Adjunctive and Alternative Therapies
INTRODUCTION Obstructive sleep apnea (OSA) is a common under-recognized disorder affecting approximately 4% of middle-aged males and 2% of m iddle-aged females (1). The disease is characterized by the repetitive collapse of the upper airway during sleep, leading to sleep fragmentation, daytime sleepiness, cognitive dysfunction, motor vehicle crashes, and cardiovascular sequelae (2-5). Positive airway pres sure therapy (Chapters 6-9), oral appliances (Chapter 12), and surgery (Chapters 11 and 15) are the most commonly employed treatment modalities for this dis ease, and are described in detail in these other chapters. This chapter will focus on adjunctive and alternative therapies for sleep apnea. In particular, we will discuss the roles of behavioral therapies, weight loss, positional therapy, correc tion of other medical disorders, oxygen, and pharmaceutical agents in the treat ment of sleep apnea.