How Snoring and Sleep Apnea are Treated: An Overview

Treatment depends on the type and severity of your sleep apnea.

How snoring and sleep apnea (apnoea) are treated depends on the type and severity of the condition.

The severity of a person’s obstructive sleep apnea (OSA) can be classified according to the AHI (apnea-hypopnea index) and lowest oxygen saturation levels (LSAT) recorded during the sleep test. The severity is usually graded as the worst of the two, based on the American Academy of Sleep Medicine (AASM) Guidelines.

In general, patients with snoring / obstructive sleep apnea are classified as those with a “global” problem, that is, obesity compounded with a “local” anatomical problem (huge tonsils, long thick palate, big tongue or a small jaw). 

Patients with a “global” problem are advised to: 

• Follow a strict trial of weight loss 
• Exercise adequately and regularly
• Consult a dietitian / nutritionist for dietary advice
• Regularly follow up on the treatment of their condition 
• Wear a nasal mask for continuous positive airway pressure (CPAP) every night during sleep as a trial (even if the patient is considering surgery, as CPAP is reversible and non-invasive). 

Surgery may be recommended to correct the condition of patients with huge tonsils, huge adenoids, thick redundant palate and/or a huge tongue. Correcting nasal and palate problems together will significantly improve sleep apnea eradication success rates. About 70% of patients with sleep apnea suffer from airway obstruction because of their palates. 

Upper airway surgery is for selected OSA patients who are deemed (by the sleep specialist) to have good prognosis after surgery. This upper airway surgery may include the nose and/or palate with or without the tongue reduction. 

Very obese patients with a body mass index (BMI) above 40 are also advised to consult a bariatric (laparoscopic gastric/stomach banding) surgeon. Occasionally, weight reduction medication is considered for patients who are unable to modify their lifestyle for a period of six months. Throughout this period, CPAP must also be strictly adhered to.  

Patients with morbid obesity and/or severe diseases like congestive heart failure, and/or respiratory/lung failure may be offered the option of a tracheostomy (surgery performed to create an artificial hole in the airway in the neck).