What if cpap doesnt help

The following CPAP alternatives can help open up your airways and provide relief from snoring and sleep apnea symptoms:. In addition, inpatient surgeries can also be performed to treat more serious cases of sleep apnea. How do you know if your CPAP isn't controlling your snoring and sleep apnea? This content does not have an Arabic version. See more conditions. CPAP machines: Tips for avoiding 10 common problems. Products and services.

By Mayo Clinic Staff. Thank you for Subscribing Our Housecall e-newsletter will keep you up-to-date on the latest health information. Please try again. Something went wrong on our side, please try again. Show references CPAP. National Heart, Lung, and Blood Institute. Accessed Sept. Weaver T, et al. Assessing and managing nonadherence with continuous positive airway pressure CPAP for adults with obstructive sleep apnea.

Choosing a mask. American Sleep Apnea Association. All you need to know about CPAP therapy. When things go wrong with PAP. Cao M, et al. Continuous positive airway pressure therapy in obstructive sleep apnea: Benefits and alternatives. Expert Review of Respiratory Medicine. Lebret M, et al. Johnson KG, et al. Treatment of sleep-disordered breathing with positive airway pressure devices: Technology update.

Medical Devices: Evidence and Research. Troubleshooting guide for CPAP problems. Olson EJ expert opinion. Mayo Clinic. See also Ambien: Is dependence a concern?

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If sleep apnea is very severe prior to treatment, the improvement may be more obvious. However, when symptoms are mild, it may take longer to notice any changes. Keep in mind that it may take several weeks before you see any improvement. If you take your mask off in the middle of the night, it could take even longer to experience the benefits of therapy.

If you are not noticing an improvement, speak with your board-certified sleep physician about ways to adjust your therapy to better work for you. It can take weeks of continuous CPAP use before you notice any improvement.

It may take those with mild symptoms even longer, as symptoms are more subtle. If you are using CPAP therapy but still feel tired, there could be several reasons why.

It's possible that you haven't been doing the therapy for long enough, you are removing your mask during the night, your pressure needs to be adjusted, or your symptoms are mild. It may take several weeks of proper and continuous usage before you feel the results of CPAP therapy. If you haven't noticed any changes, be sure to speak with your doctor. There is a chance they may diagnose you with another underlying medical condition or complex sleep apnea.

In these cases, other treatment methods may be used. Speak with your doctor. They may determine that you need a different type or size mask, or that you have another condition that may require additional treatment.

Other ways to manage sleep apnea may include:. Losing more weight may reverse sleep apnea altogether. Tossing and turning night over night can have a big impact on your quality of life. Our free guide can help you get the rest you need. Sign up for our newsletter and get it free. Pathophysiology of sleep apnea. Physiol Rev. Virk JS, Kotecha B. When continuous positive airway pressure CPAP fails. J Thorac Dis. Case report of a pressure ulcer occurring over the nasal bridge due to a non-invasive ventilation facial mask.

Symptoms of aerophagia are common in patients on continuous positive airway pressure therapy and are related to the presence of nighttime gastroesophageal reflux. J Clin Sleep Med. Insomnia and obstructive sleep apnea. Sleep Med Clin. Pigeon WR. Treatment of adult insomnia with cognitive-behavioral therapy. J Clin Psychol. Given these data, weight loss should not be considered a primary therapy for moderate to severe OSA and should be recommended as a secondary therapy or intervention that supplements a primary treatment such as CPAP or oral appliances.

Further, even for those patients who are able to lose a significant amount of weight and maintain that weight loss over time, a follow up sleep study should be performed to assess for residual disease prior to discontinuing CPAP therapy. Oral appliances: Oral appliances are dental devices that improve sleep disordered breathing by maintaining the patency of the posterior pharynx. These devices are typically fit by a dentist and maintain pharyngeal patency by advancing the mandible forward and or by maintaining the tongue in an anterior position.

In addition to less severe disease, other predictors of a more favorable response to oral appliance therapy include younger age, lower BMI, smaller neck circumference and those with more positional supine dependent OSA. In general, CPAP is more effective at resolving sleep disordered breathing and improving oxygen saturations, though oral appliances tend to improve symptoms of daytime sleepiness to similar degree as CPAP.

The effect of oral appliances on improving cardiovascular outcomes such as hypertension is not clear at this time. A recent meta-analysis that reviewed 7 studies demonstrated a favorable effect on many parameters of blood pressure, though most of the data were derived from observational studies 4. Thus more randomized controlled data with longer follow up are required prior to drawing definite conclusions. The impact of oral appliance therapy on other cardiovascular outcomes such as arrhythmias and mortality are unknown.

Commercial insurance companies and Medicare typically reimburse for oral appliance therapy, though commercial reimbursement varies by region. Oral appliances should be fit and titrated by dentists that are trained in the management of OSA. After an initial titration period, patients should undergo either polysomnography or out-of-center portable testing to objectively confirm the efficacy of the device.

Positional therapy: Some patients with OSA, only have significant sleep disordered breathing in the supine position. Thus, some clinicians may prescribe positional therapy to patients with less severe disease whose OSA occurs predominantly in the supine position. This treatment may be achieved though various interventions, such as tennis ball placed in the back of a nightshirt or through more formal devices that have been developed specifically for this purpose.

Most studies evaluating the effectiveness of positional therapy are based on data from small, uncontrolled studies with relatively short-term follow up. A few observational trials with longer-term follow suggest that compliance with positional therapy over time is poor.