Treatment of Obstructive Sleep Apnea Positive airway pressure therapy → Positive pharyngeal transmural pressure → Stabilizes upper airway through increased end-expiratory lung volume Mandibular advancement devices → Similar symptomatic improvement to PAP, but not as effective at reducing respiratory events/desats → Not ideal if severe OSA Upper airway surgery → Most effective if severe, surgically correctable, obstructing lesion of upper airway Lifestyle Modifications → Weight loss, exercise, sleeping position, avoidance of EtOH, avoid BZD, opioids, sedatives Hypoglossal nerve stimulation → Severe OSA refractory to CPAP, with BMI <32 and no unfavorable collapse on drug-induced sleep endoscopy Pharmacotherapy → Theophylline, acetazolamide, desipramine, oxybutynin... - BWH Medicine Chiefs @BrighamChiefs #Obstructive #SleepApnea #Treatment #management #pulmonary
