Rescue Pharmacotherapy for OSA

Inclusion Criteria: * Individuals who have failed MAD or HGNS therapy, defined as a residual AHI ≥ 15 events/hr on MAD or HGNS therapy. Exclusion Criteria: * Sleep disordered breathing or respiratory disorders other than obstructive sleep apnea: central sleep apnea (\>50% of respiratory events scored as central), chronic hypoventilation/hypoxemia (awake SaO2 \< 92% by oximetry) due to chronic obstructive pulmonary disease or other respiratory conditions. * Other sleep disorders: periodic limb movements (periodic limb movement index \> 20/hr), narcolepsy, or parasomnias. * Any unstable major medical condition. * Medications expected to stimulate or depress respiration (including opioids, barbiturates, benzodiazepines, doxapram, almitrine, theophylline, 4-hydroxybutanoic acid). * Use of SSRIs/SNRIs. * Contraindications for atomoxetine, including: * pheochromocytoma * use of monoamine oxidase inhibitors * benign prostatic hypertrophy, urinary retention * untreated narrow angle glaucoma * bipolar disorder, mania, psychosis * clinically significant constipation, gastric retention * pre-existing seizure disorders * clinically-significant kidney disorders * clinically-significant liver disorders * clinically-significant cardiovascular conditions * severe hypertension (SBP\>180 mmHg or DBP\>110 mmHg measured at baseline) * cardiomyopathy (LVEF\<50%) or heart failure * advanced atherosclerosi * history of cerebrovascular events * history of cardiac arrhythmias e.g., atrial fibrillation, QT prolongation * other serious cardiac conditions that would raise the consequences of an increase in blood pressure or heart rate * myasthenia gravis * pregnancy/breast-feeding * Contraindications for eszopiclone, including: * Hypersensitivity to eszopiclone * Chronic Obstructive Pulmonary Disease (COPD) * Pregnancy * Breast feeding * Liver disease * Contraindications for acetazolamide, including: * Hyperchloremic acidosis * Hypokalemia * Hyponatremia * Adrenal insufficiency * Impaired kidney function * Hypersensitivity to acetazolamide or other sulfonamides. * Marked liver disease or impairment of liver function, including cirrhosis. * Contraindications for trazodone, including: * suicidal ideation * bipolar disorder, mania * use of monoamine oxidase inhibitors * coronary artery disease * cardiac arrhythmias * QT prolongation * hepatic disease * renal failure or impairment * closed angle glaucoma * priapism * pregnancy/breast-feeding