Management of patients with obstructive sleep apnea.

Behavioral measures, such as weight loss, altered sleeping position, and avoidance of alcohol and sedatives, can benefit some patients with mild obstructive sleep apnea (OSA). The mainstay of therapy for OSA is administration of continuous positive airway pressure (CPAP). Oral appliances may benefit patients who are unable or unwilling to use CPAP or other forms of PAP therapy. The wakefulness-promoting agent modafinil is recommended for patients who experience residual sleepiness despite optimal CPAP therapy, provided CPAP compliance is closely monitored.