Overview of obstructive sleep apnea treatment

Abstract

Once diagnosed with obstructive sleep apnea (OSA), a titration with either continuous positive airway pressure (CPAP) or automatic positive airway pressure (APAP) is planned to know the pressure required to abolish the airflow limitation during sleep. Majority of OSA patients are treated with such positive pressure therapy (PAP) devices, but it is not the only form of therapy of OSA. The static obstruction in OSA can be counterbalanced by increasing the pressure from inside and this is being exactly done by PAP therapy. The static obstruction can also be relieved with surgery. IOD (intraoral device) or OPT (oral pressure therapy) is a device which also try to open the upper airway during sleep or prevent collapse. But a dynamic obstruction during sleep, on top of this static obstruction causes complete or partial closure of the upper airway. There are different therapies available to address dynamic obstruction during sleep. Like myofunctional therapy or devices which improve muscle responsiveness are such mode of treatment. Similarly, arousal threshold or loop gain can be addressed with different medications. Sometimes OSA occur only in a particular decubitus and can be addressed with positional therapy. The different form of therapies can be broadly divided into three categories: primary treatment, alternative treatment, and adjunctive treatment. In this review article, a brief description of different forms of therapy in OSA will be presented.