There are many advertised modes of treatment for sleep apnea, ranging from specially shaped pillows and chin straps to pills and rhythmic sleep lights. The most widely used device, however, is the CPAP machine. While this machine comes in several different forms, its primary purpose is always to provide positive air pressure that helps to keep the air passages in our threat open. With our face (or at least nose) covered in a mask, air is pumped into our nose and/or nose and mouth. In additional to the basic CPAP machine there is an APAP machine that automatically adjusts the air pressure based on sleep position and potential impact of medication. Another variant, the BIPAP machine increases pressure during the inhale of air and decreases pressure during the exhale. Regardless of the machine being deployed, users of CPAP machines are less likely to experience sleep apnea and to snore. On the other hand, this machine is very difficult for some people to use because it is uncomfortable to wear (thereby making it harder to fall asleep or to sleep without disruptions). Also, as many advertisements have informed us, the CPAP machine must frequently be cleaned. It certainly isn’t meant for everyone.
There is also the matter, once again, of nose breathing and mouth breathing. When the mask covers both the nose and mouth, it is just as likely that we will breathe in the pumped-in air through our mouth as we will breathe it through our nose. Even when the air is pumped specifically into our nose, our mouth is free to take in additional air. The question remains open: does the CPAP increase the portion of air that we take in through our nose? Furthermore, does the comfort of CPAP air coming into our lungs outweigh the discomfort of the CPAP machine for the sleeper? Perhaps it is just a matter of “getting use” to the CPAP—as many of its users declare. There certainly are many people who can’t sleep without their CPAP machine –and bring it with them when traveling. Perhaps the answer for some sleepers can be traced back to the multi-segment Dorveille pattern of sleep that I described earlier. The CPAP machine can be used during one sleep segments. “Natural” (“free-style”?) sleep is then embraced during one or more of the other sleep segments.
Several alternatives to CPAP are available. The choice is not between the CPAP machine and nothing. It is not between a machine and the medications, pillows and other modes I have already identified that proport to eliminate (or at least reduce the occurrence of) sleep apnea. Specifically, there are appliances that help to keep our jaw aligned when we are asleep. This alignment keeps our throat from closing up (or at least becoming constricted). They are much less expensive than the CPAP machine and cause little discomfort. The appliance does have to be produced by a dentist, who prepares a mouthpiece that is molded to fit our upper and lower teeth. This appliance can be used for many years with minimal care (occasional cleaning). While there are over the counter devices that provide some of this alignment, the ones prepared by the dentist tend to be much more effective (if somewhat more expensive).
The question still lingers, however, regarding nose and mouth breathing. The jaw alignment might encourage nose breathing (as does a CPAP) but it doesn’t require nose breathing. There might be less snoring and fewer instances of sleep apnea, but the benefits of nose breathing might not be fully realized. The jaw alignment user will often still wake up with a dry mouth and the desire to urinate (both signs of mouth breathing).
There is one other option regarding the prevention of sleep apnea that has recently arrived. This is a device that is installed in our body (via a minor operation). A handheld device is then available to the sleeper who activates the implanted device. It simulates musculature in the throat to keep open the channel through which air flows. While this device is certainly not for everyone (given its cost and the required implantation of the device), it might hold great promise for those who cannot tolerate CPAP machines and experience severe sleep apnea. Once again, the question still lingers regarding the source of air moving through the opened throat. Does it come from the mouth or nose?
