Non-CPAP Travel Sleep Apnea Treatment Options

Here’s a common scenario: you’re a regular PAP user and are doing great with your machine. But you’re headed on a trip where you don’t want to bring your equipment. You’re aware of the small, travel-sized CPAP machines on the market but they’re not the best option for you because of one or more of the following factors:

• Lack of access to “reliable” electricity for the duration of the trip
• Weight is a consideration, like with backcountry camping
• Long-haul flights
• Sharing quarters and you want a treatment that’s more "subtle" but still prevents snoring and feeling like crud in the morning
• You just don’t feel like schlepping the equipment around with you

Below is a comprehensive list of alternatives for your consideration with their associated pros and cons. I want to emphasize that the gold-standard treatment for obstructive sleep apnea (OSA) is still CPAP; therefore, if you’re doing well on CPAP, I’d only recommend using the treatments below for short-term situations where CPAP is impractical.

As a reminder, our established patients (those that have had a telemedicine consultation with me) can purchase prescription-requiring equipment from singularsleep.com. If we’ve never discussed the potential cons of mandibular advancement devices or iNAP, we’ll have to document that you don’t have any contraindications before dispensing the device. Feel free to contact us at info@singularsleep.com or 844-757-9355 for more information.

Bongo Rx: uses nasal EPAP to create back pressure on exhalation, helping to splint your airway open.

Prescription status: prescription required

Pros:

• FDA-approved for mild-to-moderate obstructive sleep apnea (OSA)
• Super lightweight and portable
• No electricity required
• No cleaning required

Cons:

• Typically expected to reduce AHI by about 50% so not fully effective for higher degrees of OSA
• If you’re a mouth-breather in your sleep, it’s probably not going to work for you because opening your mouth will bypass the mechanism of action of the device.

Cost: $199 for the starter pack, which provides all sizes of nasal inserts and will last for 90 days

Oral Appliances for Sleep Apnea: the most common type is known as a mandibular advancement device (MAD); it pushes your lower jaw forward, opening up your airway primarily behind your tongue. There are also tongue retaining devices (TRDs) that use a suction bulb to pull your tongue forward. They are hard to maintain a good seal with and many people find the traction on the tongue to be uncomfortable.

Prescription status: varies

• There are over-the-counter options like Zyppah that will be more bulky, less comfortable, and less effective than custom oral appliances. TRDs do not require a prescription. Non-prescription OAs can only advertise that they help snoring as they haven’t been tested and proven to work for OSA.
• Custom oral appliances require a prescription because they have been proven to effectively treat mild-to-moderate OSA. 

MADs:

• FDA-approved as an alternative to CPAP for the treatment for mild-to-moderate OSA; considered to be second line for severe OSA in people that have tried and failed PAP
• Super lightweight and portable
• No electricity required
• Minimal cleaning required

• Not recommended if you have certain dental issues like moderate-to-severe TMJ and periodontal disease
• Need to have most of your teeth
• Can cause teeth movement with years of use; may not be desirable for people with recent orthodontic treatment likes braces or Invisalign

Cost: highly variable

• OTC devices usually are in the $100-200 range
• Custom oral appliances made by a dentist typically run between $2,000 - $5,000, depending on your location.
• Singular Sleep carries the ApneaRx, considered a “temporary” oral appliance that you can make at home with a “boil and bite” system (like the way you’d fashion a sports mouth guard) which is $249.
• We also have a custom dentist-quality option, the Sleep-Well, for $1,500.

iNAP Sleep Therapy System: uses gentle suction from a mouthpiece to move your soft palate, uvula, and tongue forward, maintaining an unobstructed airway. Think of it as bizarro CPAP: CPAP uses positive pressure (pushing air down your throat) to keep your airway open while iNAP pulls your airway open through negative pressure.

Pros:

• FDA-approved for all degrees of obstructive sleep apnea (mild, moderate, and severe [up to an AHI of 55])
• More portable than CPAP; about the size of a smartphone
• On average the battery lasts for 6 days before needing to be recharged

• Depending on the length of your trip, may requires intermittent access to electricity to charge
• Need to be able to breathe through your nose
• Not suitable for those with front teeth that are loose or have advanced periodontal disease
• Wasn’t tested in people with BMIs >33
• Some routine cleaning required

Cost: $999

Positional therapy: keeps you off of your back, reducing your degree of snoring and sleep apnea

Prescription status: varies

• Our favorite form of this is the Rematee, which has inflatable “bumpers” that when deflated, leave a very small footprint; easily portable
• No electricity required

• Makes it hard to change sides so if you’re a side sleeper, it may irritate your shoulders over time
• Unlikely to completely eliminate your snoring and sleep apnea

Cost: $108.75 (Rematee)

If you’re in a pinch and don’t have any of the above, here are some strategies that can help while you're on your trip:

• Try to stay off of your back
• Raise your head with a couple of pillows – increasing the angle of your head and torso takes away some of the effect that gravity has on pushing tissues downward and closing off your airway
• Avoid alcohol, cigarette smoke, and sedative-hypnotic medications near bedtime
• Treatments that open up your nose like Breathe-Right Strips can help a little