Podcast #10: 9 Proven Alternatives to CPAP

Frustrated CPAP users are constantly asking me what other options are available. There are literally dozens of over-the-counter, natural, prescription, and surgical options that are available. I’ve chosen 9 options that have proven results, based on published research in peer-reviewed medical journals. There may be other options that may work very well, but as of date, I’m not aware of any prospective studies showing significant improvement based on sleep studies as well as quality of life questionnaires.
Show Notes
1. Sleep positions: Slumberbump, Rematee Anti-snore Shirt
2. Past podcasts on the advantages and disadvantages of mandibular advancement devices.
3. Acupuncture interview (#52) with Amy Hausman. Research description.
4. Tongue exercises: Interviews with Joy Moeller (#33), Janet Bennet (#45). Meta-analysis article.
5. Provent article
6. Didgeridoo article
7. Throat and tongue surgery interview (mp3).
8. Jaw surgery interview (mp3)with Dr. Kasey Li


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6 thoughts on “Podcast #10: 9 Proven Alternatives to CPAP

  1. Dear Dr. Park:
    I have been listening to you talk about sleep apnea for quite a while now and am wondering why you left out the Buteyko Breathing Technique as an alternative way to manage sleep apnea? It could be people with sleep apnea don’t breathe properly and could benefit from this method.

  2. My ENT just got his first sleep study back from his first patient who had a course of 6 RFA ablation of the tongue base treatments he administered. The AHA went from 49 to 1! Good start. I will be happy if he does me half that good!

    Don in Austin

  3. Ms. Pianetta,

    I thought about Buteyko breathing, but I could not find any prospective research studies in peer-reviewed journals documenting effectiveness for OSA. Once data is available, I will begin making recommendations.

  4. Why target the symptoms of the disease rather than the source of the disease?

    There are two things that the adult medicine clinic at Harborview Medical Center in Seattle Washington did for me that has really helped with my sleep apnea. The Lipid clinic gave me a pedometer. My general practitioner referred me to a dietitian. I now own and have regularly used for over six years a recording pedometer computer interfaced with charts and graphs going back many years documenting my efforts to obtain and maintain my 10,000 steps a day (totally successful February and March of this year). After only about three years the relationship with the dietitian ended when I moved to a different city but my efforts to learn to eat well continue. The changes I made helped me reduce the CPAP pressure I use by one half several years (and about 35 pounds) later.

    I really do believe that everyone diagnosed with sleep apnea should be referred to a long term relationship with a dietitian and a personal trainer.

    But I suppose that in looking for the sources of sleep apnea we should look more closely at the lives of truck drivers which do seem to have a rate of sleep apnea some seven times higher than the general population. I think I see:

    1. A much greater exposure to toxins from hours a day on the highway and city streets breathing lots of exhaust, roadway off gassing, the herbicides and pesticides used to treat the road shoulders, and whatever makes it into the cab from the engine compartment.
    2. A great deal of abuse of the sleep cycle circadian rhythms and the use of short sleep times trying to get the load to the customer as quickly as possible.
    3. A “culture of obesity” as I see obese trucker after trucker line up to buy chips and several 22oz soft drinks at a truck stop where I had to look a long time to find a source of salad or veggies amongst the fried foods and milkshake bar (yup they really had a make your own milkshake machine).
    4. A high stress job which maintains a low level of physical activity, seated with hands forward, apparently resulting in forward head posture and an over all low physical activity level.

    Toxins are known to be associated with “diabesity” the cravings of which have likely led to the forming of the culture of obesity that I believe I did observed. Short sleep and circadian rhythm abuse is also associated with obesity. Add stress with little physical exercise and the tendency toward inflammation is likely enough to cause nighttime obstruction I suppose. With now stress at night from the obstructions as well as in the daytime, and less real sleep, I am not shocked to see these people developing sleep apnea at very high levels.

    Now weighing some 55 pounds less than my highest level (and highest CPAP pressure) I find myself needing a bit more CPAP pressure and apparently sensitive to organophosphate pesticides. Perhaps the fat I am dealing with now is indeed the most toxic being that which the body least wants to “throw on the fire” understanding that it is hazardous to do so? So perhaps the referral to the dietitian and personal trainer should add that detoxification protocols need to be stressed.

    What I am now happy to see are doctors who recognize that treating these chronic diseases require a systems approach rather than a symptom by symptom approach.

  5. Again I am wondering why there is no discussion about the Buteyko Method which has been successfully used in many studies about Asthma. Anecdotally this method has been used for sleep apnea with success. I can’t disagree with working with a dietitian and having a good exercise program. That definitely benefits your overall amount of air you breathe in a 24 hour period.

  6. Thank you Dr. Park for taking time out of what I am sure is a very busy schedule and sharing your expert knowledge of OSA treatments. I have been following you for several years and glad you emphasize the importance of eliminating eating for 4 hours prior to bedtime when dealing with acid reflux since acid reflux makes OSA worse. That suggestion cured me of my reflux after suffering with it for many years. I am glad to hear you talk about the fact that CPAP is not the answer for everyone. I was diagnosed with severe OSA 13 yrs ago. I used BIPAP-CPAP (3 machines and 16 masks), positional therapy, PROVENT (nose too stuffy even after septoplasty and turbinectomy), 3 dental appliances with limited success but with worsening TMJ issues. A chronic pain syndrome precludes bony surgery and I didn’t think the palatal and tongue surgery alone were the way to go so I went with the INSPIRE surgery in July. I am working on getting used to the stimulation sensation but I believe it has promise for me.