The earliest treatments for obstructive sleep apnoea were mostly surgical, and there are still many people today who have an operation to widen or straighten the nasal passages, or to enlarge the space at the back of the mouth by trimming the uvula or some of the other tissues found there. The lower jaw can also be moved slightly forward to allow for extra airflow.
All surgery has a risk, and there is some doubt as to the effectiveness of these surgical procedures, as often their benefit is short-lived.
Devices and machines
Because the tongue falls back with strong snoring, and this can block the already narrowed airway, there are many types of devices to keep the tongue more or less where it should be (on the roof of the mouth, with the tip touching the top front teeth). There include:
Double-mouthguards that clamp the teeth together, pull the bottom jaw slightly forward, or pull the tongue forward as well.
As well as devices that are attached to the teeth, there is at least one that uses suction to latch onto the tongue and pull it forward. With the mouth closed, it resembles a baby’s pacifier.
Having something in your mouth tends to activate the salivary glands, and so dribbling is a problem with these things. Having a sore jaw joint (TMJ), and your natural bite upset are other possible reactions to using these treatments.
The most most widely promoted and accepted as the best treatment for OSA is the Nasal CPAP (Continuous Positive Air Pressure) machine that blows air up the nose to act like a splint and stopping the airway from collapsing.
These machines originated in Australia, reportedly by a doctor who reversed a vacuum cleaner. Today instead of air blowing continuously up your nose, there are far more sophisticated machines that ramp up the pressure slowly as you fall asleep, and are able to measure the resistance so that they only force the air in when it is necessary.
There is no doubt that these machines do the job they are designed for, but frequently people fail the machine because they are unable to wear it for the required four hours each night due to the restriction of the mask and hose, or the noise the machine makes.
Other common complaints are that the air dries the nasal passages and so the nose attempts to moisten itself by making excessive amounts of mucus. To overcome this problem a humidifier can be bought, but some CPAP users are concerned about the possible growth of germs in warm, moist tubing. Also, these are sealed units and so if there is a power failure then the air supply is also cut off until you wake up and remove the mask.
Other recommended options
If none of these interventions appeal, then the only other solutions usually offered by the medical field are to lose a considerable amount of weight, stop smoking, or stop drinking alcohol.
When a person is over-weight, they not only have excessive amounts of fat under the skin, but also inside their body as well. The diameter of the throat shrinks a little when the person is overweight due to the extra deposits of fat in this area.
Smoking irritates the delicate airway tissues, which respond by swelling and by making more mucus. Anything that restricts the airways is likely to increase the force the breathing muscles use. The more forcefully a person breathes then the faster the air will be dragged through the narrowed airways, and so the likelihood of making a noise increases.
Alcohol loosens the already relaxed muscles of the face, neck and throat, making them more likely to vibrate. As alcohol is processed by the body, it also greatly stimulates the automatic breathing pattern, and so it can cause a problem in this way as well.