Other Therapies and Emerging Options for Management of OSA

Abstract

Obstructive sleep apnea (OSA) is a common disorder caused by repetitive collapse of the upper airway during sleep. Continuous positive airway pressure (CPAP) is the gold standard treatment for OSA but suboptimal adherence and poor tolerance to CPAP limits treatment effectiveness. It is not uncommon for patients to seek an alternate treatment for management of OSA. Given the chronic nature of the condition, its detrimental effects on sleep quality, quality of life, executive functioning, and the long-term metabolic and cardiovascular sequela of untreated moderate-to-severe OSA, alternatives to CPAP may be necessary for these patients who are unable or unwilling to use CPAP. Often these alternatives may reduce the burden of sleep-disordered breathing with a treatment strategy that is acceptable to, and tolerated by the patient. This chapter highlights several alternatives to CPAP for management of OSA. Therapies reviewed include medical and surgical weight loss, positional therapy, nasal expiratory positive airway pressure, oral pressure therapy, and hypoglossal nerve stimulation. For oral appliance therapy and surgical interventions, please refer to separate chapters in this textbook.