CPAP Alternatives to Treat Snoring and Sleep Apnea

Oral Appliances, Surgery, and Weight Loss Among Helpful Options

The lungs and airway are visualized in a man with sleep apnea. Science Picture Co/Collection Mix: Subjects/Getty Images

It’s a common refrain heard in doctor offices everywhere, “I hate my CPAP!” There are a lot of accommodations that can be helpful – from a new mask, to a humidifier, to heated tubing, to adjustments in the pressure or device type – but sometimes it just doesn’t work out. What are you to do if you can’t stand your CPAP? Learn about some of the alternatives to treat snoring and sleep apnea.

Education and Early Support Helps, Insomnia Undermines CPAP Therapy

Before giving up on your CPAP, keep in mind that it is clear that people who receive early education and support as they begin to use continuous positive airway pressure (CPAP) do better.

The selection of the device, pressure settings, and mask can make a world of difference. If the mask doesn’t fit, cause sores or marks on your face, or leaks like a sieve in the night, who would want to use it? There are many early interventions that optimize therapy. If you don’t have an experienced and educated guide to this process, it can quickly become hopeless. Try to find a board-certified sleep specialist who has completed fellowship training in sleep medicine to help you work through any initial issues.

Moreover, there are other factors that undermine tolerance of CPAP therapy. Insomnia frequently coexists with sleep apnea. Sleep apnea may cause awakenings in the night and insomnia leads to prolonged wakefulness. If you strap on a mask that blows air in your face, it becomes even harder to fall asleep or to get back to sleep in the night. The temporary use of sleeping pills or cognitive behavioral therapy for insomnia (CBTI) may be helpful during initial CPAP therapy.

Alternatives to CPAP Therapy

If you are ready to throw in the towel on CPAP, don’t give up on treating your sleep apnea entirely. No matter why you choose to give up on CPAP therapy, there are many alternative therapies that exist that can be effective. These range from an oral appliance made by a dentist to surgery and even home solutions.

Selecting the proper treatment may depend on the severity of your condition. Some of these alternatives include:

This is the most effective alternative treatment for mild to moderate obstructive sleep apnea. It may reduce severe sleep apnea, but it is unlikely to resolve the condition. Your sleep specialist can provide some guidance on whether this will be helpful given your anatomy. In addition, you can be guided to local dentists who are skilled in providing these devices. They can be expensive, so you want to ensure that it is good option for you before selecting to get one. In addition, it is helpful to have it tested with a sleep study after it is fully adjusted to ensure it is optimally effective.

There are a handful of surgical options that exist to treat sleep apnea. Tonsillectomy is highly effective in children and rare adults. Soft tissue surgeries to remove excessive tissue at the back of the throat, most often the uvula and soft palate, is of mixed success in most.

Tongue surgery can also be performed. Major jaw surgery in which the jaws are surgically moved forward can be effective, but not without changes in facial appearance and a more prolonged recovery. Nasal surgery, including septoplasty to fix a deviated septum and turbinate reduction, may be helpful in some cases. If interested, speak with an ear, nose, and throat (ENT) specialist or an oral-maxillary surgeon.

  • Positional Therapy

If your sleep apnea predominates on your back, positional therapy may be effective. These options include devices that keep you off your back, including tennis ball t-shirts, backpacks, bumper belts, and vibrating neck bands. In addition, changing the position of the head of your bed or sleeping with a wedge pillow may be helpful.

  • Lifestyle Changes

As you might guess, improving your overall health with lifestyle changes can have a favorable impact on your sleep. Weight loss among those who are overweight or obese can be highly beneficial. In general, you should work to maintain an ideal body weight, but a 10% weight reduction will move you in the right direction and may yield benefits. Avoid alcohol in the hours before sleep as this can exacerbate snoring and sleep apnea. In addition, quit smoking: tobacco can irritate the lining of the airway and worsen breathing in sleep.

  • Over-the-Counter Options

There are a number of over-the-counter options that may provide partial relief. Nasal dilators, including the popular Breathe Right strips, may help to open the nasal passage and reduce snoring. Allergy treatment, if hay fever is contributing, may also be useful. Medications including oral pills as well as nasal sprays such as Nasacort and Flonase may help. Saline rinses and sprays may also provide relief.

  • No Treatment

Finally, no one is going to force you to treat sleep apnea. As long as you understand the potential risks to your overall health, you can elect to forgo all treatments. When an effective treatment is discovered, including those options described above, most people with sleep apnea will notice benefits and be willing to continue the therapy.

If you are struggling with CPAP, speak with a sleep specialist about ways to optimize your treatment. In some cases, alternatives may be an effective means to relieve the condition and help you to sleep and feel better.


Kryger, MH et al. "Principles and Practice of Sleep Medicine." Elsevier, 5th edition, 2011.

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