The primary objective of the proposed investigation is to evaluate the efficacy of the Provent device in a sample of OSA patients who have either refused or been non-adherent with PAP treatment. Both initial efficacy (evaluated after approximately one week with Provent) and efficacy after approximately 5 weeks in patients who demonstrate initial efficacy will be assessed. A secondary objective is to assess adherence with Provent treatment during the 5-week evaluation period.

Inclusion Criteria:

• Current signs and symptoms consistent with a diagnosis of OSA in the opinion of the study physician
• Rejection of PAP treatment or minimally adherent with PAP treatment
• Use of the Provent device for a specified amount of time each night during three consecutive nights of the trial period
• AHI > 15, or AHI > 10 with evidence of CMS-recognized symptoms or co- morbidities, on screening/baseline PSG
• Investigator believes that subject can benefit from OSA treatment
• Subject understands and is willing and able to comply with study requirements

Exclusion Criteria:

• Use of any device that interferes with nasal or oral breathing
• Persistent blockage of one or both nostrils which prevents airflow in one or both nostrils
• Any chronic sores or lesions on the inside or outside of the nose
• Chronic use of nasal decongestants other than nasal steroids
• History of allergic reaction to acrylic-based adhesives (such as those found in BAND-AIDS®)
• Current acute upper respiratory (including nasal, sinus, or middle ear) inflammation or infection or perforation of the tympanic membrane (may be re-considered for participation after the acute episode resolves)
• History of frequent and/or poorly treated severe nasal allergies or sinusitis which may interfere with the ability to use Provent
• Severe respiratory disorders (including respiratory muscle weakness, bullous lung disease, bypassed upper airway, pneumothorax, pneumomediastinum, etc.).
• Pathologically low blood pressure.
• Narcolepsy, idiopathic hypersomnolence, chronic insomnia, restless legs syndrome, REM sleep behavior disorder or any other diagnosed or suspected sleep disorder other than OSA that could affect the likelihood of apneas/hypopneas during a PSG.
• Periodic limb movement arousal index (PLMAI) > 10 on the screening/baseline PSG.
• Current use of diurnal or nocturnal supplemental oxygen
• Currently working night or rotating shifts
• Consumption of > 10 caffeinated beverages per day (approximately 1000 mg per day)
• History of severe cardiovascular disease, including New York Heart Association Class III or IV heart failure, coronary artery disease with angina or myocardial infarction in the past 6 months, stroke in the past 6 months
• History of cardiac rhythm disturbance (defined as a 5-beat run of sustained ventricular tachycardia or bradycardia if < 30 beats per min for a 10-second run or previously undiagnosed and untreated atrial fibrillation or Mobitz II or third-degree heart block)
• Current psychiatric disorder with psychotic features.
• Pregnant or trying to become pregnant