The first step is to get tested and see if you have sleep apnea. The disorder can sometimes be confused for other issues like insomnia or chronic partial sleep deprivation, and an accurate diagnosis is key. In the past, sleep studies to evaluate for sleep apnea would require overnight stays at a sleep center or hospital. But now, many evaluations can be done at home via less intrusive, portable devices that monitor breathing, heart rate, and oxygen levels. Usually just one or two nights of observation is enough to provide a clear answer, says Gurubhagavatula.
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If assessment does reveal sleep apnea, the first line of treatment is usually a continuous positive airway pressure (CPAP) machine–essentially a pump that keeps users’ airways at a high enough pressure to prevent collapse. Sleeping with a CPAP requires sleeping with a mask over your nose or nose and mouth, attached to the bedside pump. The idea can be off-putting to some–even becoming a reason to avoid seeking diagnosis in the first place, Gurubhagavatula notes.
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Yet CPAP machines are a very effective, life-saving treatment that many end up acclimating to better than they expect, says Malhotra. Finding the most comfortable set-up and troubleshooting initial difficulties can require some expert interventions, but “eventually most patients can tolerate it well,” he adds.
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Even for those who truly cannot adjust to a CPAP, there are other options. Oral appliances which pull the jaw forward can help. A surgery that involves implanting a hypoglossal nerve stimulating device is also effective. For mild cases, even changing your sleep position can help, as sleeping on your back can exacerbate an airway obstruction. There are tools and therapies available to assist with shifting to side-sleeping, says Pack, “though we don’t use them a lot clinically.”
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Because of the link between alcohol and apnea, eliminating or cutting back on drinking can be a boon to sleep quality, Gurubhagavatula says. Similarly, discussing the side effects of any prescribed medications with your doctor is important for keeping tabs on overall health.
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Finally, there’s weight loss. Bariatric surgery can significantly reduce severity of obstructive sleep apnea, or even eliminate it altogether for some. A recent study, on which Malhotra was the lead investigator, found that GLP-1 drugs like Mounjaro, Zepbound, Wegovy, or Ozempic can also alleviate moderate and severe sleep apnea for many, as they enable dramatic weight loss.