Sleep Apnea

Weight loss diet if overweight (most effective intervention—low-carb or Mediterranean diet for weight loss), anti-inflammatory diet (reduce upper airway inflammation), avoid alcohol (especially evening—relaxes throat muscles, worsens OSA), avoid heavy meals close to bedtime (worsens GERD, abdominal distension affects breathing), avoid sedating foods/supplements in evening, adequate hydration (but limit fluids 2-3 hours before bed to reduce nocturia), omega-3 foods (anti-inflammatory).

Weight loss CRITICAL if overweight (even 10% loss dramatically improves—can resolve mild-moderate OSA entirely in many patients), positional therapy (sleep on side not back—sew tennis ball in back of pajamas, wedge pillow, positional device), elevate head of bed 30-45 degrees (reduces airway collapse, helps GERD), CPAP compliance if prescribed (HIGHLY effective but 30-50% non-adherent—work with sleep specialist on fit, pressure, mask type), oral appliance (mandibular advancement device—pushes jaw forward, opens airway, effective for mild-moderate OSA, less invasive than CPAP), myofunctional therapy (tongue and throat exercises—strengthen muscles, reduce collapse, proven effective), treat nasal congestion (nasal steroids, saline rinse, allergies, structural issues—deviated septum repair if severe), avoid alcohol and sedatives (especially evening—relax throat muscles), quit smoking (inflammation, fluid retention in airway), regular exercise (improves sleep quality, helps weight loss, reduces OSA severity even independent of weight loss), sleep hygiene (consistent schedule, dark cool room), treat GERD if present (elevate bed, avoid late meals, address root cause), address hypothyroidism if present (worsens OSA), surgery if anatomical issue (tonsillectomy/adenoidectomy if enlarged, UPPP—uvulopalatopharyngoplasty, jaw surgery for severe skeletal issues—last resort, variable success).