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.
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
Talk through your options with Dr. Nazarian
9301 Wilshire Blvd, Suite 405, Beverly Hills, CA 90210 · Monday to Friday, 9:00 am to 5:30 pm