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The best conservative sleep measures out there
Sleep apnea affects 9-38% of the population, and I’m one of them.
I received my diagnosis two years ago after noticing my sleep had been deteriorating over several years. If left untreated, sleep apnea increases the risk of stroke and stroke-related death. I know this all too well—my mom died from a stroke, and I don’t want the same fate.
That’s why I’m sharing a tier list of conservative measures I’ve tried, backed by evidence and personal experience, to improve my sleep. My hope is that if you struggle with sleep issues, you’ll find some hope and options to help you sleep better. Just remember, consult with your doctor before starting any treatment. Sleep studies are far superior to all the wearables out there!
CPAP: The Standard Treatment
Let’s start with the CPAP (Continuous Positive Airway Pressure) machine, the gold standard for treating sleep apnea.
When we breathe, we use negative pressure to pull air in. The CPAP does the opposite; it pushes air into your airway, ensuring you remain oxygenated throughout the night.
Pros:
- It helps reduce daytime sleepiness and improves quality of life.
- It’s the most evidence-based treatment for moderate to severe obstructive sleep apnea (OSA).
Cons:
- It does not improve cardiovascular risk factors associated with apnea.
- Tolerance can be a major issue. Wearing this contraption on your face takes getting used to. If you use a nasal version, it only works well if you’re not congested. If the pressure isn’t just right, you may take it off during the night, which was my biggest problem.
- Many users, including myself, experience a dry nose, even with a humidifier.
- Adherence is low; after one year, only 30-60% of users continue to use it. You need at least four hours on the machine for it to be effective.
Despite these drawbacks, the CPAP is still a must-try for anyone diagnosed with moderate to severe sleep apnea. I’d rank it a solid B tier.
References:
Oral Appliances: The Alternative Option
Next up, we have oral appliances, also known as mandibular advancement devices (MADs). These devices bring the lower jaw forward, preventing it from falling back and causing apnea.
Pros:
- They show improvement in the Apnea-Hypopnea Index (AHI) and work best for mild to moderate cases.
- They have more cardioprotective effects than CPAP.
- Higher compliance rates.
Cons:
- Less effective in severe cases
- Can lead to permanent bite changes. That dog bite yo!
- When I tried one, it kept my mouth slightly open, leading to drooling and mouth breathing. It wasn’t comfortable on my teeth, either.
While these devices can be effective, I’d rate them a C tier based on my experience.
References:
Positional Sleeping: The Free Fix
Now let’s talk about positional sleeping, which is entirely free! Research indicates that most people with sleep apnea stop breathing when sleeping on their backs. This position compresses the airway and allows the tongue to fall back into the throat.
Pros:
- Compliance is much higher compared to CPAP.
- It may reduce AHI by about five points.
Cons:
- Not as effective as CPAP at reducing AHI, but I’ve noticed significant improvements in my sleep quality when I sleep on my side.
- Devices are available to help you stay on your side, but I haven’t tried them yet.
For its effectiveness and ease of use, I’m giving positional sleeping an A tier.
References:
Sleep Hygiene: The Unsung Hero
You can try all these treatments, but if your sleep hygiene is lacking, good luck fixing your sleep apnea. The key hygiene-related factors that can worsen apnea are:
- Poor temperature regulation
- Alcohol consumption before bed
- Intense activities requiring concentration before sleep
Additional Factors:
- Not sleeping enough and being overweight can exacerbate sleep issues.
- Going to bed late (after 1 a.m.) and sleep variability negatively impact sleep quality. Interestingly, sleeping in on weekends can help offset some of these negative effects.
Tips to Improve Sleep Hygiene:
- Comfortable Bed: Invest in a good mattress. Get the firmest you can tolerate.
- Darkness: Make your room as dark as possible with blackout curtains or film.
- Temperature: Keep your room cool, ideally between 62-68°F.
- Noise Control: Use white noise machines to drown out disturbances.
- Limit Food/Drink: Avoid eating or drinking too much before bed.
With a solid focus on sleep hygiene, I’d place this in the S tier for its profound impact on overall sleep quality.
References:
Myofunctional Therapy: The Game Changer
One of the most promising treatments is myofunctional therapy, which involves exercises to improve tongue positioning and coordination. Research shows it can reduce apneic events significantly. My wife had mild sleep apnea and was cured after completing this therapy!
Why It Works:
The exercises focus on enhancing tongue range of motion and keeping the tongue on the roof of your mouth, promoting nasal breathing while you sleep.
In my case, I discovered I had a tongue tie, which restricted my tongue movement. After a surgical procedure to release it, I saw great improvements in my sleep quality. For these reasons, I place myofunctional therapy in the S tier.
References:
Lip Taping and Nasal Strips: A Little Extra Help
For those nights when you need an extra boost, lip taping and nasal strips can help. Lip taping involves using tape or bonding gel to keep your lips closed during sleep.
Pros:
- There’s some evidence it can help with mild to moderate sleep apnea.
- Many of my patients have found it effective.
Cons:
- You must cover the entire lip to prevent mouth breathing, which can still occur for some.
For nasal breathing, nasal strips can help open your nasal passages. I’ve used several types, but my favorite is the Intake Breathing System, which uses magnets to keep your passages wide open. While effective, I place lip taping and nasal strips in the B tier due to the variability in their effectiveness.
References:
The INAP Device: A Mixed Bag
Lastly, I tried the INAP device, which creates a vacuum seal in the mouth to keep the tongue forward. Initially, it worked well for me, but after a few months, I didn’t see the same benefits.
Pros:
- It produced noticeable improvements in sleep quality at first.
Cons:
- Follow-up sleep studies showed no significant changes in my sleep apnea numbers.
Given its experimental nature and mixed results, I’d rank the INAP device in the C tier for now.
References:
The Road Ahead: Aggressive Treatments
Despite my progress, I’m still having issues with sleep. When I hit a low point, it goes WAY low.
I’m currently in process of some more aggressive treatments (in conjunction with the above). You’ll hear all about it when it’s done 🙂
I hope this tier list offers insight into the conservative measures available for sleep apnea and related sleep issues. If you’re struggling, take heart—there are options out there for you!
For more exercises and tips, check out this video to help improve your sleep quality. Your restful nights await!