Sleep Apnea

The Problem

CPAP highly effective (resolves apnea, improves symptoms, reduces cardiovascular risk) BUT: Compliance poor (30-50% can't tolerate long-term—uncomfortable, claustrophobic, dry mouth, skin irritation, noisy, affects intimacy), doesn't address root cause (obesity, anatomical issues—stops apnea while wearing but condition persists), lifelong treatment unless root cause addressed, conventional approach: fit CPAP and done (minimal emphasis on weight loss despite being MOST effective intervention—10% weight loss can resolve mild-moderate OSA entirely), doesn't offer: comprehensive weight loss support, myofunctional therapy (proven effective but rarely recommended), positional therapy (simple, helps many), oral appliances (less invasive than CPAP, effective mild-moderate OSA—often not offered as first-line), surgery: UPPP variable success (50-60% effective), significant pain, recovery, risks (bleeding, infection, voice changes), doesn't cure severe OSA usually, MMA (jaw surgery) more effective but very invasive, Inspire (nerve stimulator): expensive ($30,000-40,000), implant surgery, only for select patients, many patients could improve or resolve OSA with: aggressive weight loss (most effective—but needs comprehensive support, not just 'lose weight'), myofunctional therapy, positional therapy, oral appliance, treat nasal congestion, CPAP reserved for those who don't respond to conservative measures or severe OSA (but CPAP is life-saving for severe OSA with cardiovascular complications—appropriate treatment, just overused for mild cases manageable conservatively).