Can Sleep Apnea Be Cured?

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Is There a Cure for Sleep Apnea?

Sleep apnea is a disorder in which a person experiences multiple periods of stopped or shallow breathing while they sleep. There are two main types of sleep apnea: Obstructive sleep apnea (OSA) occurs when the airway repeatedly collapses to slow or block breathing, Trusted Source UpToDateMore than 2 million healthcare providers around the world choose UpToDate to help make appropriate care decisions and drive better health outcomes. UpToDate delivers evidence-based clinical decision support that is clear, actionable, and rich with real-world insights.View Source and central sleep apnea (CSA) occurs when the brain fails to properly control breathing. Trusted Source UpToDateMore than 2 million healthcare providers around the world choose UpToDate to help make appropriate care decisions and drive better health outcomes. UpToDate delivers evidence-based clinical decision support that is clear, actionable, and rich with real-world insights.View Source

For most people, sleep apnea is a chronic condition that can be managed but not fully cured. However, in some cases — particularly with OSA — symptoms may be significantly reduced or even resolved by addressing underlying causes. For example, weight loss, positional therapy, or surgery may improve or eliminate airway obstruction in certain individuals.

In rare cases, certain treatments, such as surgery to modify tissues near the airway or significant weight loss, may fully address the airway blockages that cause OSA. In some cases, treating an underlying condition can stop breathing disruptions from central sleep apnea.

That said, many people require ongoing treatment, such as CPAP therapy or oral appliances, to keep the airway open and maintain healthy breathing during sleep. Even when symptoms improve, follow-up testing is often needed to confirm whether sleep apnea has resolved.

Does Sleep Apnea Go Away Naturally? 

It’s extremely rare for sleep apnea in adults to resolve on its own. Trusted Source UpToDateMore than 2 million healthcare providers around the world choose UpToDate to help make appropriate care decisions and drive better health outcomes. UpToDate delivers evidence-based clinical decision support that is clear, actionable, and rich with real-world insights.View Source Without taking active steps to improve breathing during sleep, OSA can be expected to continue, leading to poor sleep and potentially serious health complications. Similarly, central sleep apnea won’t usually get better unless the underlying issues that cause it are addressed.

However, in children, treatment for obstructive sleep apnea is more likely to lead to a long-term elimination of the condition Trusted Source UpToDateMore than 2 million healthcare providers around the world choose UpToDate to help make appropriate care decisions and drive better health outcomes. UpToDate delivers evidence-based clinical decision support that is clear, actionable, and rich with real-world insights.View Source . 

Sleep Apnea in Children

Obstructive sleep apnea in children can sometimes be resolved with surgical procedures and orthodontics. Two techniques called adenotonsillectomy and rapid maxillary expansion often result in significant improvement to OSA symptoms, especially when both procedures are performed.

• Adenotonsillectomy: This surgery removes the tonsils at the back of the throat and the adenoids that sit behind the nasal cavity. Adenotonsillectomy may be appropriate for children with larger-than-usual adenoids and tonsils or for children with risk factors for OSA. For many children, adenotonsillectomy eliminates OSA, although it’s possible for symptoms to reappear if the adenoids and tonsils grow back or if body changes from puberty or weight gain cause narrowing of the upper airway.
• Rapid maxillary expansion: Certain children who haven’t gone through puberty may be treated with an orthodontic procedure called rapid maxillary expansion. This procedure widens the nasal passages and the roof of the mouth, which is called the palate. To achieve this, a dental appliance is attached to the top of the mouth and the back teeth. Rapid maxillary expansion is most effective for children who have a narrow palate and whose OSA isn’t caused by enlarged adenoids or tonsils.

For young children with mild to moderate sleep apnea, some experts recommend waiting for a few months to see if it clears up on its own before performing surgery. In the meantime, lifestyle changes to reduce congestion and improve sleep habits can help manage symptoms.

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How Is Sleep Apnea Treated?

Sleep apnea treatment aims to eliminate breathing disruptions during sleep and improve sleep quality. For people with obstructive sleep apnea, this means keeping the airway open. For people with central sleep apnea, this means addressing underlying causes of irregular breathing patterns or using treatments to better control breathing.

“Although it’s less common to fully cure sleep apnea, very effective and safe treatments exist such as PAP therapy and several non PAP therapies. Over a 100 variations of PAP interfaces exist, and working with a sleep physician can often lead to the combination that may be suitable for you.”

Abhinav Singh, MD, MPH, FAASM

Sleep Medicine Physician, MD

Positive Airway Pressure (PAP) Therapy

In positive airway pressure (PAP) therapy, users wear a mask over the nose or the nose and mouth. The mask is connected to a PAP machine and delivers a stream of pressurized air to the upper airway.

For people with OSA, the air pressure helps hold the airway open, and consistent use of a PAP device has been shown to effectively reduce breathing disruptions, enhance sleep, and improve quality of life  PAP therapy provides the most benefits for people with severe OSA.

