Alternative Treatments for Obstructive Sleep Apnea

At the Philadelphia Center for Sleep Medicine, we recognize numerous alternatives to CPAP. Although, we believe that CPAP is the best, most proven treatment for obstructive sleep apnea, we also realize that not every patient can use CPAP and some patients want to explore alternative treatments. In some circumstances, these alternative treatments can be quite effective. As part of his training, Dr. Cohen worked in an “alternatives to CPAP clinic” and collaborated with many medical specialists to help patients find treatment alternatives when they did not tolerate CPAP.

Oral Appliances for the Treatment of Sleep Apnea

An oral appliance can be an effective treatment for mild or moderate sleep apnea. For some patients who travel often or are extremely claustrophobic, it can be a good treatment option. Many dentists aggressively market oral appliances as the best treatment for sleep apnea. A dentist can help in the Treatments for Obstructive Sleep Apnea by providing a durable, well made appliance BUT most dentists should not be managing your sleep disorder. Most dentists lack extensive training in sleep medicine. In fact, in the state of Pennsylvania, there are only 7 dentists who are Board Certified in Dental Sleep Medicine.

We refer patients to competent, skilled dentists to obtain a comprehensive evaluation for a dental appliance and work with them to make sure the treatment is successful. Furthermore, we help direct you to dentists that provide treatments covered by your medical insurance.

Upper Airway Surgery (Uvulopalatopharyngoplasty /UPPP)

Many patients are referred to us by ENT (ears nose and throat physician or otolaryngologist) physicians for sleep testing or an evaluation. Some patients choose upper airway surgery in an attempt to “cure sleep apnea” or “avoid using CPAP”. We understand some patients want to pursue alternative treatments. If that is the case, we will help you find a skilled ENT physician who will carefully examine you and decide if upper airway surgery could be a possible alternative. Many insurance companies require a trial of CPAP before upper airway surgery is covered.

Weight Loss

Weight loss is extremely important for many patients with Sleep Apnea. Rather than simply telling you to “lose weight and exercise”, we work with our patients to find a diet plan that can work for them, and help them set reasonable goals for weight loss.

Bariatric / Weight Loss Surgery

We work closely with several bariatric surgeons in the evaluation and treatment of patients. We have extensive experience, and see over 150 new patients each year who are contemplating weight loss surgery. We focus on treatment to make sure you can have surgery safely and effectively, and also are experienced in helping adjust your treatment with continued weight loss. While bariatric surgery is not a first line treatment for sleep apnea, and other methods for weight loss should be tried first, we can help you find a surgeon if this is an avenue you want to pursue.

Positional Therapy

This is a successful treatment for some patients with sleep apnea. If your sleep study shows you have sleep apnea only while sleeping on your back, this could be an alternative treatment. We can instruct you on methods to achieve this successfully. (Simply trying to lay on your side doesn’t usually work.)

Provent Nasal Strips

This is a newer therapy that is not presently covered by insurance. It is our experience that it is unpredictable in its effectiveness. However, we recognize that this can sometimes be an effective option and can help you obtain it.

Bimaxillary Advancement

This is another surgical alternative treatment for obstructive sleep apnea. It involves an Oral and Maxillofacial surgeon providing reconstructive surgery of your jaw to open the airway. While this is often an effective surgery, it usually is reserved for severe cases where other alternatives have failed.