Got sleep apnea? Official treatment recommendations released Sept. 23 point to two complimentary approaches: Lose weight and undergo treatment with continuous positive airway pressure (CPAP).
Surgery, on the other hand, should not be considered as an initial treatment, as evidence is limited on its effects, the recommendations say.
The recommendations, published in the journal Annals of Internal Medicine and created by the American College of Physicians, are directed toward people with the most common kind of sleep apnea, which is called obstructive sleep apnea. It is a sleep disorder that causes a person to stop breathing for short periods during sleep because of a collapsed or blocked airway. The other kind of sleep apnea, central sleep apnea, is rarer than the obstructive type, and occurs when nerves and parts of the brain responsible for the regulation of breathing don't work properly.
"Obesity is a risk factor for obstructive sleep apnea and the evidence indicates that intensive weight loss interventions help improve sleep study results and symptoms of OSA," Dr. Molly Cooke, M.D., FACP, the president of the American College of Physicians, said in a statement. "Plus, losing extra weight is associated with many other health benefits."
For people who don't experience a benefit from CPAP, or choose not to use CPAP, a mandibular advancement device -- which is worn in the mouth and opens up the airway by moving the jaw -- could be a good alternative treatment option, according to the recommendations.
"The evidence shows that a mandibular advancement device can effectively improve sleep study results and sleepiness," Cooke said in the statement. "However, CPAP more effectively raised the minimum oxygen saturation compared to MAD."
Sleep apnea affects more than 18 million adults, and is a known risk factor for a host of other conditions including heart attack, diabetes, high blood pressure and daytime drowsiness. Overweight and obesity are known to raise the likelihood of having sleep apnea, but people of any weight can experience it.