Can you treat sleep apnea without CPAP?

Sleep apnea treatment Nov, 01 2023

A guide to alternative sleep apnea treatments

CPAP* therapy is among the most widely prescribed and effective treatment options for sleep apnea, but you need to use it correctly and consistently to get results.¹

If you are unable or unwilling to continue with CPAP, there are several alternatives you could explore – from simple lifestyle changes to surgical procedures.

We will outline some options for you here but if you are currently using CPAP, seek medical advice before you stop your therapy.

Lifestyle changes

Exercise: Being regularly active can reduce sleep apnea symptoms even when you are not losing weight.⁵

Weight loss: Excessive weight is a major factor behind many cases of sleep apnea. Losing weight has been known to lessen the symptoms of this condition.^1,3

Mouth and throat exercises: Doing exercises to tone the muscles behind your tongue can help with sleep apnea. But although they can reduce symptoms of OSA, these exercises may not be successful across all treatment-efficacy indicators.⁶

Non-surgical treatment options

It is advisable to try non-surgical treatments first to avoid unnecessary surgery, and to check in with your healthcare professional for advice on the most suitable treatment for you. Here are three examples of non-surgical treatment options.

Oral appliances or mandibular advancement devices: These are designed to keep your throat open (some by bringing your jaw forward and maintaining the position of the tongue). Commonly available from dental clinics, there is a range of these appliances available, and you may have to try a few to get the right fit for you.¹

Supplemental oxygen: There are a variety of devices to help deliver oxygen to your lungs, which could be helpful if you are experiencing central sleep apnea.¹

Adaptive servo-ventilation (ASV): Unlike the fixed pressure of CPAP devices, ASV pressure continuously adjusts to trigger your breathing into its normalized pattern. It is used to treat complex sleep apnea and central sleep apnea.²

Surgical alternatives

Surgery can be an option for some sleep apnea sufferers, especially those who have tried non-surgical therapies without success. There are several types of surgery aimed at relieving sleep apnea. We have listed some options here.

Tissue shrinkage: Radiofrequency ablation shrinks the tissue at the rear of your mouth and the back of your throat.¹

Tissue removal: Called an uvulopalatopharyngoplasty (UPPP), this procedure involves the removal of tissue from the rear of your mouth and throat and, possibly, your tonsils. This increases the size of the airway and lessens the incidences of tissue collapse.¹

Nerve stimulation: A stimulator is inserted into the hypoglossal nerve which controls tongue movement to keep the airway open.¹

Jaw repositioning (maxillomandibular advancement (MMA) surgery): The jaw is moved forward to enlarge the space behind the tongue and soft palate. This procedure can lessen the chance of blockages.¹

Tracheostomy: A surgeon creates a permanent opening in the neck to the trachea and inserts tubing through which you breathe. This procedure should be considered only if you are experiencing life-threatening sleep apnea and other methods have been unsuccessful.¹

Whichever treatment route you take, it is imperative you act as the effects of untreated sleep apnea can be chronic – it may also be a risk factor for cardiovascular disease, potentially leading to complications such as hypertension and type 2 diabetes mellitus.⁴

If you have not used CPAP – or tried and failed – it may well be worth persevering with the therapy as it has been shown to effectively treat sleep apnea.

Therapy success is dependent on using the right equipment and mask design so you achieve an effective sleep and can comfortably sleep throughout the night. Talk with your doctor and, with proper support and education, you can improve your tolerance to the treatment and more fully enhance your treatment outcomes.

Go to, Which type of CPAP mask is right for me?

* We refer to CPAP in this instance, but this may also include other positive airway pressure device models such as APAP or Bilevel. Masks must be used with a PAP device to deliver therapy.

¹ Adult Obstructive Sleep Apnea Task Force of the American Academy of Sleep Medicine. Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. Journal of clinical sleep medicine. 2009 Jun 15;5(3):263-76.

² Morgenthaler TI, Gay PC, Gordon N, Brown LK. Adaptive servoventilation versus noninvasive positive pressure ventilation for central, mixed, and complex sleep apnea syndromes. Sleep. 2007 Apr 1;30(4):468-75.

³ Randerath WJ, Verbraecken J, Andreas S, Bettega G, Boudewyns A, Hamans E, Jalbert F, Paoli JR, Sanner B, Smith I, Stuck BA. Non-CPAP therapies in obstructive sleep apnoea.

⁴ Shahar E, Whitney CW, Redline S, Lee ET, Newman AB, Javier Nieto F, O'Connor GT, Boland LL, Schwartz JE, Samet JM. Sleep-disordered breathing and cardiovascular disease: cross-sectional results of the Sleep Heart Health Study. Vol. 163, American Journal of Respiratory and Critical Care Medicine. 2001. p. 19-25.

⁵ Iftikhar IH, Kline CE, Youngstedt SD. Effects of exercise training on sleep apnea: a meta-analysis. Lung. 2014 Feb;192(1):175-84.

⁶Guimarães KC, Drager LF, Genta PR, Marcondes BF, Lorenzi-Filho G. Effects of oropharyngeal exercises on patients with moderate obstructive sleep apnea syndrome. American journal of respiratory and critical care medicine. 2009 May 15;179(10):962-6.

View References

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