Nasal expiratory positive airway pressure (EPAP) devices are an emerging treatment option for obstructive sleep apnea (OSA), offering a portable, noninvasive alternative to continuous positive airway pressure (CPAP) therapy. These devices function by generating expiratory resistance, which increases upper airway pressure, preventing collapse, and reducing apneic events. Nasal expiratory positive airway pressure devices, such as Bongo Rx, Provent, and ULTepap have demonstrated efficacy in reducing the apnea-hypopnea index (AHI) and improving sleep quality, particularly in patients with mild-to-moderate OSA. Studies have shown comparable adherence rates to CPAP, with benefits including simplicity, portability, and the absence of external power requirements. However, limitations include reduced efficacy in severe OSA, patient discomfort due to expiratory resistance, and nasal irritation. This review explores the mechanism of action, clinical evidence, and critical considerations for EPAP devices, highlighting their role as a viable alternative for CPAP-intolerant patients while emphasizing the need for tailored therapy based on individual patient characteristics.