Non-CPAP treatment of obstructive sleep apnoea

Obstructive sleep apnoea is a frequently occurring disease that can have important consequences including disabling hypersomnolence and sleepiness as well as cardiovascular diseases like hypertension. Treatment modalities are, however, limited. The efficacy of nasal continuous positive airway pressure (CPAP) stands out, but not all patients can tolerate this treatment or be compliant with it. Efficacious alternative therapies are still remarkably few in number. It is demonstrated and concluded that only patients with mild forms of the disease can currently be considered for non-CPAP treatments. Patients with predominantly breathing pattern abnormalities can be cured with medical therapy. Those with predominantly upper airway collapse and with mildly elevated critical closing pressure can be treated with surgical procedures such as uvulopalatopharyngoplasty (UPPP). The exact indications for electrical stimulation of the hypoglossal nerve are still to be determined, although preliminary results seem to be promising for well-selected patients.