Can Sleep Apnea Be Cured?

During college, one of the most influential coursers that I took was called “Paradigms of Health and Disease.” It was taught by my advisor in the biophysics department. This course looked at how we define what is is to be healthy or sick, and compare and contrast our definitions with other cultures and societies. One important concept that stuck with me from this course is that no disease can ever be truly “cured.” We as physicians can help to alleviate the severity of disease, but we can never completely eradicate conditions like cancer, Alzheimer’s disease, or asthma. The same concept also applies to obstructive sleep apnea. 

 
Obstructive sleep apnea is a distinct clinical condition that can only be made based on a formal sleep study. However, I’ve argued that all modern humans are susceptible to partial or totally obstructed breathing, leading to various degrees of deep-disordered breathing. Only the more severe extreme is called obstructive sleep apnea. All of us are on a continuum, with various degrees of obstructed breathing that generally worsens with age and various other factors such as menopause, weight gain, and sleep position. This is due to our ability  to talk, which unprotected our upper airways. Modern diets and infant feeding patterns may have accelerated this problem by causing more dental crowding and smaller oral cavity dimensions. 
 
Unfortunately, as we all age, not only does our skin sag on the outside, but also sags and relaxes on the inside of your upper airway. It’s only natural that as your ability to breathe or sleep gradually goes downwards, the more rapidly your body will get sick or not function properly. The major treatment options we have for sleep apnea only help to alleviate this blockage using air pressure, dental gadgets or surgery, but they never really “cure” the problem. At one extreme, a tracheotomy (making a surgical hole in your windpipe below your voice box) can be described as a “cure”, but not too many people will be happy with this option.
 
One way of looking CPAP and dental appliances is to think of it as a cane, or a wheelchair. As you get older, many people will require one of these devices to help get around. Similarly, these nonsurgical options for OSA will help you breathe and sleep better, but it’s never an ideal situation. Throat surgery is similar to undergoing a facelift. Sooner or later, your face will continue to sag, and you may require another facelift. The same issues can rise with throat surgery, no matter how good the initial results. This “relapse” happens slowly and may take years or decades to occur. You may then ask, what’s the point of doing surgery if it’s going to come back? 
 
Even with CPAP or dental appliances, you’ll have to make constant adjustments and modifications every few months to years. The same goes with surgery. Ultimately, it’s a choice between using a device on your face or in your mouth for the rest of your life, or undergo surgery every few decades. Some people will need a combination of CPAP, dental appliance and surgery to achieve optimum results.
 
Regardless of which option you choose, what’s most important is that you think of OSA as a lifelong condition, like diabetes or even cancer. You’ll have to be vigilant and constantly monitor your condition, or be on the lookout to make sure it’s not slowly coming back. Not only do you have to make significant lifestyle changes but also a mindset shift. It’s not like a broken leg that’s treated and never have to worry about it after it’s been fixed. Unfortunately, there’s no quick “fix” for OSA.
 
For those of you with obstructive sleep apnea, what kind of lifestyle changes have you made? Has this condition altered the way you look at health or wellness? 

 

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5 thoughts on “Can Sleep Apnea Be Cured?

  1. I wasn’t breastfed but I have a large airway – 224mm^2 at the smallest point and I have all my teeth with only a slightly narrow upper arch. I’m only in my 30s, am not overweight, and am in good shape. Yet, I still have severe OSA. I’m told my tongue must be too large. How does that relate to the causes you cite above?

    In any case, I’ve also been told (by someone you interviewed) that no treatment would be permanent. I need double jaw surgery anyway probably and they’re suggesting a 10mm advancement for the sleep apnea. That would likely put me well over 300mm^2. Hard for me to grasp how that would not be a permanent fix. What do you think?

  2. balor123,

    Significantly enlarging your airway can only help, regardless of how you approach it. As I stated in my article, over time, everyone sags on the inside. If you ever undergo an MMA, you’ll likely feel better, but over many decades, the soft tissues may begin to loosen and begin to obstruct again (slowly).

    Good luck

  3. balor;
    I had double jaw surgery and my OSA is not cured. I had the 1cm mandibular advancement, and my airway is more than doubled what it was, yet still not as wide as yours. the jaw surgery did cure my intracranial hypertension, for the most part, however, so it was worth it. my airway is wide enough that I ought not to have OSA though, and the issue now seems to be that of airway tone. in my mind, if your tongue was too large, then your airway would be narrow, right? so for you, it must be tone. before you have surgery, I would make a serious attempt at myofunctional therapy and see what happens. are you hyperflexible? perhaps all of your connective tissue is somewhat lax. I am. I can still touch my palms to the floor at age 49, without doing anything to stay limber. perhaps you need the jaw surgery for other reasons too, and I’m sure it will help no matter what. but I have to wonder if you will need to address the tone issue as well.

  4. I agree that Myofunctional Therapy would be a great help. You have made a major step in having orthognathic surgery, but that does not change your tongue posture. Therapy is relatively easy and usually short term. The focus is on re-educating the muscles of the tongue, the lips and the jaw. I would be happy to answer any questions you might have. I have forty-five years’ experience in the profession of Myofunctional Therapy and I lecture and teach both nationally and internationally.

  5. Surgery and machines or appliances don’t address the root cause of sleep apnea which is a breathing dysfunction called ‘chronic hyperventilation’. Surgery/machines /appliances are band-aids. Only the Buteyko method calms down the tendency to ‘chronically hyperventilate’.