What Are the Options for People Who Struggle With CPAP Therapy?

Ever thought your CPAP is more of a nightmare than a comfort? We have! CPAP, or continuous positive airway pressure, is a common treatment for sleep apnea that involves a machine and mask that supports a healthy airway during sleep. It’s effective for many patients but isn’t always the best option – some patients struggle to use it or find it uncomfortable. Perhaps you experience nasal congestion, dry mouth, or mask irritation, or just can’t get accustomed to it. Fortunately, CPAP alternatives exist that can address your sleep apnea and improve your sleep.

So, why is CPAP so hard? The better you understand what makes CPAP so hard, the more likely you are to find a better treatment. Your sleep apnea severity, airway structure, and health concerns all factor into what other treatments might be best for you.

Why Do Some People Struggle With CPAP Therapy?

If you have CPAP and have a hard time wearing the mask at night you’re not alone. It can be tough to adapt to the sensation of wearing a mask every night, and if it’s uncomfortable or causes other sleep problems that can make it tougher.

Let’s take a look at common problems:

Pressure marks, skin irritation or leaks from an uncomfortable mask.
Dry mouth and nose: Breathing a constant stream of air is going to have a drying effect on your oral and nasal passages especially when that air isn’t on the set to the correct humidity levels.
Claustrophobia: Do you feel boxed in or panicked by the mask? You’re not alone.
If the nose is blocked, then breathing through the face mask in itself can be difficult.
You can be disturbed by the sound of the machine, the pressure in your airway or simply by the tubes.

Here’s the thing: these issues are not typically the end of the story for CPAP use. Usually, a different mask, a change in pressure, or a humidifier helps resolve the problem.

1. Oral Appliance Therapy

So what if CPAP just isn’t working? An oral appliance therapy might just be the solution. These machines are like mouthguards you can wear at night.

They position your lower jaw a little ahead, creating more room behind your tongue.

Often people with mild to moderate OSAS can use an oral appliance. Some with severe sleep apnea can also use oral appliances if they’re unable to tolerate CPAP.

A sleep medicine dentist can recommend the right oral appliance for you. Be sure you visit your sleep dentist on a regular basis to make sure the device is functioning properly and isn’t damaging your teeth or jaw.

2. Positional Therapy

Well, here’s some good news: Sleeping on your back can make your sleep apnea worse. When you sleep on your back gravity causes your tongue and soft tissues to fall back which can partially or completely block your airway.

Positional therapy might be your escape. Positional pillows, sleeves, and devices prevent you from sleeping on your back, allowing you to stay on your side.

This could be helpful if sleeping in a particular position makes your sleep apnea worse. However, this may not be an effective long-term solution if you get apneas in any position.

3. Weight Management and Lifestyle Changes

Are you overweight? Fatty deposits around your neck and airway can put pressure on your breathing passages. This can make them more likely to collapse during sleep.

Decreased weight slowly may mitigate your symptoms. Lifestyle modifications may also impact your sleep and breathing.

Consider these tweaks:

Weight control. Consume a nutritious diet with a variety of foods.
Skip alcohol close to bedtime.
Stop smoking to keep your airways free.
Stick to a consistent sleep schedule.
Don’t take sleeping pills without your doctor’s approval.

However, these changes should be in conjunction with other treatments and not a substitute for your breathing device.

4. Surgical Treatment for Sleep Apnea

Could Surgery Help? If anatomic abnormalities in your nose, throat or upper airway are the cause, surgery can be effective.

The best technique differs based on the location and reason for the airway being blocked. The following are surgical approaches that can be taken:

Nasal work: Opens up the nasal passages for improved breathing.
Tonsillectomy: Gets rid of enlarged tonsils obstructing the airway.
Uvulopalatopharyngoplasty (UPPP): Excises or alters back of mouth tissues to enable the airway.
An implant activates the nerve that controls tongue movement so that the tongue moves forward.

Surgery isn’t suitable for everyone. In most cases a specialist will order a sleep study, carry out a physical exam and assessment of the airway before considering surgical options.

5. Inspire Therapy and Other Advanced Treatments

Do you know Inspire therapy? If you’re not a candidate for CPAP, a small implant called Inspire therapy may be an option. This therapy helps advance your tongue to keep the airways open while you sleep. A small sensor is implanted to help your breathing.

You use a remote when you’re in bed, so Inspire therapy doesn’t require a mask or air compressor like CPAP does. To be a candidate for Inspire therapy, you will need to have a sleep study and an airway assessment.

Could Nasal Problems Be Making CPAP Difficult?

Are you struggling to breathe? Structural blockages can be what’s blocking your nose – for instance, a deviated septum surgery, when the middle of your nose isn’t smack in the middle.

Misaligned septum and sleep apnea If you have a deviated septum, your doctor may recommend nasal surgery (septoplasty) to fix it and improve your airflow and comfort with the CPAP. This doesn’t treat OSA but can help with nasal breathing as a part of treatment.

Conclusion

Having a hard time adjusting to CPAP? We’ve got you covered. From mouth guards to surgery and everything in between, there are other options to improve your sleep.

Your best treatment will be determined by your symptoms, sleep study report, and airway structure. Look for a well-trained sleep doctor or ENT specialist who can identify the cause of your breathing issues and recommend the most effective treatment. Sleep and breathe easier without a device that is difficult to use.

Questions We Frequently Ask

What else can I use instead of CPAP?

It depends on the cause and the severity of your sleep apnea. For some people, other options such as an oral device, positional therapy, weight loss, surgery or Inspire are more effective.