Sleep apnea is treatable, and the right fix depends on how severe it is and what’s causing it. Severity is measured by how many times per hour your breathing stops or becomes shallow during sleep. Fewer than 15 interruptions per hour is mild, 15 to 30 is moderate, and 30 or more is severe. Treatments range from simple lifestyle changes to surgery, and many people use a combination of approaches.
Weight Loss Has the Biggest Impact for Most People
Excess weight is the single most common driver of obstructive sleep apnea. Fat deposits around the neck and throat narrow the airway, and losing weight directly reverses that. A meta-analysis of weight loss studies found that for every 1% of body weight lost, the number of breathing interruptions per hour drops by about 2.6%. That means someone who loses 20% of their body weight can expect roughly a 53% reduction in sleep apnea severity. For people with mild or moderate cases, that reduction can be enough to bring their numbers into the normal range.
Weight loss doesn’t work overnight, and it won’t fix every case. People with anatomical issues like a narrow jaw or enlarged tonsils may still have significant apnea even at a healthy weight. But for the majority of people whose apnea worsened as they gained weight, it remains the most effective long-term fix. The FDA has also approved tirzepatide (sold as Zepbound) specifically for adults with moderate-to-severe obstructive sleep apnea and obesity, making medically assisted weight loss a formal treatment pathway.
CPAP: The Standard Treatment
Continuous positive airway pressure remains the most widely prescribed treatment. A CPAP machine delivers a steady stream of air through a mask, keeping your airway open while you sleep. It works for all severity levels, and when used consistently, it essentially eliminates breathing interruptions.
The challenge is actually using it. Many people find the mask uncomfortable, dislike the noise, or pull it off during the night. Effectiveness depends entirely on wearing it, and a large number of patients struggle with that. If you’re having trouble with CPAP, talk to your sleep specialist about trying different mask styles, adjusting pressure settings, or using a machine with auto-adjusting pressure. Sometimes the difference between hating CPAP and tolerating it is finding the right mask fit.
Oral Appliances for Mild to Moderate Cases
Custom-fitted mouthpieces that push the lower jaw slightly forward can open the airway enough to reduce or eliminate apnea in people with mild to moderate cases. These devices are made by dentists who specialize in sleep medicine, and they look similar to a sports mouthguard.
In head-to-head studies, oral appliances don’t reduce breathing interruptions quite as much as CPAP does. But they produce comparable improvements in daytime sleepiness, symptom relief, and quality of life. The reason is straightforward: people actually wear them. Nightly adherence is consistently higher than with CPAP because they’re smaller, quieter, and easier to travel with. Side effects are generally mild and temporary, like jaw soreness or changes in bite that usually settle within a few weeks.
Positional Therapy
Some people only have significant apnea when sleeping on their back. Gravity pulls the tongue and soft tissue backward, blocking the airway, but side sleeping keeps it open. If a sleep study shows your breathing is substantially worse in the supine position, positional therapy may be all you need.
Devices range from simple (a tennis ball sewn into the back of a sleep shirt) to sophisticated (wearable sensors that vibrate when you roll onto your back). Studies show positional therapy reduces breathing interruptions by about 7 events per hour compared to doing nothing, and it significantly improves daytime sleepiness. CPAP still outperforms it in raw numbers, but people use positional devices about 2.5 hours more per night than they use CPAP, which narrows the real-world gap. The American Academy of Sleep Medicine recognizes positional therapy as a valid second-line treatment or supplement to CPAP for people with position-dependent apnea.
Mouth and Throat Exercises
Orofacial myofunctional therapy is a structured set of exercises that strengthen the muscles of the tongue, throat, and face. Think of it as physical therapy for your airway. The exercises include specific tongue postures, swallowing techniques, breathing pattern training, and even certain speech articulation drills. The goal is to increase muscle tone so the airway is less likely to collapse during sleep.
This approach won’t replace CPAP for someone with severe apnea, but it can meaningfully reduce snoring and mild-to-moderate apnea. It works best as a complement to other treatments. The exercises need to be done consistently, typically daily for several months, and results are gradual.
Hypoglossal Nerve Stimulation
For people who can’t tolerate CPAP, an implantable device (most commonly known by the brand name Inspire) offers a surgical alternative. A small generator is placed under the skin of the chest, with a wire that stimulates the nerve controlling the tongue. Each time you breathe in during sleep, the device gently pushes your tongue forward to keep the airway open.
You’re a candidate if you have moderate-to-severe apnea (15 to 100 events per hour), a BMI of 40 or below, have tried and failed CPAP, and don’t have a specific pattern of airway collapse at the soft palate. You need to be at least 18 years old, though children with Down syndrome may qualify starting at age 10 under specific criteria. About two-thirds of patients achieve clinical success with the device, though most still have some residual apnea rather than complete elimination.
Jaw Advancement Surgery
Maxillomandibular advancement surgery physically moves both the upper and lower jaw forward, permanently enlarging the airway. It’s the most aggressive surgical option, but also the most effective. More than half of patients achieve complete elimination of their apnea, with fewer than 5 breathing interruptions per hour.
Recovery takes about six weeks before most people return to work or school, though the jaw continues healing and settling into its final position over 9 to 12 months. This surgery is typically reserved for people with severe apnea who haven’t responded to other treatments, or for those with clear jaw-related anatomy contributing to their obstruction. It permanently changes facial structure, so it requires careful discussion with a surgical team experienced in the procedure.
Medications on the Horizon
There is currently no widely available pill that treats the core mechanics of obstructive sleep apnea. But that may change soon. A drug called AD109, which targets airway muscle tone during sleep, has completed two large clinical trials involving 660 participants. After nearly a year of treatment, about 23% of participants achieved complete disease control, with their breathing interruptions dropping below 5 per hour. The manufacturer plans to submit the drug for FDA approval in early 2026.
If approved, a medication option would be significant for people who struggle with devices and aren’t candidates for surgery. For now, though, treatment still centers on the mechanical and lifestyle approaches described above.
Matching Treatment to Severity
Mild apnea (5 to 14 events per hour) often responds well to weight loss, positional therapy, an oral appliance, or some combination of the three. Many people with mild cases can fully resolve their apnea without a machine or surgery.
Moderate apnea (15 to 29 events per hour) typically calls for CPAP or an oral appliance as the primary treatment, ideally combined with weight loss if excess weight is a factor. Positional therapy can supplement either approach.
Severe apnea (30 or more events per hour) almost always requires CPAP as a first-line treatment. If CPAP fails, hypoglossal nerve stimulation or jaw advancement surgery become the main alternatives. Weight loss is still valuable but rarely sufficient on its own at this severity level.