Why CPAP Treatment is Not Always the Best for Sleep Apnea: A Commentary by Founder Dr Jordan Stern

CPAP does not work for every individual diagnosed with sleep apnea, nor does surgery, nor does oral appliance therapy, nor does weight loss.

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Why is it that most sleep doctors tell patients that CPAP is the best or only treatment for sleep apnea. Because, they have not done their homework, and are set in their old ways ...

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Let me tell you which is the best treatment for sleep apnea ... the one that works for you ...!

First of all if you have been diagnosed with sleep apnea, make sure you have the details. Many patients are still diagnosed in sleep labs (even though home sleep testing technology has been available for over 25 years, and is now considered the preferred method of diagnosis in most cases because it is easy, allows you to sleep in your normal environment, and a fraction of the cost of old lab studies. Yes, in some cases patients need to be evaluated in a "sleep lab", but rarely given the now accurate and reliable home sleep tests.

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So, ... how bad is your sleep apnea? Is it mild, moderate, severe, or ... extremely severe (my added category ... if . you stop breathing more than 50 or 60 times an hour ...). Does it occur only on your back ... do you ever sleep on your back?, or does it occur in all body positions ... Is it associated with daytime sleepiness, fogginess, or poor memory ?, or do you not have symptoms at all? Is it snoring that is the biggest problem? Did your sleep doctor also discuss treatments for snoring ... did you meet the sleep doctor? ... No?

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Do you have high blood pressure, a heart arrhythmia, have you had a stroke?, do you have glaucoma, do you have diabetes, do you have erectile dysfunction, or sexual disinterest? All important questions that need to be asked and addressed.

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So ... the best treatment? ... the treatment that you can accept (maybe surgery is the best treatment in your case, but you categorically refuse the risk and discomfort of surgery), maybe CPAP is most likely to control all of your breathing pauses at nigh (especially if they occur more than 50- or 60 times an hour), but you have tried CPAP and it didn't work, or ... you refuse to try it because you are worried that you will never find a partner to sleep with you or live with you if you sleep with a breathing machine.

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So ... did your sleep doctor or your general doctor tell you that the only treatment that really works for sleep apnea is CPAP? Well, they are simply wrong, and have not done their homework. Worse, if they have not told you that CPAP is just one of the treatments, and that other treatments like mouthguards worn at night, or surgical procedures either in the office or in the hospital are available, and in many cases have better outcomes ... then shame on them ...

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Pros and cons of CPAP. Its a breathing machine attached to a tube and a mask. It was invented in intensive care units about 40 years ago, for patients recovering from lung failure that needed to be on breathing machines (ventilators). About 3 thousand years earlier, surgical treatments existed involving removing tonsils from the throat, making an opening in the throat (tracheotomy). CPAP only works when you use it.