CPAP Alternatives: Sleep Apnea Treatments Without CPAP

Getting quality sleep each night is important, but if you find that you’re snoring, frequently waking up throughout the night, and feeling exhausted all day, you may want to get tested for sleep apnea. And while continuous positive airway pressure (CPAP) therapy is a common and effective solution for sleep apnea, it’s not the only remedy to sleep apnea symptoms. In fact, there are other CPAP alternatives to try if you get diagnosed with obstructive sleep apnea (OSA).

A CPAP machine delivers pressurized air as you sleep to ensure your airway stays open. However, if you would prefer to try another option first, speak with your doctor about other treatments that might work for you. Here are some alternatives.

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Alternative PAP Therapies

Though CPAP therapy is the most commonly recommended treatment Trusted Source UpToDate More than 2 million healthcare providers around the world choose UpToDate to help make appropriate care decisions and drive better health outcomes. UpToDate delivers evidence-based clinical decision support that is clear, actionable, and rich with real-world insights. View Source for sleep apnea, there is a such thing as sleep apnea treatment without CPAP that you can discuss with your doctor.

CPAP machines deliver a constant stream of air Trusted Source UpToDate More than 2 million healthcare providers around the world choose UpToDate to help make appropriate care decisions and drive better health outcomes. UpToDate delivers evidence-based clinical decision support that is clear, actionable, and rich with real-world insights. View Source at the same level throughout the night. Some people may find this pressure uncomfortable. Here are some alternative PAP machines and emerging treatments that may be considered:

• BiPAP: Bilevel positive airway pressure (BiPAP) machines allow for different pressure settings for inhalation and exhalation. Users who find it uncomfortable to exhale against the constant pressure of a CPAP machine may prefer the lower expiratory pressure on a BiPAP machine.
• APAP: An auto-adjusting positive airway pressure (APAP) machine, or auto-CPAP, responds to changes in the user’s breathing patterns. 
• EPAP: Expiratory positive airway pressure (EPAP) therapy is a newer alternative to CPAP. Instead of using a machine that delivers pressurized air, a nasal EPAP device uses valves to create air pressure when the user exhales, keeping the upper airway from collapsing.
• cNEP: Research into emerging treatments is ongoing. CPAP alternatives such as continuous negative external pressure (cNEP) Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source and oral pressure therapy (OPT) Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source may be effective at treating OSA.

Sleep Apnea Mouth Guards

Oral appliances can address anatomical factors that contribute to sleep apnea, such as a small lower jaw or a tongue that obstructs the airway.

Mandibular Advancement Devices

Mandibular advancement devices cover the upper and lower teeth Trusted Source National Heart, Lung, and Blood Institute (NHLBI) The NHLBI is the nation's leader in the prevention and treatment of heart, lung, blood and sleep disorders. View Source and keep the jaw in a position that prevents it from blocking the upper airway. These devices are silent, easy to use, and less expensive than CPAP machines. 

However, it’s important to keep in mind that mandibular advancement devices work best for people who have mild OSA or those who experience OSA only when sleeping on their back Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source .

Tongue Retaining Devices

Tongue retaining devices keep the tongue forward so that it does not block the airway. These devices also help reduce the number of apnea events experienced, although studies have shown issues with compliance. Some people tend to prefer mandibular advancement devices over tongue retaining devices Trusted Source Journal of Clinical Sleep Medicine (JCSM) JCSM is the official, peer-reviewed journal of the American Academy of Sleep Medicine. View Source . 

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Home Remedies and Changes

At-home or lifestyle changes can help manage sleep apnea symptoms and may also help those who want to lower their risk of developing sleep apnea. Home remedies are typically complementary to a doctor’s recommended approach for treating sleep apnea and are not enough to treat moderate to severe cases of sleep apnea Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source . 

Sleeping Position

Sleeping in a supine position, or back sleeping, can increase the number of apnea episodes a person has in a night. In this sleep position, the tongue and larynx can obstruct breathing Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source . One study found that nearly 62% of people with OSA Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source have supine-predominant sleep apnea.

Instead of back sleeping, experts recommend side sleeping to reduce the impacts of OSA. Studies have shown that patients who wear devices that alert them when they are on their backs have fewer apnea events Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source . That being said, these devices don’t always stay on that well throughout the night and the technology itself needs improvement, so it’s not a fool-proof method. 

Quitting Smoking

There has been some research connecting smoking with OSA, as both can impact sleep and upper airway function. When paired together, they can make sleep apnea worse. As such, quitting smoking may help people with OSA find at least some relief, though more research is needed to determine the full effect on sleep quality Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source . 

Avoiding Alcohol

Alcohol use can worsen OSA symptoms in many people. The American Academy of Sleep recommends avoiding alcohol Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source as one of the first steps in treating OSA, along with losing excess weight and changing sleep position.

