CPAP Alternatives for Obstructive Sleep Apnea

If you dislike your CPAP machine and are looking for an alternative we can help! Dr. Ali, with his extensive experience in all the alternative treatments for Obstructive Sleep Apnea, will help you get rid of your CPAP machine.

Alternatives


CPAP Alternative #1: Oral Appliance (worn during sleep only)

The oral appliance moves the lower jaw bone forward in space during sleep, therefore pulling the tissues behind the tongue forward. This creates the space needed for the patient to breath comfortably during the night.

Photo of mouth guard to wear for sleep apnea treatment Side effects from using the oral appliance include: temporary excessive salivation (likely), TMJ/facial discomfort (unlikely), damage to teeth like chipping or loosening (unlikely), and claustrophobia (unlikely).

The Success Rate is 85–90% in patients with mild-moderate sleep apnea who actually use the appliance and tolerate it. This is the chance of cure, with no further need for the CPAP machine. Some of the complications mentioned above are the reasons you may not tolerate the appliance. Photo: Clear oral appliance for Sleep Apnea

It takes around 2–3 months of wearing the appliance in order to be ready for another sleep study to determine efficacy. This time is used to get used to wearing the appliance and advancing the position of the lower jaw, in order to open up the airway.

If the repeat-sleep study shows sufficient improvement, there may be no need for further treatment outside of wearing the appliance over night. If the appliance is not effective, and you still do not tolerate the CPAP machine, further discussion regarding curative surgical options will be necessary.


CPAP Alternative #2: Combination Surgery (Chin Advancement + Soft Tissue Surgery)

The chin advancement procedure moves the chin bone forward in space, therefore pulling the tissues behind the tongue forward. This creates the space needed for the patient to breath comfortable during the night.

The procedure involves only the chin segment of the lower jaw (mandible). The segment that bears the teeth is not affected by the operation.

There are two ways of performing the Chin Advancement procedure:

  • Sliding Genioplasty: This is done in patients whose facial features can tolerate (and can even be enhanced) by advancing the whole chin including the bottom border.
  • Genioglossus Advancement: This is done in patients whose chin is already in a forward position and their facial features cannot tolerate an advancement of the chin. Instead, a smaller window of bone is moved forward that opens up the airway. This causes little or no aesthetic change in the face.

Illustration: Chin Advancement Procedure at Integrative Oral & Facial Surgery in McLean VAYour jaws will not be wired shut after the procedure and you will be able to open your mouth comfortably.

There are no restrictions on what kind of food you can eat after the surgery.

Complications from the surgery include: excessive bleeding (unlikely), infection (unlikely), temporary numbness of the lower lip and chin (likely), temporary swelling (likely), temporary feeling of tightness in the chin (likely).

When you combine this chin surgery with the palatal/tonsil/base of tongue surgery by the Ear, Nose, and Throat surgeon, the Success Rate is 70%. (Success Rate = the odds of OSA cure, with no further need for the CPAP machine).

Recovery from the surgery:
The pain after the surgery is very well controlled with medications. The swelling will increase for 2–3 days, then stabilize and start regressing. Most of the swelling is gone after 2 weeks, while the residual swelling will take a few more weeks to subside.

For more information or to schedule a consult with Dr. Ali or Dr. Nokkeo, please call us: Integrative Oral & Facial Surgery in McLean VA Phone Number 703-388-2889.


CPAP Alternative #3 : Corrective Jaw Surgery (Maxillo-Mandibular Advancement, or MMA)

The upper and lower jaw advancement procedure moves both jaws forward in space, therefore pulling the tissues behind the roof of the mouth (palate) and tongue forward. This creates the space needed for the patient to breath comfortably during the night.

Before Corrective Jaw Surgery Procedure: Illustration showing profile and underlying bones
After Corrective Jaw Surgery in McLean VA: Illustration showing profile and newly positioned underlying bones

Complications from the surgery include: excessive bleeding (unlikely), infection (unlikely), temporary numbness of the cheeks, lips and chin (likely), temporary swelling (likely).

The vast majority of time, your jaws will not be wired shut after the surgery, and you will be able to open your mouth without restrictions.

Nutrition: You will be eating a non-chew diet after the procedure (noodles, scrambled eggs, rice … food that is cut into small enough pieces as to be eaten using only the lips, roof of the mouth, and tongue) for 6 weeks.

The Success Rate is 90–95%. This is a strong chance of OSA cure, with no further need for the CPAP machine.

Recovery from the surgery: The pain after the surgery is very well controlled with medications. The swelling will increase for 2–3 days, then stabilize and start regressing. Most of the swelling is gone after 2 weeks, while the residual swelling will take a few more weeks to subside. The numbness will gradually improve for several weeks to months after the procedure. You can eat soft, non-chewable foods such as mashed potatoes, scrambled eggs, rice, etc. (as long as you don’t need to put your teeth together to crush the food).

Call our office if you have any questions or would like to schedule an appointment: Integrative Oral & Facial Surgery in McLean VA Phone Number 703-388-2889.