What can I do now that I've tried CPAP and I found out it doesn't work for me? Do I have to have surgery now?
Doctors Answers (4)
CPAP intolerance is common but often is only temporary. A fairly new approach is the "PAP NAP". This therapy is administered by a sleep technologist during the day. It is a 3-5 hour "one on one" session during which the patient is introduced to various masks which are custom fitted. Other treatment options include dental devices to enhance mandibular advancement and surgical intervention IF ANATOMICALLY APPROPRIATE.
If you are CPAP intolerant, you need to speak with your sleep medicine doctor or primary care doctor for alternatives. Surgery may be an option but usually works about 50% of the time. Oral lower jaw positioning appliances may also be an option. If you have mild obstructive sleep apnea, an oral appliance should work if you are a good candidate for one. If you have moderate to severe sleep apnea, oral appliances may help but may not successfully treat your sleep apnea. Talk with your sleep medicine doctor about your options and have him refer you for an oral evaluation to see if you are a candidate for an oral appliance.
You don't necessarily have to undergo surgery. If you cannot tolerate CPAP, then other therapy may be the best option for you. Depending on your complaints and pressure requirements an auto-titrating CPAP or a Bi Level device may be more comfortable. A Bi Level therapy device provides a lower pressure when you exhale allowing for additional comfort and be an option. Evaluating your interface such as nasal mask, nasal pillows or full face mask my also alleviate your complaints. You should speak with your Board Certified Sleep Specialist at the sleep disorder center and determine what can be done to help.
One option for c-pap intolerance is an oral appliance for obstructive sleep apnea. Recent studies are showing success even for severe sleep apnea. Surgery for sleep apnea is usually successful about 10% of the time and it can be quite painful. So, you might want to investigate other options before you do surgery.