Myofunctional Therapy

Myofunctional therapy, or therapy for facial and mouth muscles, may help reduce apnea events. This therapy includes exercises to strengthen the muscles in the tongue, soft palate, lips, and face. Correcting the position of the tongue can help prevent it from blocking the airway Trusted Source National Center for Biotechnology Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source . 

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Weight Loss

Obesity is a risk factor for OSA, but the relationship between weight and sleep apnea is complex. It is important to consult with a medical professional when considering weight loss to treat symptoms of sleep apnea.

Research shows that losing excess weight can reduce the severity of OSA symptoms Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source . A combination of a change in diet and moderate exercise may be recommended. However, weight loss alone cannot completely eliminate OSA Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source . 

People who lose weight and change their sleeping positions see better results than those who only lose weight. 

Zepbound for Sleep Apnea

In January 2025, Zepbound became the first medication to be approved by the FDA to treat sleep apnea. Zepbound is more widely known as a weight loss injectable prescription medication that targets GIP and GLP-1 hormones to regulate appetite and metabolism. However, after promising trials showed that patients taking Zepbound saw reduced breathing disruptions and achieved sleep apnea remission (for mild cases), it can now be prescribed for OSA patients Trusted Source American Academy of Sleep Medicine (AASM) AASM sets standards and promotes excellence in sleep medicine health care, education, and research. View Source . 

Bariatric Surgery

Because of the links between OSA and a higher body mass index, bariatric surgery, which is primarily done to help with weight loss, has been shown in studies to have a positive impact on patients’ sleep apnea as well. This is especially true in people with milder cases of OSA Trusted Source Obesity Surgery View Source .  

Sleep Apnea Surgery

A number of surgeries can reduce apnea events, though the evidence for their efficacy is limited to small studies. 

• Adenotonsillectomy: Commonly, children who have OSA will have their tonsils and adenoids removed.
• Maxillomandibular advancement: The upper and lower jawbones Trusted Source UpToDate More than 2 million healthcare providers around the world choose UpToDate to help make appropriate care decisions and drive better health outcomes. UpToDate delivers evidence-based clinical decision support that is clear, actionable, and rich with real-world insights. View Source are repositioned to help keep the upper airway open.
• Uvulopalatopharyngoplasty: This surgery includes removal or repositioning of tissue from around the upper airway.
• Hypoglossal nerve stimulation: For this treatment, a surgeon inserts a stimulator into the nerve that controls tongue movement. When this nerve is stimulated, the tongue is positioned to keep the airway open.

Why Use an Alternative to a CPAP Machine?

While CPAP machines are the most common treatment for OSA, some people may seek out alternative treatment for a number of reasons. If you’re considering trying any of these methods out, you should talk to your doctor or a specialist, who can offer advice on what alternatives may be most suitable for your specific case. 

Here are some reasons why someone may be interested in using an alternative to a CPAP machine.

• Cost: The machine’s out-of-pocket cost can start near $500 and can be up to $1,000 or more. Those who use insurance to get a CPAP machine may be required to enroll in a rent-to-own plan Trusted Source Medicare.gov Medicare.gov provides essential information about signing up for and using Medicare, which is health insurance for people 65 or older. View Source with strict compliance requirements.
• Compliance requirements: Insurers such as Medicare may require CPAP machine users to adhere to a 30-day compliance period Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source , using the machine for at least four hours a night on 70% of nights. CPAP users may struggle to meet these requirements or feel it is an invasion of privacy.
• Side effects: Side effects vary among CPAP users. Some find the mask uncomfortable Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source or experience dry mouth, red or itchy eyes, and a dry, stuffy, or runny nose. CPAP users and their sleeping partners may also be affected by noise caused by mask leaks. All of these CPAP side effects may impact adherence or how often a person uses their machine.
• Adherence: Adherence rates for CPAP machines may be as low as 50% Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source .

When to Talk to Your Doctor

Depending on the severity of your OSA and if you have other health conditions, there are a range of CPAP alternatives that you can discuss with your doctor. Talk to your doctor if:

• You suspect you have or have already been diagnosed with OSA, but are hesitant to try CPAP therapy for any of the reasons outlined above.
• You are using a CPAP machine but are having challenges with it. In some cases, a doctor might be able to suggest a different type of PAP therapy, a different mask, or other accessories that can make it more comfortable to use.
• You are considering other treatments, such as bariatric surgery or Zepbound, that may also help your OSA.

In most cases, CPAP will be the first-line treatment suggested for OSA since it’s been proved to be most effective. However, it requires high compliance in order to be impactful, meaning that if you don’t actually wear your mask through the night on most nights, then it’s not going to help. In that case, it could be worth looking into alternatives.

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