Treatment Options
From the simplest behavioral change to the most advanced implantable device — every treatment we offer is grounded in the latest sleep medicine evidence and personalized to you.
PAP Therapy
CPAP · BiPAP · APAP
Positive airway pressure therapy is the most proven and widely used treatment for obstructive sleep apnea, with decades of research confirming its effectiveness in eliminating apnea events and restoring healthy sleep architecture.
Key Benefits
- Eliminates or dramatically reduces apnea events
- Restores normal sleep architecture including deep and REM sleep
- Lowers blood pressure and reduces cardiovascular risk
- Improves daytime alertness, mood, and cognitive function
- Covered by virtually all major insurance plans
1How It Works
A PAP machine delivers a continuous stream of pressurized air through a mask worn during sleep. This air acts as a pneumatic splint, holding the throat open and preventing the collapse of soft tissue that causes apnea events. CPAP delivers a fixed pressure; BiPAP alternates between higher pressure on inhalation and lower on exhalation; APAP self-adjusts throughout the night based on real-time airflow data.
2Who It's For
- Diagnosed obstructive sleep apnea (mild, moderate, or severe)
- Upper airway resistance syndrome (UARS)
- Complex or mixed sleep apnea
- Post-surgical support following airway procedures
3What to Expect
- 1A titration study to determine your optimal pressure settings
- 2Mask fitting session with our respiratory therapists
- 3Data review at 30-day and 90-day follow-up visits
- 4Remote monitoring so we can proactively adjust your therapy
Inspire Therapy
Upper Airway Stimulation
For patients who cannot tolerate CPAP therapy, Inspire offers a revolutionary alternative: a small implanted device that works with your body's natural breathing rhythm to keep the airway open — no mask, no hose, no noise.
Key Benefits
- No mask, no external equipment required during sleep
- Clinically proven to reduce AHI by more than 70% in study participants
- Significant improvement in daytime sleepiness (Epworth scores)
- FDA-approved since 2014 with over 30,000 patients implanted worldwide
- Remote patient monitoring capability
1How It Works
Inspire monitors breathing patterns during sleep via a sensing lead placed around the chest. When it detects a breath, it delivers a mild electrical impulse to the hypoglossal nerve — the nerve that controls the tongue. This gentle stimulation moves the tongue and surrounding tissues forward, opening the airway before an obstruction can occur. Patients control the device with a small handheld remote.
2Who It's For
- Moderate-to-severe obstructive sleep apnea (AHI 15–65)
- CPAP intolerance or documented CPAP failure
- BMI typically under 32 (as evaluated by your physician)
- No complete concentric collapse at the palate (assessed via drug-induced sleep endoscopy)
3What to Expect
- 1Candidacy evaluation including drug-induced sleep endoscopy (DISE)
- 2Outpatient surgical implant procedure (approximately 2–3 hours)
- 34–6 week recovery before device activation
- 4In-office titration over the following weeks to optimize stimulation
CBT-I
Cognitive Behavioral Therapy for Insomnia
CBT-I is the gold standard treatment for chronic insomnia — recommended as the first-line intervention by the American Academy of Sleep Medicine, the American College of Physicians, and the NIH. It outperforms sleep medications in long-term outcomes without dependence or side effects.
Key Benefits
- 75–80% of patients with chronic insomnia achieve significant improvement
- Effects are durable — improvements persist years after completing treatment
- Reduces reliance on sleep medications
- No side effects or withdrawal risks
- Addresses root causes rather than masking symptoms
1How It Works
CBT-I is a structured multi-component program that addresses the underlying thoughts and behaviors that perpetuate insomnia. Rather than targeting symptoms with medication, it retrains the brain's relationship with sleep. The program typically spans 6–8 weeks and combines several evidence-based techniques administered by a trained sleep specialist.
2Who It's For
- Chronic insomnia (difficulty falling or staying asleep ≥3 nights/week for ≥3 months)
- Sleep-onset insomnia or sleep-maintenance insomnia
- Insomnia comorbid with anxiety, depression, or chronic pain
- Patients seeking to taper off sleep medications
3What to Expect
- 1Sleep diary baseline assessment (2 weeks)
- 2Stimulus control therapy — rebuilding the bed-sleep association
- 3Sleep restriction therapy — consolidating sleep drive
- 4Cognitive restructuring — challenging sleep-disrupting beliefs
- 5Relaxation training and sleep hygiene optimization
remede® System
Central Sleep Apnea Treatment
The remede® System is the only FDA-approved implantable therapy for central sleep apnea (CSA) — a form of sleep apnea caused by the brain's failure to send proper signals to the breathing muscles, not by airway obstruction. It is a breakthrough for patients whose CSA is unresponsive to PAP therapy.
