Beyond CPAP: Alternative Treatments for Sleep Apnea

By Dr. Samer Alkhuja, MD March 28, 2025 | Treatment Options
sleep-and-heart-health

Exploring effective alternatives to CPAP therapy for those who struggle with traditional treatment approaches

Continuous Positive Airway Pressure (CPAP) therapy is widely recognized as the gold standard for treating obstructive sleep apnea (OSA). However, many individuals find the mask uncomfortable, noisy, or difficult to tolerate. If you're among the millions struggling with CPAP compliance, you're not alone — and you're not out of options.

In this article, we explore alternative treatments that offer relief from sleep apnea symptoms without relying solely on CPAP machines.

1. Oral Appliance Therapy (OAT)

Oral appliances, often fitted by a dental sleep specialist, reposition the lower jaw and tongue to keep the airway open during sleep. These devices are small, quiet, and travel-friendly.

Ideal for: Mild to moderate OSA, patients who snore or grind their teeth, individuals intolerant to CPAP

Pros: Compact and comfortable, no electricity required, easier long-term compliance

Cons: Not as effective for severe OSA, may cause jaw discomfort initially

2. Positional Therapy

Some people experience apneic events primarily when sleeping on their back. Positional therapy trains individuals to sleep on their side using wearable devices or specialized pillows.

Tools include: Positional belts or vibration trainers, side-sleeping backpacks, wedge pillows

Effective for: Positional sleep apnea, mild OSA in younger adults

3. Weight Loss and Lifestyle Changes

Excess weight — especially around the neck — can obstruct the airway during sleep. Research shows that even a 10% weight reduction can significantly improve sleep apnea symptoms.

Suggested changes:

  • Nutrient-rich, low-calorie diet
  • Regular aerobic exercise
  • Reducing alcohol and sedative use
  • Smoking cessation

Lifestyle changes not only reduce apnea severity but also improve heart health, energy levels, and mood.

4. Surgical Options

When anatomical issues are a primary cause of airway blockage, surgery may be considered. Surgical interventions vary from minor procedures to more complex reconstructions.

Common surgeries include:

  • Uvulopalatopharyngoplasty (UPPP)
  • Nasal surgery (for deviated septum or enlarged turbinates)
  • Inspire therapy (nerve-stimulation implant)

Note: Surgery is typically considered only after other therapies fail and must be evaluated by an ENT or sleep surgeon.

5. Inspire Sleep Therapy (Hypoglossal Nerve Stimulation)

Inspire is an FDA-approved, implantable device that monitors breathing and stimulates the hypoglossal nerve to keep the airway open. It’s activated each night with a small remote.

Benefits: Quiet, discreet, and mask-free; clinically proven for moderate-to-severe OSA; high patient satisfaction rates

Candidacy Requirements:

  • Diagnosis of moderate to severe OSA
  • CPAP intolerance
  • BMI under 35
  • No significant central sleep apnea

6. Myofunctional Therapy

This involves exercises that strengthen the tongue, throat, and facial muscles to reduce airway collapse. It's particularly beneficial for children or adults with mild OSA.

Best for: Pediatric OSA, mild adult cases, combined approach with other therapies

Conclusion

CPAP therapy is highly effective—but it’s not the only option. From dental devices to implantable technology, there are several evidence-based alternatives for managing sleep apnea. The key is working closely with your sleep specialist to identify a solution tailored to your lifestyle, comfort, and severity of condition.

“Treatment shouldn’t be one-size-fits-all. Today’s sleep medicine offers a toolkit-not just a single tool.” Dr. Samer Alkhuja, MD

Still Struggling with CPAP?
Schedule a consultation with a certified sleep specialist to explore your options beyond CPAP and reclaim restful, healthy sleep.