You may be able to treat obstructive sleep apnea with alternative therapies or devices if a CPAP machine does not work well for you.

Obstructive sleep apnea (OSA) is a sleep disorder that affects your breathing. It occurs from complete or partial blockage of the airway during sleep.

If you have OSA, the soft tissue in the back of your throat relaxes while you sleep and blocks your airway. Your brain can jolt you awake each time that happens in order to restart your breathing.

OSA causes symptoms like:

  • snoring
  • gasping for breath during sleep
  • waking up many times during the night

Along with making you sleepy the next day, OSA can increase your risk of high blood pressure, heart attack, stroke, and depression.

The main treatment for OSA is a continuous positive airway pressure (CPAP) device. This device has a mask that you wear over your nose or nose and mouth, as well as a variety of newer options, such as nasal pillows, which are small cushions that snuggle up to the nose. The machine pushes air through your nose and mouth to keep your airway from collapsing while you sleep.

CPAP machines can improve sleep and mood and lower blood pressure and other heart disease risks. Despite its effectiveness, more than one-third of people who try CPAP don’t stick with it.

Common reasons for ditching a traditional CPAP machine are that the device is clunky, uncomfortable, or noisy. In some cases, it doesn’t help with OSA symptoms.

That said, there are newer CPAP machines that are a lot smaller and quieter, which has meant that more people are able to continue using them.

If you’re unhappy with CPAP, here are a few other treatment options.

If CPAP isn’t for you, a few other OSA treatment options include:

  • an oral appliance
  • bilevel positive airway pressure (BiPAP)
  • nasal valve therapy
  • lifestyle changes, such as losing weight or quitting smoking
  • surgery to fix an underlying cause of OSA

Treatments for mouth breathers

Most people breathe through their nose and mouth. Some people with OSA breathe only through their mouths when they sleep. Mouth breathing typically happens when enlarged tonsils or adenoids, congestion, or a deviated septum blocks the nose.

If you breathe through your mouth while on a CPAP machine, you can wake up with a dry nose and throat. This unpleasant side effect causes many to abandon CPAP treatment.

You may be able to overcome this problem by wearing a chin strap with your nasal mask, adjusting the strap’s pressure to suit your comfort, or switching to a full face mask. You can also use a CPAP machine with a built-in humidifier to add moisture to the air you breathe.

A few other ways to relieve mouth breathing without CPAP include:

  • using a nasal decongestant, antihistamine, or saline wash to clear up nasal congestion before you go to bed
  • propping up your head on a pillow while you sleep
  • consulting your doctor about surgery if you have a deviated septum or another structural problem with your nose

A CPAP machine can be a pain to carry with you on a plane. Plus, you need to clean it while you’re away. Though you could buy a smaller travel CPAP machine, here are a few less cumbersome ways to manage OSA when you travel.

  • Use an oral appliance: It’s much smaller, more portable, and easier to clean than a CPAP machine.
  • Try nasal valve therapy (Provent): This newer treatment consists of a valve that goes into your nostrils and is held in place with tape. When you breathe out, the valve creates resistance on the back of your throat that keeps your airway open. Provent is small and disposable, so it travels easily, but insurance typically doesn’t cover the cost.
  • Bring your own pillow: Hotel pillows may be too soft to support your head and neck while you sleep properly, making breathing harder at night.
  • Carry a supply of decongestants or antihistamines: These medications relieve nasal stuffiness.
  • Bring a tennis ball or a pair of rolled-up socks: Pin it to the back of your pajamas to keep you from rolling onto your back while you sleep.
  • Pack the right cords: Bring an extension cord so any machine you may need at night will easily be in reach. If you’re traveling overseas, don’t forget any necessary outlet adaptors.

BiPAP machine

Another option is bilevel positive airway pressure (BiPAP) therapy. It’s similar to CPAP in that you wear a mask that pushes pressurized air into your airways to keep them open.

The difference is that with CPAP, the pressure is the same when you breathe in and out. People who use a CPAP may find the pressure hard to breathe out against.

A BiPAP machine has two pressure settings. It’s lower when you breathe out than when you breathe in. That lower pressure may make it easier for you to exhale, especially if you have trouble breathing because of heart or lung disease.