Key Benefits
- Directly addresses the neurological root cause of central sleep apnea
- Pivotal trial showed 55% reduction in AHI at 12 months
- Significant improvement in sleep quality and daytime function
- Works while patient sleeps — no conscious effort required
- Compatible with MRI under specific conditions
1How It Works
A small device implanted under the collarbone continuously monitors respiratory effort via a sensing catheter in the pericardiophrenic vessel. When the device detects a central apnea event — a pause caused by absent neural drive — it delivers an electrical stimulation to the phrenic nerve. This stimulus activates the diaphragm, restoring the breathing rhythm before oxygen levels drop significantly.
2Who It's For
- Moderate-to-severe central sleep apnea (CSA)
- CSA related to heart failure (Cheyne-Stokes respiration)
- CSA that persists or worsens on PAP therapy
- Complex sleep apnea syndrome with central component
3What to Expect
- 1Comprehensive cardiac and sleep evaluation to confirm CSA diagnosis
- 2Outpatient implant procedure under general or conscious sedation
- 3Device activation and initial titration at 1-month follow-up
- 4Ongoing remote monitoring and annual in-office assessments
Medication Management
Narcolepsy · Hypersomnia · RLS · Circadian Disorders
For conditions where behavioral interventions alone are insufficient — narcolepsy, idiopathic hypersomnia, restless legs syndrome, periodic limb movements, and circadian rhythm disorders — targeted pharmacotherapy under specialist supervision produces the best outcomes.
Key Benefits
- Access to the full range of FDA-approved sleep medications
- Management by FAASM- and DABSM-certified sleep specialists
- Coordination with primary care and specialists for complex cases
- Prior authorization support for specialty medications
- Ongoing monitoring for safety and efficacy
1How It Works
MWCSD's board-certified sleep physicians manage a full formulary of FDA-approved sleep medications, including wake-promoting agents, sodium oxybate (Xyrem/Lumryz), dopaminergic agents, and melatonin receptor agonists. Treatment is highly individualized: your physician considers your specific diagnosis, comorbidities, occupation, and lifestyle before prescribing. Regular monitoring ensures efficacy and minimizes side effects.
2Conditions We Treat
- Narcolepsy Type 1 (with cataplexy) and Type 2
- Idiopathic hypersomnia
- Restless legs syndrome (RLS) and periodic limb movement disorder (PLMD)
- Circadian rhythm sleep-wake disorders (shift work, DSPD, ASPD, jet lag disorder)
- REM sleep behavior disorder (RBD)
3What to Expect
- 1Complete diagnostic workup to confirm diagnosis before prescribing
- 2Discussion of all treatment options including non-pharmacological alternatives
- 3Careful titration to lowest effective dose
- 4Regular follow-up visits to assess response and tolerability
Clinical Research Trials
Access to Novel Therapies
As an academic sleep center with a dedicated research program led by Dr. Vishal Saini, MWCSD offers eligible patients access to investigational therapies for sleep disorders — often at no cost and with the highest standard of medical supervision.
Key Benefits
- Access to therapies not yet available to the general public
- Closely supervised care by research-experienced sleep physicians
- Contribution to advancing sleep medicine for future patients
- Often no cost to participants for study-related procedures
- Research conducted under the direction of Dr. Vishal Saini, FAASM
1How It Works
Clinical trials investigate new medications, devices, and therapeutic approaches before they become widely available. Participation is entirely voluntary and governed by strict ethical standards and IRB oversight. Dr. Saini's research program focuses on novel pharmacological agents, device therapies, and diagnostic technologies in sleep medicine. Every participant receives close monitoring and contributes to advancing knowledge for future patients.
2Who May Qualify
- Adults with confirmed sleep disorder diagnoses
- Patients who have not responded to standard treatments
- Individuals interested in contributing to sleep medicine research
- Eligibility varies by trial — contact us for current studies
3What to Expect
- 1Screening visit to assess eligibility for active trials
- 2Detailed informed consent process — no pressure to participate
- 3Frequent monitoring visits with close physician oversight
- 4Access to investigational therapies often at no out-of-pocket cost
Not sure which treatment is right for you?
Our board-certified sleep physicians will review your symptoms, history, and test results to recommend the most appropriate treatment path — personalized for your specific diagnosis.