What is the first-line nonpharmacologic treatment for adult obstructive sleep apnea?

What is the first-line nonpharmacologic treatment for adult obstructive sleep apnea?

• A. Oral appliance therapy
• B. Continuous positive airway pressure (CPAP) therapy.
• C. Surgery
• D. Nasal steroids

Answer: (B)

Continuous positive airway pressure (CPAP) is the first-line nonpharmacologic treatment for adult obstructive sleep apnea because it mechanically keeps the airway open during sleep, preventing the collapse that causes apneas and hypopneas. By splinting the airway, CPAP reliably reduces the apnea-hypopnea index, improves overnight oxygenation, and leads to better daytime sleepiness and quality of life. It has the strongest evidence base and is recommended as initial therapy for most adults, with effectiveness closely tied to regular use. Alternatives like oral appliance therapy or surgery are considered if CPAP is not tolerated or in specific clinical scenarios, while nasal steroids address only nasal congestion and do not treat airway collapse.

Continuous positive airway pressure (CPAP) is the first-line nonpharmacologic treatment for adult obstructive sleep apnea because it mechanically keeps the airway open during sleep, preventing the collapse that causes apneas and hypopneas. By splinting the airway, CPAP reliably reduces the apnea-hypopnea index, improves overnight oxygenation, and leads to better daytime sleepiness and quality of life. It has the strongest evidence base and is recommended as initial therapy for most adults, with effectiveness closely tied to regular use. Alternatives like oral appliance therapy or surgery are considered if CPAP is not tolerated or in specific clinical scenarios, while nasal steroids address only nasal congestion and do not treat airway collapse.