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Best Treatments for Sleep Apnoea

Sleep apnoea causes repeated interruptions to breathing while you sleep. Treatment can help improve breathing, sleep quality and daytime symptoms, but there is no single option that is right for everyone.

The most suitable treatment depends on the type and severity of sleep apnoea, your symptoms, general health and other individual factors.

For obstructive sleep apnoea, treatment may include CPAP, a custom-made oral appliance, lifestyle changes, positional therapy or, in selected cases, surgery.

If you think you may have sleep apnoea, diagnosis should come before choosing a treatment. A doctor or sleep specialist can assess your symptoms and determine whether a sleep study or other investigation is needed.

What Is Sleep Apnoea?

Sleep apnoea is a sleep disorder in which breathing repeatedly reduces or stops during sleep.

There are different types.

Obstructive Sleep Apnoea

Obstructive sleep apnoea, or OSA, occurs when the upper airway partly or completely closes during sleep.

This is the form most commonly associated with loud snoring.

The Sleep Health Foundation’s guide to obstructive sleep apnoea explains that these airway closures can interrupt sleep and reduce blood oxygen levels.

Central Sleep Apnoea

Central sleep apnoea is different. The problem is related to the signals controlling breathing rather than a physical blockage of the upper airway.

Treatment for central sleep apnoea can therefore be quite different from treatment for OSA.

Dental oral appliances used for obstructive sleep apnoea are generally not suitable for central sleep apnoea.

What Are the Signs of Obstructive Sleep Apnoea?

A person with OSA may not realise their breathing is being interrupted while they sleep.

Possible signs include:

loud or frequent snoring
pauses in breathing noticed by another person
waking while choking or gasping
feeling excessively sleepy during the day
waking without feeling refreshed
difficulty concentrating
morning headaches

Snoring does not automatically mean someone has sleep apnoea.

According to Healthdirect’s guidance on snoring, some people who snore have OSA, but not everyone who snores has the condition.

If your main concern is snoring, you can also read our guide on whether sleep apnoea snoring can be cured.

How Is Sleep Apnoea Diagnosed?

Sleep apnoea should not be diagnosed from snoring alone.

A doctor can review symptoms, medical history and other factors before deciding whether further assessment is required.

An overnight sleep study may be used to record breathing and other measurements while you sleep.

The results can help determine whether sleep apnoea is present and how severe it is.

This matters because treatment for mild OSA may differ from treatment for moderate or severe OSA.

The Sleep Health Foundation advises that people being considered for an oral appliance are generally assessed by a sleep specialist first, often including an overnight sleep study.

What Are the Best Treatments for Obstructive Sleep Apnoea?

There is no single best treatment for every person.

Current Australian sleep-health guidance includes CPAP, oral appliances, lifestyle changes, positional approaches and surgery among the options used for OSA.

The right choice depends on the severity and cause of the condition and how well a person can use a particular treatment.

1. CPAP Therapy

Continuous positive airway pressure, usually called CPAP, is one of the main treatments for obstructive sleep apnoea.

A CPAP machine sends air through a mask while you sleep. The pressure helps keep the airway open and reduces episodes where breathing becomes restricted or stops.

The Sleep Health Foundation’s treatment guidance for OSA describes CPAP as the most effective treatment for OSA and notes that it is generally recommended for moderate to severe cases.

Some people need time to become comfortable with the mask or pressure settings.

If CPAP is difficult to use, speak with your sleep physician or treatment provider rather than stopping treatment without advice. Adjusting the mask, equipment or settings may sometimes make treatment easier to tolerate.

2. Oral Appliances

Oral appliances are where dentists can have a direct role in the management of obstructive sleep apnoea.

A mandibular advancement device or mandibular advancement splint is worn in the mouth while sleeping.

It holds the lower jaw further forward, which can help create more space in the upper airway.

According to the Sleep Health Foundation’s guidance on oral appliances, these appliances are generally most useful for people with mild to moderate OSA or for some people who cannot use CPAP successfully.

They may also help with snoring.

Should You Buy an Oral Appliance Online?

An over-the-counter device is not the same as a custom-made sleep apnoea appliance.

The Sleep Health Foundation recommends having an oral appliance individually fitted by a dentist because mouths and jaw positions vary between people.

The appliance may also need adjustment over time.

Long-term use can sometimes affect the teeth, bite, jaw joints or surrounding muscles, which is another reason regular dental follow-up is important.

3. Weight Management and Lifestyle Changes

Lifestyle changes can form part of treatment, particularly when certain factors contribute to OSA.

Depending on the individual, a healthcare professional may discuss:

weight loss when a person is living with overweight or obesity
reducing alcohol consumption, particularly before sleep
stopping smoking
improving general sleep habits
changing sleeping position

Lifestyle changes should not automatically be treated as a replacement for prescribed therapy.

A person with moderate or severe OSA may still require CPAP or another active treatment even after making lifestyle changes.

4. Positional Therapy

Some people experience more airway obstruction when sleeping on their back.

For these patients, positional therapy aims to encourage sleeping on the side.

This can involve behavioural techniques or devices designed to make back-sleeping less likely.

The Sleep Health Foundation includes avoiding sleeping on the back as an option that may help some people with OSA.

Positional treatment does not work equally well for everyone, so it should be considered in the context of an individual’s sleep study and treatment plan.

5. Surgery

Surgery may be considered for selected people with obstructive sleep apnoea.

There is no single operation used for every case.

Treatment may involve different parts of the nose, throat, tongue or jaws depending on the anatomy contributing to airway obstruction.

