Sleep apnea treatment

CPAP Alternatives for Sleep Apnea

If you can’t sleep with CPAP, you still have good options. Dr. Nazarian compares them with you based on how severe your sleep apnea is, your weight, your jaw and airway anatomy, and what you are willing to use every night.

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Compare your options

Option	Best suited for	How we provide it
Oral appliance	Mild to moderate sleep apnea, or people who can’t tolerate CPAP	Custom-made by a dental sleep specialist we refer to, then checked with a follow-up sleep test
Weight-loss injections	Moderate to severe sleep apnea with obesity	Prescribed and monitored by Dr. Nazarian; Zepbound is FDA-approved for this use
Airway surgery	A clear blockage such as large tonsils or adenoids, or a deviated septum	CT of the head and sinuses ordered by Dr. Nazarian, then referral to an ENT surgeon
Inspire (hypoglossal nerve stimulation)	Moderate to severe sleep apnea in people who can’t use CPAP and meet weight and airway criteria	Referral to a surgeon for evaluation, including a sleep endoscopy
Positional therapy	Sleep apnea that occurs mostly when lying on your back	Guided by the position data from your WatchPAT test

Oral appliance therapy

A custom mouthpiece worn at night holds the lower jaw slightly forward, which keeps the airway from collapsing. The American Academy of Sleep Medicine recommends it for adults who prefer it to CPAP or can’t tolerate CPAP. It should be custom-made and adjusted by a qualified dentist, not bought over the counter. We refer patients to Dr. Nason at Bedford Dental Group. Read more about oral appliances.

Weight-loss injections

For adults with obesity, weight loss can substantially reduce sleep apnea. Zepbound (tirzepatide) was approved by the FDA in December 2024 for moderate to severe obstructive sleep apnea in adults with obesity, used with diet and exercise. Dr. Nazarian prescribes and monitors weight-loss injections and repeats your sleep test once you have lost weight. See how weight loss fits into treatment.

Finding and fixing a blocked airway

Some sleep apnea has a clear structural cause. Dr. Nazarian orders a CT scan of the head and sinuses to look for enlarged tonsils or adenoids, a deviated septum and other blockages. When surgery could help, he refers you to an ENT surgeon and stays involved in your care.

Inspire

Inspire is a small implanted device that stimulates the nerve controlling the tongue so the airway stays open during sleep. It is for people with moderate to severe obstructive sleep apnea who can’t use CPAP and meet criteria for weight and airway shape, which a surgeon confirms with a sleep endoscopy. If you may be a candidate, Dr. Nazarian refers you for evaluation.

Before giving up on CPAP, it is worth one more try with a different mask, humidity or pressure setting. Our partner sleep lab can make those changes. CPAP troubleshooting

Medically reviewed by David Nazarian, MD, board-certified internist · Last reviewed October 2026

Sources: Ramar K et al. Clinical practice guideline for the treatment of OSA and snoring with oral appliance therapy. J Clin Sleep Med, 2015 · FDA: First medication for obstructive sleep apnea · NHLBI: Sleep apnea treatment