Adjunctive and Alternative Therapies for Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) is present in over 2% of the population in most developed countries, and this disorder is a significant risk factor for cardiovascular disease and neurobehavioral impairment. The most effective therapy is a mechanical pump tightly adhered to the nose and/or mouth worn across sleep periods to stent open the upper airway. This pressure therapy is tolerated by less than half of the individuals with OSA. Many mechanical and chemical therapies have been tested over the past three decades. To date, there is no therapy as effective as pressure therapy. However, all patients must be screened for unique circumstances that would suggest other therapies might improve outcomes. Upon initial visit, it is important to screen for hypothyroidism, acromegaly, and nasal obstruction, and to assess the risk of drowsy driving and impaired performance at school or work. This information may guide a more personalized and more effective complete treatment for individuals with OSA.