How to treat sleep apnea without CPAP or surgery?

Doctor's Answer

Obstructive sleep apnoea (OSA) is a medical condition in which a person "stops breathing" repeatedly for a short period of time during sleep. The classic symptoms are loud snoring, excessive daytime somnolence and feeling unrefreshed in the morning. At risk individuals include those who are overweight or obese, has a small/receded chin, have significant nasal blockage or large tonsils/adenoids.

Elderly patients may also be at risk of OSA because the soft tissues around the airway may be more lax with age. This may predispose one to sleep apnoea too. Untreated OSA (esp moderate or severe OSA) risk potential complications in the heart (e.g high blood pressure, irregular heartbeats, heart failure etc), brain (e.g stroke, poor concentration and memory) and metabolic system (e.g. diabetes)

I agree with Dr Leong that dental devices (e.g. mandibular advancement device) and lifestyle modications are alternative treatment options for your mother. Do note however that dental devices works best if your mother has mild or moderate sleep apnoea (but not as well for severe sleep apnoea).

CPAP (continuous positive airway pressure) therapy is the gold standard in the treatment of OSA because it works almost 100% if one uses it regularly and properly. You may also want to bring your mother to the Sleep Technologist or ENT Specialist to troubelshoot the reason why your mother was not able to tolerate the CPAP mask. Many potential rectifiable issues with CPAP masks include a pressure that is too high pressure from the machine (making it uncomfortable), incorrect mask fitting or size or concurrent blocked nose during sleep (which your ENT Specialist should be able to help).

As the management of OSA is often a muti-modality approach and is complex, I would suggest that you bring your mother to a doctor trained in managing sleep apnoea (all ENT Specialist in Singapore or some Neurologist or Respiratory Physician with an interest in Sleep Medicine) for an assessment. For more information on snoring & OSA, do check out my article on Human

Hope this helps and all the best!

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