Slumping Slumber Remedies

Sleep apnea reports shows CPAP and MAD reign supreme for treatment

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) One can try any number of home remedies including vigorous exercise to increase sleep duration at night. If those don't work, it may be time to call in the big boys.

Agency for Healthcare Research and Quality (AHRQ) has evaluated the medical interventions available for sleep apnea and ranked them based on evidence. Continuous positive airway pressure (CPAP) and mandibular advancement device (MAD) were ranked number one and two by the report.

"Ask your doctor about CPAP and MAD for sleep apnea."

AHRQ Director Carolyn M. Clancy, M.D. reports that obstructive sleep apnea is discouraging and oftentimes debilitating for many Americans. Some people don't seek treatment as they aren't aware that their struggle with daytime sleepiness, driving accidents, poor work performance and struggles with sleep may be connected to a medical condition. The doctor hopes that the study's guidelines will inform undiagnosed patients about their treatment options, so maybe they will seek medical help.

AHRQ evaluations and recommendations for Treatment Include:

  • Continuous positive airway pressure (CPAP) machine
  • Mouthpiece called a mandibular advancement device (MAD)
  • Weight loss
  • Surgery to clear airway blockage

The recommendation for the breathing machine called CPAP was backed by the strongest evidence. The report verified that CPAP, which requires a mask to be worn at night to pump air to the patient, is highly effective. The mouthpiece device called MAD is also quite effective. Weight loss and surgery to clear the airway passage may be effective in some cases, but the supporting evidence was not quite as profound in these last two options, according to the review by Tufts Medical Center Evidence-based Practice Center for AHRQ's Effective Health Care Program.

The report also notes that all of the treatments may have side effects.

Possible side effects from CPAP are nose bleeds, chest discomfort, feeling trapped and dry nose and mouth. Also, this treatment is only effective if implemented every night and some patients give up on it. MAD side effects include potential teeth damage or loss from the mouthpiece.

The third major medical treatment for obstructive sleep apnea is surgery to clear the airway blockage, but the report was not able to determine through evidence if surgery is more or less effective than CPAP and MAD treatments.

AHRQ has also developed companion guides for consumers and clinicians that summarize the report on obstructive sleep apnea.

Reviewed by: 
Review Date: 
August 9, 2011
Last Updated:
August 11, 2011