Obstructive sleep apnoea (OSA) is treated by keeping the airway open during sleep. For moderate or severe OSA, the main treatment is CPAP: a machine that blows air through a mask. If CPAP is declined or not tolerated, a custom mouth device that holds the jaw forward is the main alternative. Lifestyle changes, especially weight loss, are advised at every level of severity.
Surgery is kept for specific situations, such as large tonsils. An implanted nerve stimulator is an option for a few people, but NICE says its evidence is limited. In the US, the weight-loss drug tirzepatide is approved to treat OSA in adults with obesity. In the EU and UK it is licensed for weight management, not OSA itself.
This guide explains each option, what the evidence shows, and how to get it in Ireland and the UK. If you have not been diagnosed yet, start with our STOP-BANG self-check and our guide to home sleep apnoea tests.
Your sleep study gives an apnoea–hypopnoea index (AHI). This is the number of breathing pauses and shallow breaths per hour. NICE uses these bands:
Symptoms matter too. NICE says that people with mild OSA and no symptoms affecting daily life usually do not need treatment beyond lifestyle changes.
NICE advises discussing lifestyle changes with everyone who has OSA. These include losing weight, stopping smoking, cutting down on alcohol and improving sleep habits.
The NHS adds sleeping on your side, and avoiding sleeping pills unless a doctor recommends them, because they can make OSA worse.
Continuous positive airway pressure (CPAP) pumps air through a mask over your nose, or nose and mouth. The air pressure stops the throat closing.
NICE recommends offering CPAP, alongside lifestyle advice, to people with moderate or severe OSA. For mild OSA, it should be offered if symptoms affect quality of life and lifestyle changes have not worked. NICE also suggests:
The HSE lists common problems: an uncomfortable mask, a blocked or runny nose, headaches, ear pain and wind. Tell your sleep team early, because masks and settings can often be changed. NICE notes that switching mask type and adding humidification can help when a blocked nose is the problem.
A mandibular advancement device (MAD), or splint, looks like a gum shield. It holds the lower jaw and tongue forward, widening the airway.
NICE says to consider a customised or semi-customised splint if CPAP is declined or not tolerated. This applies at any severity, for adults aged 18 and over with healthy teeth and gums. Semi-customised splints may not suit people with gum disease, few teeth or tonic-clonic seizures.
The HSE says a MAD should be fitted by a dentist experienced in treating sleep apnoea.
Some people only have OSA when lying on their back. NICE suggests considering a positional device for mild or moderate positional OSA, if other treatments are unsuitable. It is unlikely to work in severe OSA.
NICE recommends considering:
The HSE says surgery is not usually recommended, and is mostly considered when other treatments have not helped.
This treatment uses a small device implanted under the skin of the chest. A lead connects it to the hypoglossal nerve, which moves the tongue. During sleep, it stimulates the nerve to keep the airway open.
NICE's guidance (HTG455, first published in 2017 as IPG598) says the evidence on safety and efficacy is "limited in quantity and quality". It should only be used with special arrangements for consent and audit, or in research.
The evidence NICE reviewed included:
In April 2026, NICE prioritised a new assessment of nerve stimulation devices for OSA. It noted that more evidence is now available. No publication date is set.
In the US, the FDA approved the Inspire system in 2014. That approval covered adults aged 22 and over with moderate to severe OSA (AHI 20 to 65) who cannot use or tolerate CPAP. We could not confirm its CE or UKCA marking from an official register. We found no HSE information on access to this procedure in Ireland.
This section is for information. It is not a recommendation to take a weight-loss medicine.
Two 52-week trials (SURMOUNT-OSA) tested tirzepatide in 469 adults with obesity and moderate to severe OSA. People with type 2 diabetes were excluded. One trial enrolled people not using CPAP; the other enrolled people on CPAP.
According to the UK product information, compared with placebo at 52 weeks:
Around half did not reach this goal after a year. The most common side effects of tirzepatide are digestive, such as nausea, diarrhoea and vomiting.
Any decision about weight-loss medicine is one for you and your doctor.
The National Treatment Purchase Fund (NTPF) does not publish a separate list for sleep clinics. The nearest published figure is for respiratory medicine. On 24 September 2026, 30,166 adults were on the respiratory medicine outpatient waiting list. Of these, 2,825 had waited more than 18 months. These figures cover all lung conditions, not just sleep. Our guide to HSE outpatient waiting lists explains how to check waits by hospital.
NICE advises that sleep services prioritise some people for rapid assessment. These include vocational drivers, people in safety-critical jobs, pregnant women and people with unstable heart disease.
We searched ClinicalTrials.gov, the EU clinical trials register and ISRCTN on 3 November 2026. Studies recruiting in Ireland include one on CPAP in people with difficult asthma, at St James's Hospital, Dublin. UK studies include a registry of people with Inspire implants and a study on using mouth devices. We found no tirzepatide OSA trial with an Irish or UK site. Trials are research, not a treatment option.
For more, see our guide to driving with a medical condition in Ireland.
None of the guidance above includes supplements. We explain why in why sleep supplements don't fix sleep apnoea.
Often it is used long term, because it treats OSA only while you wear it. NICE recommends follow-up tailored to your overall treatment plan, which may include lifestyle changes.
NICE recommends customised or semi-customised splints, and says semi-customised ones are not suitable for everyone. The HSE advises fitting by a dentist with sleep apnoea experience.
It can reduce severity. In the tirzepatide trials, about half (43% and 52%) reached remission or mild symptom-free OSA after a year. Weight loss is not a reason to stop treatment without your sleep team's advice.
We found no HSE information on it. In the UK, NICE says it should only be used under special arrangements because the evidence is limited.
This article is general information, not medical advice. Do not stop or change your OSA treatment without talking to your sleep team or GP.
Reviewed by: Proco Team
Last updated: November 2026