Obstructive Sleep Apnea
Each treatment is graded on the outcome its trials measured. Breathing counts and sleepiness scores are not the same as fewer heart attacks, and the letters say which one was tested.
At a glance
The letters on this page
Eight interventions on this page. Every one carries a letter.
How it is measured
What has been graded
On a lab test of staying awake, sleepy adults with moderate to severe sleep apnea did better than on sham CPAP in two independent trials (PMIDs 10382693, 23204602). In mild sleep apnea two small crossovers found no clear change (PMIDs 9927358, 15860720).
Four randomized trials, SAVE the largest at 2,717 adults (PMID 27571048), found no fewer heart attacks, strokes or cardiovascular deaths. Most participants were not sleepy and averaged about 3 hours of use a night.
In a randomized crossover against CPAP, apnea severity fell less on the appliance while sleepiness and blood pressure improved by similar amounts (PMID 23413266); network meta-analyses of randomized trials agree (PMIDs 26624827, 26497082).
Graded in implanted adults with moderate to severe sleep apnea who cannot use CPAP; the trials were run with the device makers, stated on the record.
Sleepiness and breathing pauses improved against sham exercises in the Cochrane review (PMID 33141943) and a second meta-analysis of seven trials (PMID 37606313). Sleepiness is self-rated, and children did not benefit.
Two placebo-controlled trials lowered the apnea-hypopnea index by 20 to 24 events an hour more than placebo (PMID 38912654). Both were funded and run by Eli Lilly, the maker.
One double-blind sham-controlled trial in 120 adults lowered the apnea-hypopnea index by 4.4 events an hour, with no change in sleepiness (PMID 40992934).
A maker-funded sham-controlled trial was positive (PMID 21461326); an independent placebo-controlled trial in moderate to severe disease was null (PMID 23723343).
Cautions
- •Long-term opioid use is linked to several kinds of disturbed breathing in sleep, including central sleep apnea. In people with sleep apnea, any change to an opioid is a decision for the prescribing physician.
- •Alcohol before sleep raised the apnea-hypopnea index in pooled studies, more in people with sleep apnea.
- •Tirzepatide is a prescription medicine. Its sleep apnea trials enrolled adults with obesity, and whether it fits is a decision for your physician.
This page is educational only. Sleep apnea is diagnosed with a sleep study, and which treatment fits depends on its severity, your anatomy and your other conditions, decisions for your physician or a sleep specialist. The sleep evidence hub sets these treatments in context.
Disclosure
These statements have not been evaluated by the Food and Drug Administration. Any grade on this page describes the strength of published human trial evidence in the populations studied. It is not a recommendation for any individual and is not medical advice. Starting, stopping or changing any supplement or medication is a decision for your physician.