Just wanted to hop on and say that there's a lot of sensible advice on this thread, over what can be quite a tricky problem. Always glorious on geekzone how sensible most of the discussions are. DOI - I'm a sleep and resp physician working in the public sector.
Just a couple of extra notes:
1) Snoring and sleep apnoea are a couple of overlapping Venn diagrams. You can have sleep breathing issues with not a lot of snoring, or can have dreadful snoring without OSA. Often the key issue is the effect on the individual the following day - and this often predicts tolerability of CPAP. If people don't feel better using CPAP then it's a real challenge to keep going with it, as it is a bit of an embuggerance at the best of times - about 1 in 3 just can't do CPAP for whatever reason.
2) A properly fitted and adjusted mandibular advancement splint is an excellent choice for mild and moderate OSA especially if travelling/tramping/hunting etc. It's not a great choice for severe OSA - may take it down to mild or moderate but probably won't be back to normal. Over the counter devices rarely work as they fit poorly and are not that adjustable. Privately about $2.5k would be the ballpark, some public access e.g. from Dent school in Dunedin.
3) The new kid on the block is pacing the base of tongue/neck muscles. There's a place in AKL doing this now privately. It's again probably better for milder OSA, costs a lot, and usually treatment success is limited by friction of tongue edges inside the mouth causing ulcers. I don't know anyone who has actually had a pacemaker implant for this and would be pretty wary until the tech matures and NZ experience has accumulated.
4) Various drug combos are being used but as usual they might lessen severity but often not sort out the underlying issue. We don't as yet know what their use is in real life.
5) For many people weight loss is effective unless there is another anatomical factor (such as tonsils the size of Australia or a marked underbite). "Curative" weight loss means usually about a 25% loss of body weight, so needs to be slow and deliberate. Tonsillectomy as an adult is exceptionally sore post op! Anti-snoring surgery like the UPPP procedure tends to be effective for a short time rather than a long term fix.
6) Severe OSA is associated with worse cardiovascular health (>30 pauses/hr) but mild and mod OSA aren't particularly, so there's no real gain to treating mild OSA without daytime symptoms i.e. sleepiness, for most people
7) Positionally severe OSA is quite common but really quite hard to stop falling on to your back in the night. The tennis ball technique is cheap and easy but rarely a long term training solution. There are some electronic devices (the Night Shift has USB export for position data; the Phiips Night Balance seems well liked but is hard to find in NZ). They're not cheap...
Hope that helps - good luck to the OP with your CPAP trial! If you are happy using it, it is still the best "tonight" treatment.
cheers
b


