In short
- Positive airway pressure, usually CPAP or auto-adjusting APAP, is the most common and most effective treatment for obstructive sleep apnea.
- The AASM makes a strong recommendation for PAP in adults with sleep apnea and excessive sleepiness, and a conditional one for those with high blood pressure.
- Custom oral appliances fitted by a dentist are an option for mild to moderate sleep apnea or for people who can't tolerate CPAP. Over-the-counter devices aren't recommended.
- Positional therapy, surgery, upper airway stimulation, weight loss and lifestyle changes all have a place, depending on your sleep study and your anatomy.
- Mouth tape and nasal strips are not treatments for sleep apnea. A sleep specialist should guide the choice.
The main treatment for obstructive sleep apnea is positive airway pressure, usually a CPAP machine that keeps your airway open with a steady flow of air. If CPAP doesn't suit you, or your sleep apnea is milder, a sleep specialist may suggest a custom oral appliance, positional therapy, surgery, an implanted nerve stimulator or weight loss. The right choice depends on your sleep study and your anatomy.
How do doctors decide which treatment to use?
Doctors decide on sleep apnea treatment after a diagnosis. Sleep Education, the AASM's patient site, says a sleep doctor must first diagnose sleep apnea with a sleep study or home sleep apnea test before an oral appliance is fitted, and that surgery and upper airway stimulation both involve sleep studies before and after. Our guide to the home sleep apnea test explains that step.
From there, the NHLBI says your provider may talk to you about lifelong healthy lifestyle changes along with a positive airway pressure machine, an oral device or other treatments to keep your airway open. Severity matters, and so does whether your breathing problems happen mainly on your back, how well you tolerate a mask and what is narrowing your airway.
What does CPAP do, and how well does it work?
Research: strong (what this means)CPAP stands for continuous positive airway pressure. Sleep Education describes it as the leading treatment for sleep apnea. A small machine pushes air through a tube and mask, which splints the airway open and stops the breathing pauses. The mask may cover your nose, or your nose and mouth, or use nasal pillows that sit in the nostrils.
The NHLBI says a PAP machine is the most common treatment and describes three types. CPAP gives one constant pressure. Bilevel PAP (BPAP) gives different pressures for breathing in and out. Auto-adjusting PAP (APAP) changes the pressure through the night.
The AASM's 2019 clinical practice guideline backs this up. It makes a strong recommendation that clinicians use PAP to treat adults with sleep apnea and excessive sleepiness. It makes conditional recommendations for PAP in adults with impaired sleep-related quality of life and in adults with high blood pressure. For ongoing treatment, it recommends either CPAP or APAP, and suggests those over BPAP for routine use. Our article on sleep apnea and high blood pressure covers what treatment means for blood pressure.
How do you make CPAP easier to live with?
To make CPAP easier to live with, consistency is the main thing. Sleep Education says CPAP works best when used all night, every night, including naps. The NHS says it may feel strange or awkward at first, but to keep using it and tell your doctor if it's uncomfortable. The AASM guideline also makes a strong recommendation for education when PAP is started.
Most side effects can be fixed. Sleep Education says strap marks often come from a poor mask fit, a heated humidifier can ease a dry nose and sore throat, and a saline spray can help with mild congestion. Many machines also have a ramp setting that starts with low pressure so you can fall asleep. The NHLBI lists possible side effects including congestion, dry eyes or mouth, nosebleeds and a runny nose, and says to stop and contact your provider if you get stomach discomfort or bloating. If you breathe through your mouth on CPAP, our piece on mouth tape and CPAP lists questions to bring to your provider. Sleep Education notes that a change of mask style is sometimes needed to prevent a dry nose, mouth or throat.
What about oral appliances?
An oral appliance is a mouthpiece worn at night. Sleep Education says it keeps the airway from collapsing by supporting the jaw or holding the tongue forward. The most widely used type moves the lower jaw forward and slightly down. Tongue-retaining devices hold the tongue in place.
Sleep Education is clear on its limits. CPAP remains the most effective treatment, and oral appliance therapy is most helpful for mild to moderate sleep apnea. It must be custom fitted by a dentist working with the sleep team, and over-the-counter devices are not recommended for sleep apnea. Common side effects include extra saliva, dry mouth, tooth or jaw discomfort and temporary bite changes. A follow-up sleep test may be done to check that the device is working. Our guide to oral appliances for snoring explains how the devices differ.
When does positional therapy make sense?
Positional therapy makes sense for people who stop breathing mainly when they lie on their back. Sleep Education says that if your breathing is interrupted primarily on your back and is normal on your side or stomach, your sleep doctor may recommend positional therapy. This can be a belt or backpack-style device, or a newer device that vibrates gently when you start to roll onto your back. It can be used alone or alongside another treatment. The NHS suggests side sleeping for people diagnosed with sleep apnea, for example with a tennis ball taped to the back of your sleepwear or a special pillow. We cover this in detail in positional sleep apnea.
Which surgeries are used?
