Obstructive Sleep Apnea (OSA) is caused by the downward drop of the soft palate (a flexible, muscular part of the roof of the mouth) or soft tissue that relaxes and enlarges, blocking the airway and preventing sufficient airflow.

Central Sleep Apnea (CSA) occurs when the brain fails to send the proper signals that support the respiratory system. Unlike obstructive sleep apnea, CSA occurs not because of physical blockages but due to a lack of respiratory effort.

Also referred to as “treatment-emergent sleep apnea”, Complex Sleep Apnea is a form of sleep apnea that combines features of both obstructive and central sleep apnea. This typically happens when a patient begins obstructive sleep apnea treatment and then later develops central apneas.

CPAP therapy using a Continuous Positive Airway Pressure (CPAP) or an Auto-adjusting Continuous Positive Airway Pressure (APAP) machine that works by delivering consistent, pressurized air through a CPAP machine that forces the airway open during sleep.

Bi-Level Continuous Positive Airway Pressure (BiPAP)(or Bilevel Positive Airway Pressure) machines also deliver pressurized air.

However, instead of offering only inspiratory pressure like CPAP and APAP devices, a BiPAP machine produces both inspiratory and expiratory pressures to reduce the amount of work required to breathe and allows for more comfortable exhalation.

All 3 machine types feature the same parts/components (water chamber, tubing, filter, and CPAP mask) and the same consistent use is required for positive treatment results regardless of what type of machine is used.

According to the National Institute of Health (NIH), approximately 25% of individuals diagnosed with a sleep disorder will never fill their prescription or begin therapy with as many as 31% of sleep apnea patients abandoning treatment within the first year. When asked, most users report that they’re unable to tolerate treatment for reasons such as the strength of the airflow, claustrophobia, or inability to sleep while wearing a CPAP mask.

For many, standard treatment with a CPAP machine and its accompanying supplies isn’t always an option due to their living circumstances, employment, or lifestyle. Afterall, for someone who travels often or is without a consistent sleep schedule and environment, it can be more difficult to achieve effective treatment.

It’s not uncommon for treatment to be abandoned by CPAP users when other matters such as facial deformities, chronic congestion, or even facial hair begin to interfere with the success of their therapy. Some sleep apnea patients find that their skin is too sensitive to wear a mask that requires a tight seal for a minimum of 4 to 5 hours each night and many users report issues with skin allergies to CPAP masks, as most masks are made with a silicone rubber cushion.

CPAP alternatives such as oral appliance therapy and surgical treatments are beneficial for sleep apnea patients who find the size, sound, and routine of CPAP therapy to be a stress of hindrance on their everyday lives. Oftentimes, the convenience of a small, easy-to-carry device (or even no device at all following a surgical procedure) is an attractive alternative.

Even if you meet or relate to candidate requirements 1-4, that doesn’t necessarily mean that you’re an eligible candidate. An important thing to keep in mind is that in most cases,  candidates need to have a mild enough case of obstructive sleep apnea (OSA) to be managed by alternative therapy.

For this reason, severe sleep apnea patients are not typically able to take advantage of CPAP alternative treatments and those with moderate sleep apnea will need to have an in-depth conversation with their healthcare provider about what options are available to them.

For those who are not candidates for surgical intervention or simply do not mind the use of medical equipment, there are alternative therapy devices which have grown in popularity in recent years for their ease of use.

Sleep apnea patients interested in this form of therapy will have no shortage of options to choose from and we’ve listed the most common and effective options below.

Expiratory Positive Airway Pressure (EPAP) devices like the BongosRx by AirAvant use a distinctive exhalation system to keep airways open during sleep. Perhaps the most simple, travel-friendly, and easy-to-use alternative treatment, these types of devices are typically standalone items that do not require the use of electricity. Instead, only the user’s own exhalated air is used to power this device.

Using negative air pressure and a compact mouthpiece that eliminates the need for a CPAP mask, intermittent negative airway pressure devices such as the iNap by Somnetics are non-invasive devices that keep soft tissues from obstructing airflow by keeping the airway open.

Neuromuscular Electrical Stimulation (NMES) devices such as the eXciteOSA improve the way that the tongue and upper airway muscles function which leads to better muscle endurance and the prevention of airway collapse. Not only does this CPAP alternative eliminate the need for machines and masks, it can also be used while the user is awake.

Many find that their mild sleep apnea is nearly nonexistent unless they’re laying flat on their back (supine position) which is when it’s most likely that the tongue and soft palate will fall backward and cause blockages in the airway. For these individuals, positional therapy is a simple, non-invasive option and one that can often prevent the patient from graduating to a CPAP machine, BiPAP machine, or other more invasive options by encouraging side-sleeping. Products such as the CPAPology Sleep Noodle Positional Sleep Aid comfortably deliver positional therapy.

Oral Appliance Therapy (OAT) is a common approach to treatment for obstructive sleep apnea (OSA) that uses a custom-fitted dental device worn in the mouth to hold the airway open. These devices work by moving the lower jaw slightly forward and keeping the tongue from falling backward, effectively preventing airway collapse.a

For some, surgical treatments are an extreme approach to the treatment of a sleep disorder but for others, it’s an ideal solution that frees them from the tubes and cords that accompany sleep therapy with a machine.

Individuals with decent overall health may find any one of the following procedures to be just what the doctor ordered.

While it isn’t typically an effective alternative for those with central sleep apnea (CSA) or moderate to severe sleep apnea, lifestyle changes can have a drastic impact on the lives of those dealing with a sleep disorder.

Concentrating on weight loss to avoid obesity, exercise for cardiovascular support, and a healthy diet can not only lessen sleep apnea severity for some but also contribute to overall health.

 Limiting use of tobacco products and alcohol, avoiding phone/computer screens within the hour before falling asleep, and establishing a consistent bedtime routine can also promote better sleep quality.

Just as there’s no one simple answer for most things healthcare-related, there’s really no one obvious course of action for beginning treatment with a CPAP alternative.

Each comes with its own benefits but also side effects or risk factors. We recommend researching each of these treatments we’ve reviewed, making a list of the options that you find most appealing, and speaking with your healthcare provider about which would be the most beneficial for your individual case of sleep apnea.

Luckily, as you now know, there’s more than one way to achieve a great night’s sleep in the pursuit of a high quality of life.