Types of PAP devices include:

• CPAP: With continuous positive airway pressure (CPAP) therapy, the mask is set to blow air at a steady rate to keep the airway open 
• BiPAP: Bilevel PAP, also known as BiPAP or BPAP, delivers air at one pressure level when breathing in and another when breathing out 
• APAP: In auto-titrating PAP (APAP), the machine detects changes in breathing and adjusts air pressure accordingly 
• ASV: Adaptive servo-ventilation (ASV) is a less commonly used form of PAP therapy that dynamically modifies air pressure levels during inhalation to offer breathing assistance that matches an individual’s needs. ASV may be used for certain types of central sleep apnea 

Although there’s less research on PAP therapy for central sleep apnea, studies suggest that PAP machines are effective in encouraging more stable respiration with fewer lapses in breathing.

PAP therapy doesn’t cure sleep apnea, and it only works when the sleeper uses the device. However, some people find using a PAP machine or wearing the mask to be uncomfortable. In fact, as many as 50% of people stop using their PAP device, causing symptoms to come back. A doctor can usually suggest practical steps to make using a PAP device more comfortable.

Oral Appliances

Oral appliances are worn during sleep to keep the airway open. The two most common types are mandibular advancement devices, which bring the jaw forward, and tongue retaining devices, which prevent the tongue from slipping back Trusted Source Merck ManualFirst published in 1899 as a small reference book for physicians and pharmacists, the Manual grew in size and scope to become one of the most widely used comprehensive medical resources for professionals and consumers.View Source and blocking the airway. Oral appliances are custom-fitted to a person’s mouth by a dentist, and while they can reduce OSA symptoms, they’re generally less effective than PAP therapy.

Mouth and Throat Exercises

Mouth and throat exercises aim to strengthen muscles so they are less likely to fall into a position that blocks the airway during sleep. Studies suggest these exercises may help reduce mouth breathing and marginally improve sleep apnea symptoms, but more research is needed to fully validate the extent of their benefits.

Surgery

Sleep apnea surgery for adults is most likely to work in people who have a clear anatomical reason for their OSA, such as large tonsils or a jaw that is set back significantly. OSA surgery has varying rates of success, and even when surgery is initially effective, sleep apnea can sometimes recur in the future.

Hypoglossal Nerve Stimulation 

People whose symptoms don’t get better with PAP therapy may elect to have hypoglossal nerve surgery in which doctors implant a device that activates the nerves running to the tongue Trusted Source UpToDateMore than 2 million healthcare providers around the world choose UpToDate to help make appropriate care decisions and drive better health outcomes. UpToDate delivers evidence-based clinical decision support that is clear, actionable, and rich with real-world insights.View Source . The goal of this treatment is to stimulate the tissue so that it doesn’t fall back and block the airway, and evidence suggests it can reduce symptoms in certain people with OSA.

Phrenic Nerve Stimulation

To treat central sleep apnea, doctors may implant a device to stimulate the phrenic nerve, which causes the diaphragm to contract as required for breathing. This type of treatment may offer benefits by compensating for the brain’s irregular control of breathing in people with CSA. 

Medication

Medications aren’t typically a first-line treatment for sleep apnea, but they may be used in certain situations to help manage symptoms or underlying causes.

One emerging option for people with OSA is Zepbound, a medication originally developed for weight loss. Because excess weight is a major risk factor for OSA, medications like Zepbound may help reduce the severity of sleep apnea symptoms in some individuals.

However, they don’t treat sleep apnea directly and are typically used alongside standard therapies. Because the role of medications in treating sleep apnea is still evolving, they’re usually recommended as part of a broader treatment plan under the guidance of a healthcare provider.

Can You Reduce Your Risk of Sleep Apnea?

One way to reduce the risk of developing sleep apnea or to manage sleep apnea symptoms is to address factors that contribute to disrupted breathing during sleep. 

• Lose weight: For people with overweight or obesity, losing weight can help control sleep apnea symptoms, although it usually does not cure the condition completely Trusted Source UpToDateMore than 2 million healthcare providers around the world choose UpToDate to help make appropriate care decisions and drive better health outcomes. UpToDate delivers evidence-based clinical decision support that is clear, actionable, and rich with real-world insights.View Source . A doctor can suggest the best way to lose weight at a healthy rate and may recommend drug therapy or bariatric surgery for weight loss.
• Avoid back sleeping: OSA symptoms are generally worse when back sleeping, especially for people with few other risk factors. As part of a larger treatment plan, sleeping on one’s side may contribute to better breathing during sleep.
• Raise the head of the bed: Experts sometimes recommend raising the head of the bed or using a large wedge pillow to prop up the upper body because these may help keep the airway open.
• Treat allergies: Allergens, tobacco smoke, and other environmental pollutants can cause nasal congestion that exacerbates symptoms of obstructive sleep apnea. Taking steps to reduce allergens in the bedroom may help. When these substances are difficult to avoid, using a saline spray or medications may decrease congestion.
• Quit smoking: Research suggests that people who smoke are up to three times more likely to have symptoms Trusted Source UpToDateMore than 2 million healthcare providers around the world choose UpToDate to help make appropriate care decisions and drive better health outcomes. UpToDate delivers evidence-based clinical decision support that is clear, actionable, and rich with real-world insights.View Source of obstructive sleep apnea. Even for those who do not smoke, being around tobacco smoke can aggravate inflammation and increase symptoms of obstructive sleep apnea.
• Avoid alcohol before bed: Alcohol, sedatives, and certain other medications can dampen activity in the central nervous system, which may increase the risk of OSA symptoms. Limiting use of these substances before bedtime may reduce their impact on breathing during sleep.

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