than CPAP
• Smaller and easier to travel with

Cons: 

• Not as effective as positive airway pressure (PAP) therapy
• Can cause excess saliva 

Mandibular advancement device (MAD) 

Mandibular advancement devices are similar to mouth guards that fit inside the mouth, but have metal hinges that allow the lower jaw to gently slide forward.

Pros: 

• Less expensive than CPAP
• Smaller and portable 

Cons: 

• Not as effective as positive airway pressure (PAP) therapy
• Can be uncomfortable

Sleep Positioning Devices 

Episodes of sleep apnea are less frequent while sleeping on your side as opposed to your back. Sleep positioners are therapy devices that prevent you from rolling from your side onto your back. 

Some consist of collars that fit around the neck and vibrate when they sense you rolling over in order to force you back on your side. Others fit around the torso and have protrusions on the back that stop you when you try to roll over. 

Pros: 

• Can hold you in side-sleeping position and reduce sleep apnea episodes
• Can reduce snoring as well 

Cons: 

• These devices can be uncomfortable 
• May wake you when you attempt to roll over and interfere with a good night’s sleep

Positive Airway Pressure Devices

EPAP (Expiratory Positive Airway Pressure)

EPAP is a device that enables you to draw in more air and exhale less air through the nostrils. This creates positive air pressure that prevents the airways from collapsing. EPAPs are usually made of adhesive strips that stick to the nose that allow you to inhale normally through your nostrils, but exhaling is more difficult. 

Pros: 

• EPAPs are not machine-assisted
• More portable than other PAP devices 

Cons: 

• It may feel odd not to fully exhale through your nose, 
• It can take a week or longer to get used to the therapy.

CPAP (Continuous Positive Airway Pressure) 

CPAP therapy is a common treatment for sleep apnea. CPAP devices consist of a face mask that’s hooked up to a machine by a long hose. The machine provides a continuous flow of air into the airway.

Pros: 

• Provides continuous positive airway pressure for effective sleep apnea treatment
• Newer models are quieter, have lighter weight face or nasal masks, and add-ons like heated humidifiers

Cons: 

• Some find the face masks and continuous positive airway pressure claustrophobic  
• Wearing a CPAP mask throughout the night can cause dry mouth, dry nose, and congestion

BiPAP (Bilevel Positive Airway Pressure) 

Unlike CPAP machines which deliver a single level of pressure, BiPAP machines deliver one pressure for inhaling and another pressure for exhaling. 

Pros: 

• Can be a more comfortable option for people who cannot tolerate CPAP’s single continuous pressure
• BiPAPs make it easier to exhale, and reduce the risk of side effects caused by too much CO2 buildup

Cons: 

• In most cases, BiPAP is not recommended until CPAP therapy has failed
• Wearing a BiPAP mask overnight can cause dry mouth, dry nose, and congestion

APAP (Automatic Positive Airway Pressure) 

APAP therapy has two separate settings — high and low — which allow the machine to automatically adjust to varying pressure needs as you sleep and change positions during the night.  

Pros: 

• APAP’s automatic adjustable setting is generally more tolerable than CPAP’s constant pressure
• A good option for combination sleepers or people who toss and turn a lot at night

Cons: 

• In most cases, APAP is not recommended until CPAP therapy has failed
• Not recommended for patients with chronic heart failure or obesity hypoventilation syndrome

Surgeries and Procedures

People with obstructive sleep apnea who cannot tolerate CPAP or similar positive airway pressure therapy may be candidates for medical procedures or surgeries.

Nasal surgery — Nasal obstructions and nighttime nasal congestion can contribute to sleep apnea. Nasal surgery for these issues usually involves straightening the septum (the cartilage in the nose that separates the nostrils) which creates room for air to pass smoothly. In some cases, cartilage removed from the septum can be used to strengthen the nostril valve and prevent collapse. These procedures are usually performed in hospitals as out-patient surgeries. 

Uvulopalatopharyngoplasty (UPPP) — UPPP is the most performed sleep apnea surgery. It involves removing excess tissue from the soft palate and pharynx and, in some cases, the tonsils. This surgery usually requires an overnight stay in the hospital, and pain can persist for up to a week after the surgery has been performed. 

