What are treatments options for obstructive sleep apnea (OSA)?

Updated: Sep 15, 2020
  • Author: Himanshu Wickramasinghe, MD, MBBS; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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From least invasive and effective to most invasive and effective, treatments can be summarized as follows:

  • All patients should be offered nasal CPAP therapy first.

  • In patients with mild-to-severe obstructive sleep apnea who refuse or reject nasal CPAP therapy, BiPAP therapy should be tried next. If this therapy fails or is rejected, OA therapy should be considered.

  • OAs may be considered first-line therapy for patients with mild OSA, particularly if they are unwilling to try nasal CPAP therapy.

  • All interventions to improve tolerance of CPAP therapy should be attempted prior to deciding that treatment has failed in a particular patient.

  • Patients in whom noninvasive medical therapy (eg, CPAP, BiPAP, OAs) fails should be offered surgical options. Patients should be made aware of the success rates for each surgical procedure. They should be informed that they might require more than 1 surgical procedure, some fairly extensive, to cure OSA. Refer patients only to centers that have personnel experienced in these special surgical techniques.

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