How to treat sleep apnea without CPAP or surgery?

My mother is 63 and has dementia. She is unable to tolerate the CPAP mask, and we also do not want her to undergo surgery as I understand that anaesthesia will worsen her cognitive decline. What non-invasive, non-CPAP treatments are available to treat sleep apnea?

Non-invasive, non-CPAP treatments are only considered for occasional or mild OSA, and if these are relevant:

  • Your mom should avoid alcohol and smoking if there is the off chance she is on them.
  • Your mom can try a change of sleep position to sleep on her side instead of on her back if there is no discomfort.
  • If she is overweight, losing help can help. If there is a nose block from allergy or infection, medications, nasal rinses and allergen control may help.

The European patent office lists more than 2000 devices which the public is tempted often to use to self-manage.

However, it is better to seek an ENT, sleep physician or neurologist’s consult first. For example, many of my patients try to use nasal splints or external nasal stickers to widen the nasal passages.

However, the level of block in their nose may not be at the nose, and those extra cost and discomfort would then not be helpful.

Mandibular Advancement Splints (MAS) worn at night may help advance the lower jaw in sleep. They are better prescribed by sleep dental specialists, as there can be discomfort in the temporomandibular joints and dentition otherwise.

There are tongue retainers which are used, but few patients have tolerated those well long term.

Unfortunately, continued sleep apnea will worsen dementia and cognitive decline, so treatment for your mom’s sleep apnea is very important. Anaesthesia comparatively, when expertly done, will not worsen her cognitive decline.

It is important to work with your vendor and doctor to see why the CPAP tolerance is low, as there is likely a simple solution to increase the CPAP tolerance.


Dr Lynne Lim
MBBS, FAMS

Lynne Lim Ear Nose Throat & Hearing Centre

Lynne Lim Ear Nose Throat & Hearing Centre (Child & Adult)

#17-07, Mount Elizabeth Medical Centre,

3 Mount Elizabeth, Singapore 228510


1196 views 19 Aug 2018
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