Soft palate implants — Also called the Pillar Procedure, this involves the placement of polyester rods into the soft palate, which creates an inflammatory response that stiffens the tissues. This procedure can be done during a medical clinic visit with the patient awake under local anesthesia. 

Mandibular maxillomandibular advancement surgery — This is a type of facial skeletal surgery that repositions the jaws to move them forward in order to expand the airway. Incisions are usually performed inside the mouth. It generally requires a one- to two-day hospital stay.

Upper airway stimulation (UAS) — This sleep apnea treatment involves surgically implanting a system that monitors breathing patterns and provides a small amount of stimulation to contract the throat muscles to keep the airway open. 

Hyoid advancement — The hyoid is a U-shaped bone at the base of the neck that supports the tongue. People with sleep apnea often have a large tongue base that is more prone to obstructing the airway during sleep. Hyoid advancement surgery repositions the bone to expand the airway and prevent collapse. It is usually performed in the hospital as an outpatient surgery. 

Tongue base reduction — This procedure involves using radiofrequency waves to shrink the tissues at the base of the tongue to help open air passages and prevent obstruction. This surgery requires a one-night stay in the hospital.  

Tongue base advancement — This surgery moves forward one of the muscles of the tongue to limit the tongue’s backward fall during sleep. This procedure usually requires an overnight stay in the hospital. 

Tracheostomy — A tracheostomy is a temporary or permanent procedure in which a hole is made in the trachea in the neck where a tube is inserted that delivers air to the lungs, bypassing any obstructions in the mouth or throat. It is an option for people who are morbidly obese with a condition known as obesity hypoventilation syndrome, or people with significant craniofacial anomalies. 

Somnoplasty — Somnoplasty is a procedure used to treat snoring and is not recommended for sleep apnea. It uses heat to modify the tissues of the uvula and the soft palate. Somnoplasty is generally performed in a doctor’s office with the patient awake, under local anesthesia.  

Lifestyle Adjustments

Sometimes making a small adjustment to your lifestyle can greatly reduce episodes of sleep apnea. Here are some suggestions:

• Avoid alcohol. Alcohol can relax the muscles in your throat and cause them to fall into your airway. 
• Avoid sleeping pills. Just like alcohol, sleep medicine can relax the muscles in your throat and cause an airway obstruction. 
• Lose weight. Studies show that you can reduce episodes of sleep apnea by 50% by losing just 10-15% of your body weight. Some people saw a complete reduction of sleep apnea with more substantial weight loss. 
• Change sleep positions. Back sleepers are more prone to snoring and sleep apnea because gravity is working against them, causing the soft tissues in the mouth to fall into the airway. Reduce your risk by rolling over onto your side. 
• Get an adjustable bed. It might be worth investing in a new mattress that works with an adjustable bed frame. Sleep apnea symptoms can often be alleviated by adjusting the head of the bed up.
• Quit smoking. Smoking cigarettes can increase inflammation and fluid retention in the upper airway, leading to sleep apnea. 

How to Choose the Best Sleep Apnea Products

If you think you suffer from sleep apnea and would benefit from treatment, you should first talk with your doctor or, if your insurance provides coverage without a referral, go directly to a sleep specialist. Sleep specialists come from different medical backgrounds such as pulmonology, otolaryngology, neurology, and psychiatry, and use their expertise to help diagnose you with a particular sleep disorder, like obstructive sleep apnea, and the best treatment options. 

To diagnose you with sleep apnea, your doctor may ask you to take a sleep apnea test called a polysomnogram. This is usually performed at a sleep disorder clinic. The test records your brain activity while you sleep using electrodes placed on your face and scalp, your breathing with belts around your chest and abdomen, and the oxygen levels in your blood with an oximeter probe on your finger. 

Once a diagnosis is made, you will work closely with your sleep specialist to determine which treatment options are best for you.

Summary

Sleep apnea is a common sleep disorder that can disrupt your sleep, leading to excessive daytime sleepiness. But it can also lead to chronic diseases like heart disease and high blood pressure. In severe cases, it can be life threatening. 

If you think you have sleep apnea, consider lifestyle changes; try oral sprays, nose dilators, sleep positioners, or other readily available remedies; and talk with your doctor about getting tested. You may need medical treatment or even surgery to overcome your sleep apnea in order to get a good night’s sleep.