AUTHOR=Gruenberg Eli , Cooper Jessica , Zamora Tania , Stepnowsky Carl , Vahabzadeh-Hagh Andrew M. , Malhotra Atul , Nokes Brandon 

TITLE=Beyond CPAP: modifying upper airway output for the treatment of OSA

JOURNAL=Frontiers in Neurology

VOLUME=14

YEAR=2023

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1202271

DOI=10.3389/fneur.2023.1202271

ISSN=1664-2295

ABSTRACT=<p>Obstructive Sleep Apnea (OSA) is exceedingly common but often under-treated. Continuous positive airway pressure (CPAP) has long been considered the gold standard of OSA therapy. Limitations to CPAP therapy include adherence and availability. The 2021 global CPAP shortage highlighted the need to tailor patient treatments beyond CPAP alone. Common CPAP alternative approaches include positional therapy, mandibular advancement devices, and upper airway surgery. Upper airway training consists of a variety of therapies, including exercise regimens, external neuromuscular electrical stimulation, and woodwind instruments. More invasive approaches include hypoglossal nerve stimulation devices. This review will focus on the approaches for modifying upper airway muscle behavior as a therapeutic modality in OSA.</p>