Sleep apnea treatments range from wearable devices and lifestyle changes to surgery, depending on how severe your condition is. Severity is measured by how many times per hour your breathing partially or fully stops during sleep: 5 to 14 events per hour is mild, 15 to 29 is moderate, and 30 or more is severe. The right treatment for you depends on that number, your anatomy, your body weight, and what you can realistically stick with long term.
CPAP: The First-Line Treatment
Continuous positive airway pressure, or CPAP, remains the standard treatment for obstructive sleep apnea. The machine delivers a steady stream of pressurized air through a mask you wear while sleeping, keeping your airway from collapsing. Most people need a pressure setting somewhere between 8 and 10 cm H2O, though the full range runs from 4 to 20. Your setting is dialed in during a sleep study or titration test, with the goal of bringing your breathing interruptions below five events per hour.
CPAP works extremely well when people actually use it. The problem is adherence. The mask can feel claustrophobic, cause dry mouth, irritate skin, or simply be hard to sleep with. Many people abandon it within the first year. Modern machines are quieter and lighter than older models, and trying different mask styles (nasal pillows, nasal masks, full-face masks) can make a significant difference in comfort. If you’ve tried CPAP and can’t tolerate it, that opens the door to other options below.
Oral Appliances
A mandibular advancement device is a custom-fitted mouthpiece that pushes your lower jaw slightly forward while you sleep, which helps keep the airway open. These devices are smaller, quieter, and simpler than CPAP, and patients consistently report higher satisfaction with them. In clinical crossover trials where patients tried both CPAP and an oral appliance, satisfaction and perceived effectiveness were significantly higher with the mouthpiece, even though CPAP produced slightly better numbers on sleep studies.
Oral appliances work best for mild to moderate sleep apnea, but they can be effective across all severity grades in the right patients. A dentist trained in sleep medicine creates the device, and it’s adjustable so the jaw position can be fine-tuned over time. Side effects include jaw soreness, changes in bite alignment, and excessive salivation, though these often improve after an adjustment period.
Weight Loss
Carrying excess weight is the single biggest modifiable risk factor for obstructive sleep apnea. Fat deposits around the upper airway narrow the space available for airflow, and abdominal fat pushes up on the diaphragm, reducing lung volume. The relationship between weight loss and improvement is remarkably direct: every 1% loss in body weight produces a measurable drop in breathing interruptions during sleep. A 20% reduction in BMI has been associated with a 57% decrease in sleep apnea severity, though the benefits taper off beyond that point.
Weight loss alone can sometimes resolve mild cases entirely. For moderate to severe cases, it typically reduces severity enough to make other treatments (like CPAP at a lower pressure setting) more comfortable and effective. The approach to weight loss matters less than the result. Diet, exercise, medication-assisted weight loss, and bariatric surgery all show benefits proportional to how much weight is actually lost.
Positional Therapy
Some people only experience significant airway collapse when sleeping on their back. If a sleep study shows that your breathing events are concentrated in the supine position, positional therapy can be surprisingly effective. Newer vibrotactile devices are small, lightweight sensors worn on the chest or neck that detect when you roll onto your back and deliver a gentle vibration, nudging you to shift without fully waking you up.
A meta-analysis of 18 studies found that these devices reduced breathing interruptions by about 43% and cut the amount of time spent sleeping on the back by 70%. That’s a meaningful improvement for people whose apnea is truly position-dependent. The catch is that positional therapy only helps a subset of patients. If your airway collapses regardless of sleeping position, this approach won’t do much.
Nerve Stimulation Surgery
For people with moderate to severe sleep apnea who can’t tolerate CPAP, a surgically implanted nerve stimulator is one of the more promising options to emerge in recent years. The device, implanted under the skin of the chest during an outpatient procedure, monitors your breathing pattern and delivers mild electrical stimulation to the nerve that controls your tongue. This keeps the tongue and surrounding muscles from collapsing backward into the airway during sleep.
In the landmark clinical trial that led to FDA approval, the device reduced breathing interruptions by 68%, dropping the average from about 29 events per hour to 9. Two-thirds of patients achieved at least a 50% reduction. Those results held up at three- and five-year follow-ups, suggesting this isn’t a treatment that wears off over time.
Not everyone qualifies. You need to be at least 22, have a BMI below 33, and have an apnea severity between 15 and 65 events per hour. A procedure called drug-induced sleep endoscopy is done beforehand to check whether your airway anatomy is compatible with the device. People whose airway collapses in a complete circular pattern at the back of the palate are excluded because the stimulator can’t overcome that type of obstruction.
Jaw Advancement Surgery
Maxillomandibular advancement is the most effective surgical option for obstructive sleep apnea. The procedure moves both the upper and lower jaw forward, physically enlarging the airway behind the tongue and soft palate. It has a surgical success rate of 86% and a cure rate (meaning sleep apnea is fully resolved) of about 43%. Those numbers make it the gold standard among surgical approaches.
This is a major operation with a recovery period of several weeks, involving a liquid or soft diet while the jaw heals. It’s typically reserved for people with severe sleep apnea who haven’t responded to CPAP, oral appliances, or less invasive surgeries. Facial appearance changes slightly because the jaw is moved forward, which most patients consider a neutral or positive cosmetic outcome.
Medications for Daytime Sleepiness
No pill treats the airway obstruction itself, but medication can help with one of sleep apnea’s most disabling symptoms: excessive daytime sleepiness that persists even after you’ve started using CPAP. The FDA has approved solriamfetol for this purpose. It works by increasing the activity of two brain chemicals involved in wakefulness, and in trials of over 900 adults, it was significantly better than placebo at promoting alertness. Its effects held steady after six months of use.
Common side effects include headache, nausea, decreased appetite, anxiety, and difficulty falling asleep. It can also raise blood pressure and heart rate, so it requires monitoring if you have cardiovascular risk factors. This is an add-on treatment, not a replacement for addressing the underlying obstruction.
Mouth and Throat Exercises
Myofunctional therapy involves a set of exercises that strengthen the muscles of the tongue, soft palate, and throat. Think of it as physical therapy for your airway. The exercises are simple (tongue presses against the roof of the mouth, exaggerated swallowing, specific vowel sounds) and are typically done for about 20 minutes a day.
A meta-analysis of studies in children with sleep apnea found a 43% reduction in breathing interruptions and a small but statistically significant improvement in blood oxygen levels. The evidence is stronger for mild cases and in children, where the muscles are more responsive to training. For adults with moderate to severe apnea, these exercises are best used alongside other treatments rather than as a standalone solution. The upside is that they’re free, carry no side effects, and can complement virtually any other therapy on this list.