Conservative measures in the treatment of obstructive sleep apnea (OSA) include weight loss, positional therapy, reducing alcohol intake, cessation of smoking and improving sleep hygiene.
Excess weight, particularly around the neck region, is directly linked to the likelihood of the airway narrowing (or collapsing) during sleep, a time where the ability to hold open the airways is reduced due to muscle relaxation.
When OSA is diagnosed, weight loss is almost always a strong recommendation. Depending on the type and severity of OSA, weight loss can reduce the severity of (and in some instances resolve) snoring and OSA.
OSA is often more severe when sleeping supine (on your back). During supine sleep, the tongue is more likely to fall backwards in the throat causing snoring and an obstruction to the airway.
In some instances, OSA and snoring is only present during supine sleep. A sleep study which monitors positional changes throughout the night will properly diagnose whether sleep disordered berthing is related to body position. If the diagnosis of OSA is significant when supine, but other sleep positions have undisturbed sleep, an effective treatment may simply be avoiding supine sleep.
There are a range of devices available that can help the transition the process to “train” the body to avoid supine sleep. These can range from stitching a pocket in the back of a t-shirt with a tennis ball inside (which creates discomfort when you roll onto your back during the night); to a high-tech device called NightShift which detects when the body moves supine and buzzes to wake you up and shift back onto your side.
Reduction of alcohol consumption
Alcohol is a muscle relaxant. The airway is a muscle that requires tone to remain open and breathe. Therefore alcohol can often cause a decrease in muscle tone, making the airway more vulnerable to obstruction. Although the effects of alcohol usually dissipate as it clears the body throughout the night, reducing alcohol intake of an evening does often help reduce the severity of snoring and OSA.
Cessation of smoking
Smoking acts as an irritant and hence can make the nose and throat swell, thus reducing the space for air to flow through. This means that smoking increases the chance of snoring and the risk of OSA. Cessation of smoking will not only reduce the risk of OSA, but may also reduce sleep disruptions due to the stimulating effect of nicotine.
Sleep Hygiene refers to the behaviours that occur several hours leading up to bedtime. Poor sleep hygiene can have a detrimental effect on the quality of sleep. Large amounts of caffeine or fluid intake, exposure to bright artificial light such as TV’s before bed can all negatively impact sleep. Creating better habits prior to bedtime may help improve sleep quality.