Sleep Education says surgery may be recommended if you can't tolerate CPAP. The aim is to treat the parts of the airway that collapse, whether that's the soft palate, tonsils, tongue or jaw. Options include:
- Uvulopalatopharyngoplasty (UPPP), which removes and repositions tissue at the back of the throat
- Removal of the tonsils
- Genioglossus advancement and hyoid suspension, which open space behind the tongue
- Maxillomandibular advancement, which moves the upper and lower jaws forward
- Weight loss surgery for people with severe obesity
UPPP and other soft palate procedures are the most common, but Sleep Education says UPPP alone is unlikely to cure moderate to severe sleep apnea. Benefits may not be permanent, and some people still need CPAP after surgery. A repeat sleep study is usually done afterward. Nose surgery such as septoplasty rarely treats sleep apnea by itself, but it may allow more mask options and lower CPAP pressures. If you have a deviated septum, that's worth raising with your specialist.
What is upper airway stimulation?
Upper airway stimulation is an implanted device that senses your breathing and stimulates the hypoglossal nerve, which moves the tongue forward to keep the airway open. You switch it on with a remote before sleep. Sleep Education says candidates must have moderate to severe sleep apnea, be unable to tolerate CPAP or an oral appliance, be at least 22 years old and not be significantly overweight. The NHS also lists this nerve stimulation among treatments.
Can weight loss and lifestyle changes help?
Yes, weight loss and lifestyle changes can help, and they often go alongside other treatments. The NHLBI says healthy lifestyle changes can be very effective, including regular physical activity, a healthy weight, healthy sleep habits, less alcohol and caffeine, and quitting smoking. It also notes that the FDA has approved an injectable weight loss medicine for adults with moderate to severe sleep apnea and obesity, used with diet and exercise.
The NHS says lifestyle changes may be all you need if your sleep apnea is mild. It also advises against sleeping pills unless a doctor recommends them, because they can make sleep apnea worse. The NHLBI adds orofacial therapy, exercises that strengthen the tongue and face muscles, as another option. See weight loss and snoring for more on the weight side.
Do mouth tape or nasal strips treat sleep apnea?
No, mouth tape and nasal strips don't treat sleep apnea. Neither should replace a sleep study or the options above. If you have warning signs such as pauses in breathing, gasping or heavy daytime sleepiness, see a doctor. Our safety page explains who shouldn't use mouth tape.
This article is general information, not medical advice. A doctor or sleep specialist can match a treatment to your results.
Read next
- Snoring vs. sleep apnea: how to tell the difference
- Positional sleep apnea: when sleeping on your back is the problem
- Sleep apnea and high blood pressure: what's the link?
Common questions
What is the most effective treatment for sleep apnea?
CPAP. The AASM's Sleep Education site calls it the leading treatment and says it works best when used all night, every night. Other options are usually considered when CPAP isn't tolerated or the sleep apnea is mild to moderate.
Is there an alternative to CPAP?
Yes. Options include a custom oral appliance, positional therapy, surgery, an implanted upper airway stimulation device and weight loss. Which one fits depends on how severe your sleep apnea is, when it happens and what is blocking your airway.
What is the best oral appliance for sleep apnea?
The best one is a custom device fitted by a dentist after a sleep doctor has diagnosed you. Sleep Education says oral appliance therapy is most helpful for mild to moderate obstructive sleep apnea, that the most widely used type moves the lower jaw forward, and that over-the-counter devices aren't recommended for sleep apnea.
Can sleep apnea be cured?
Sometimes it improves enough with lifestyle changes, but many people need ongoing treatment. The NHS says sleep apnoea can sometimes be treated by losing weight, giving up smoking and drinking less alcohol, but many people need a CPAP machine. Sleep Education says UPPP surgery alone is unlikely to cure moderate to severe sleep apnea, and some people still need CPAP after surgery.
Does sleep apnea affect surgery?
It can. A 2016 guideline from the Society of Anesthesia and Sleep Medicine notes an increased risk of complications around surgery in people with obstructive sleep apnea, and recommends that people on CPAP keep using it at their usual settings while sleeping in hospital. Tell your surgical team if you have sleep apnea or think you might.
Can losing weight treat sleep apnea?
It can help when excess weight contributes. The NHLBI lists a healthy weight among lifestyle changes that can be very effective, and says the FDA has approved an injectable weight loss medicine for people with moderate to severe sleep apnea and obesity.
Who qualifies for upper airway stimulation?
According to Sleep Education, people with moderate to severe sleep apnea who can't tolerate CPAP or an oral appliance, who are at least 22 and not significantly overweight. A surgeon assesses whether it's an option.
Sources
- Sleep apnea: treatment
- Treatment of adult obstructive sleep apnea with positive airway pressure: an American Academy of Sleep Medicine clinical practice guideline
- CPAP
- Oral appliance therapy
- Surgery
- Upper airway stimulation therapy
- Positional therapy
- Society of Anesthesia and Sleep Medicine guidelines on preoperative screening and assessment of adult patients with obstructive sleep apnea
- Sleep apnoea
About this article
- Research
- 9 published sources, listed above.
- Evidence
- Strong. How we rate it
- Last checked
- October 10, 2026
- Funding
- Paid partner of Titan Recovery. Their ads are labeled.
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- Tell us. We log fixes on the corrections page.
* This content is for informational and educational purposes only and is not medical advice. It is not intended to diagnose, treat, cure or prevent any disease or health condition. Talk to a qualified healthcare provider about your health.