The Sleep Health Foundation’s information on surgery for OSA states that surgery in adults is generally considered when treatments such as CPAP or an oral appliance have not been successful or when there is a specific anatomical reason for considering surgery.

A sleep physician and appropriately qualified surgeon need to assess whether a surgical option is suitable.

What About Medication or Supplemental Oxygen?

Medication is not generally considered a standard replacement for treatments such as CPAP or an appropriate oral appliance for obstructive sleep apnoea.

Supplemental oxygen is also different from keeping a collapsing airway open.

There may be circumstances where medicines, oxygen or treatment of another medical condition forms part of an individual’s care, but these decisions belong with the medical professionals managing the patient’s sleep disorder.

For a general dental information site, it is more useful to recognise these as medical decisions rather than present them as routine sleep apnoea treatments.

When Can a Dentist Help With Sleep Apnoea?

A dentist can be involved when an oral appliance is part of an obstructive sleep apnoea treatment plan.

Their role can include:

assessing the teeth, gums and jaw before an appliance is made
taking impressions or digital records
fitting a custom mandibular advancement appliance
adjusting the appliance
checking the teeth, bite and jaw during ongoing use

A dentist does not replace the medical assessment needed to diagnose sleep apnoea.

Ideally, management involves communication between the sleep physician and the dentist providing the appliance.

The Australasian Sleep Association also recognises specific training and competencies for dentists involved in oral appliance therapy for obstructive sleep apnoea.

Is an Oral Appliance Better Than CPAP?

Not generally.

CPAP and oral appliances work differently and are not interchangeable for every patient.

The Sleep Health Foundation notes that CPAP is generally more effective at controlling OSA, while oral appliances can be useful for appropriate patients, particularly those with mild to moderate OSA or people who cannot tolerate CPAP.

However, the treatment a person actually uses consistently also matters.

This is why treatment should be selected according to the individual’s diagnosis, severity, health and ability to use the therapy.

Can Sleep Apnoea Be Cured?

The answer depends on what is causing it and what is meant by “cured”.

Some people may experience a major reduction in OSA after changes such as weight loss, treatment of an anatomical obstruction or other targeted interventions.

For many people, sleep apnoea is better considered a condition that needs ongoing management.

CPAP controls OSA while it is being used. An oral appliance also works while it is worn.

Treatment should not be stopped simply because snoring or tiredness improves.

If you want to understand this question specifically in relation to snoring, read our article on whether sleep apnoea snoring can be cured.

When Should You See a Doctor?

Speak with a doctor if you:

regularly snore loudly
wake choking or gasping for air
have pauses in breathing noticed by someone else
experience significant daytime sleepiness
regularly wake feeling unrefreshed
suspect you may have a sleep disorder

Healthdirect recommends medical assessment when snoring is concerning or when someone wakes gasping or choking. A doctor may then refer the person to a sleep specialist or recommend an overnight sleep study.

Daytime sleepiness can also affect driving and workplace safety. Do not drive if you are struggling to remain awake.

Frequently Asked Questions

What Is the Most Effective Treatment for Sleep Apnoea?

For obstructive sleep apnoea, CPAP is generally considered the most effective treatment for keeping the airway open during sleep.

That does not mean it is the best option for every individual.

Severity, symptoms, medical history and ability to use the treatment all influence the final recommendation.

Are Dental Devices Effective for Sleep Apnoea?

Custom-made mandibular advancement appliances can help selected people with obstructive sleep apnoea.

They are generally used for mild to moderate OSA or for some patients who cannot tolerate CPAP.

They should be fitted and monitored by an appropriately trained dentist as part of a broader sleep apnoea treatment plan.

Can a Dentist Diagnose Sleep Apnoea?

A dentist may recognise signs or symptoms that suggest someone should be assessed for sleep apnoea, but a dental examination alone does not establish a sleep apnoea diagnosis.

A doctor or sleep specialist can arrange the medical assessment and sleep testing required.

Does Everyone Who Snores Have Sleep Apnoea?

No.

Snoring is common, and many people who snore do not have sleep apnoea.

However, loud snoring combined with pauses in breathing, choking, gasping or significant daytime sleepiness should be medically assessed.

Can Losing Weight Cure Sleep Apnoea?

Weight loss can reduce the severity of OSA for some people who are living with overweight or obesity.

It does not guarantee that sleep apnoea will disappear.

Anyone already using CPAP or another prescribed treatment should speak with their healthcare provider before changing or stopping treatment.

Can You Treat Sleep Apnoea Without CPAP?

Sometimes.

Depending on the severity and individual circumstances, alternatives may include a custom oral appliance, positional treatment, lifestyle changes or surgery.

A sleep physician can help determine which options are appropriate after the condition has been properly assessed.

Finding the Right Sleep Apnoea Treatment

Sleep apnoea treatment should start with understanding what type of sleep apnoea you have and how severe it is.

For obstructive sleep apnoea, CPAP remains a major treatment. Custom-made oral appliances can also play an important role for suitable patients, which is where dental care becomes particularly relevant.

Lifestyle changes, positional treatment and surgery may be considered in certain situations.

If you suspect sleep apnoea, speak with a doctor or sleep specialist first. If an oral appliance is recommended, a dentist with appropriate training can then help fit and monitor the device.

Sources and Further Reading

This information is for general educational purposes and does not replace diagnosis or personalised advice from a doctor, sleep physician or dentist.

Written and editorially reviewed by the Aussie Dental Care Editorial Team