Oral appliances

An oral appliance is a less cumbersome alternative to CPAP. It looks similar to the mouthguard you’d wear while playing sports.

More than 100 different types of oral appliances are approved by the FDA to treat OSA. These devices move your lower jaw forward or hold your tongue in place. This helps prevent your tongue and the tissues of your upper airway from collapsing and blocking your airway while you sleep.

Oral appliances work best for people with mild to moderate OSA. They’re most effective when custom-fitted to you. Poorly fitting devices can cause jaw problems and may actually make sleep apnea worse.

A specialized dentist can fit you for the device and follow up with you to make sure that it’s helping your OSA.


If devices and lifestyle changes haven’t improved your nighttime breathing, you might need surgery. Your doctor may recommend one of the following procedures, depending on the underlying problem causing your OSA.

  • Genioglossus advancement: With this procedure, the surgeon cuts your lower jaw bone to move your tongue forward. The result holds your tongue in place so it doesn’t cover your airway.
  • Hypoglossal nerve stimulation (Inspire, Apnex, Genio, and Aura6000): A device is implanted in your chest and connected to the hypoglossal nerve to control tongue movement. An attached sensor monitors your breathing while you sleep. If you stop breathing, the sensor stimulates the hypoglossal nerve to move your tongue out of your airway.
  • Jaw surgery: This type of surgery, referred to as maxillomandibular advancement, moves your upper jaw (maxilla) and lower jaw (mandible) forward to create more space for you to breathe.
  • Nasal surgery: Surgery can remove polyps or fix a deviated septum if one of these prevents you from breathing easily through your nose.
  • Soft palate implants: This less invasive option, also known as the pillar procedure, implants three small rods in the roof of your mouth. The implants prop up your soft palate to prevent it from collapsing over your upper airway.
  • Tongue reduction surgery: If you have a large tongue that blocks your airway, surgery can make it smaller.
  • Tonsil and adenoid removal. Your tonsils and adenoids sit in the back of your throat. If they’re so large that they block your airway, you may need to have them removed.
  • Uvulopalatopharyngoplasty (UPPP or UP3): A common surgical treatment for OSA, this procedure removes extra tissue from the back of your mouth and the top of your throat to let more air into your airway. An alternative is uvulectomy, which removes all or part of the uvula, which is the teardrop-shaped tissue that hangs down at the back of your throat.

Weight loss

When you are overweight or live with obesity, fat can settle around your neck and throat. During sleep, that extra tissue may block your airflow and cause sleep apnea.

Losing just 10-15% of body weight may help improve sleep apnea symptoms. It may even cure the condition.

Losing weight isn’t easy. With your doctor’s help, you can find the right combination of dietary changes and exercise techniques to make a difference with your OSA.

If diet and exercise aren’t enough to help you lose weight, you might be a candidate for bariatric surgery.

New treatments

There are a few additional treatments that have been researched in recent years and have been found to have some success.

These include electrical stimulation of the upper airway and Ansa Cervicalis Stimulation (ACS), which is the stimulation of the nerve loop in the neck joining the upper root of the cervical spinal nerves (C1-2) with the lower root descending from C2-C3.

These simple changes to your routine could help you sleep better at night:

  • Sleep on your side: This position makes air getting into your lungs easier.
  • Avoid alcohol: A few glasses of wine or beer before bed can relax your upper airway muscles and make it harder to breathe, which can interrupt your slumber.
  • Exercise often: Regular aerobic activity can help you lose the extra weight that makes it hard to breathe. Exercise can also help reduce the severity of sleep apnea.
  • Relieve congestion: Take a nasal decongestant or antihistamine to help open up your nasal passages if they’re clogged.
  • Don’t smoke: In addition to its other harmful effects on your health, cigarette smoking worsens OSA by increasing airway swelling.

CPAP is the standard treatment for OSA, but it’s not the only treatment. If you’ve tried a CPAP machine and it didn’t work for you, ask your doctor about other options like oral appliances or surgery.

Along with taking OSA treatment, try maintaining healthy habits. Losing weight, exercising regularly, and quitting smoking can all go a long way toward helping you get more restful sleep.