Alternative therapies for sleep apnea.
Obstructive sleep apnea is characterized by the repetitive collapse of the upper airway during sleep. A variety of nonsurgical treatments for obstructive sleep apnea have been developed, including behavioral therapies, continuous positive airway pressure (CPAP) devices, oral appliances and medications. Presently, CPAP is considered the first-line treatment for moderate to severe sleep apnea and one of the first-line treatments for mild disease. However, the effectiveness of CPAP is compromised because a large proportion of patients cannot tolerate the devices. Oral appliances are one of the first-line therapies for mild sleep apnea and a treatment for more severe disease if CPAP cannot be tolerated. Medications have thus far been unsuccessful as a treatment option for sleep apnea. All patients should be counseled to avoid sleep deprivation and sedatives (including alcohol) and to lose weight if obese.
Ayas
N T
NT
Pulmonary and Critical Care Medicine Section, Brockton/West Roxbury Veterans Administration Medical Center, West Roxbury, Massachusetts and Harvard Medical School, Boston, Massachusetts 02132, USA.
Malhotra
A
A
Epstein
L J
LJ