ABSTRACT Objective This study aims to investigate the medical management of obstructive sleep apnea ( OSA ) utilizing continuous positive airway pressure ( CPAP ) by the Otolaryngology departments within a tertiary care institution. Methods Data was retrospectively reviewed from electronic medical records over 12 months. Patients were categorized into two cohorts based on the department managing their treatment with CPAP therapy: Otolaryngology or Sleep Medicine. Loss to follow‐up was defined as the absence of a follow‐up appointment within the first 12 months after prescription. Two‐tailed t ‐tests and multivariable regression analysis were performed. Results Of 242 total patients included, 65 (26.9%) received CPAP from Otolaryngology and 177 (73.1%) from Sleep Medicine. Otolaryngology patients exhibited significantly higher CPAP compliance, defined as usage ≥ 4 h/night over 30 days, over the first 30 (88% vs. 47%, p < 0.001) and over the last 30 (54% vs. 37%, p = 0.031) days of usage, respectively, compared to General Sleep patients. Loss to follow‐up rates did not differ between the two cohorts. Multivariable analysis found White race to be associated with higher CPAP compliance over the first 30 days ( OR 6.39, 95% CI 1.29–46.5, p = 0.03). Management of CPAP by Otolaryngology was independently associated with increased CPAP compliance over the first ( OR 8.02, 95% CI 3.80–19.1, p < 0.001) and last 30 days ( OR 1.99, 95% CI 1.06–3.75, p = 0.032), respectively. Conclusion Comprehensive management of OSA , including both medical and surgical interventions, can be successfully performed by the Otolaryngologist–Head and Neck Surgeon. Level of Evidence 3.