Treating mild sleep apnea: Should you consider a CPAP device?

There have not always been consistent outcomes data or consensus about treatment recommendations for people with mild sleep apnea. Nonetheless, there are several studies that have demonstrated quality of life benefits in treating mild OSA, including a recent study published in The Lancet, where researchers from 11 centers throughout the United Kingdom recruited and randomized 301 patients with mild OSA to receive CPAP plus standard of care (sleep hygiene counselling) vs. standard of care alone, and followed them over three months. The results found that in patients with mild OSA, treatment with CPAP improved their quality of life, based on a validated questionnaire.

This study supports a comprehensive approach to evaluation and treatment of mild OSA. While all people with mild OSA may not need to be treated with CPAP, there are patients who can greatly benefit from it.

Treatments may be trial and error until you and your doctor get it right

When sleep apnea is mild, treatment recommendations are less clear-cut, and should be determined based on the severity of your symptoms, your preferences, and other co-occurring health problems. Working in conjunction with your doctor, you can try a stepwise approach — if one treatment doesn’t work, you can stop that and try an alternative. Managing mild sleep apnea involves shared decision-making between you and your doctor, and you should consider just how bothered you are by sleep apnea symptoms, as well as other components of your health that could be made worse by untreated sleep apnea.

Take-home suggestions

Conservative approaches for mild OSA:

If you have bothersome symptoms related to OSA — such as loud, disruptive snoring, long pauses in breathing, repeated nighttime awakenings, unrefreshing sleep, insomnia, trouble thinking, or excessive daytime sleepiness — or significant health problems that might be exacerbated by OSA (even mild) — such as arrhythmia, high blood pressure requiring multiple medications to control, stroke, or a severe mood disorder — medical treatment(s) for OSA should be considered.

The medical treatments for mild OSA:

If you are concerned you might have OSA, talk to your doctor

Based on your symptoms, exam, and risk factors, your doctor may recommend a sleep study, or you might be referred to see a sleep medicine specialist. A comprehensive sleep assessment is needed to accurately evaluate sleep complaints, since sleep disorders tend to overlap. Treatment for mild OSA may improve sleep-related symptoms and your quality of life. However, there is no one-size-fits-all approach when it comes to sleep disorders, but rather a multidimensional and individualized approach to find what works for you.

(Melanie Pogach, M.D., is a contributor to Harvard Health Publications.)