What are the current guidelines for the management of OSA in adults, including lifestyle modifications and CPAP therapy?

The current guidelines recommend that adults with obstructive sleep apnoea (OSA) should have lifestyle modifications, including weight loss, smoking cessation, reducing alcohol intake, and improving sleep hygiene, tailored to individual needs ¹.

For mild OSA with no significant symptoms, lifestyle changes alone may be sufficient, and treatment is not usually needed; these measures can help prevent disease progression ².

In cases where symptoms affect quality of life or daytime activities, fixed-level continuous positive airway pressure (CPAP) should be offered alongside lifestyle advice, especially if lifestyle modifications alone are ineffective or inappropriate ².

Telemonitoring with CPAP is recommended for up to 12 months, with consideration for ongoing use beyond that period ².

Auto-CPAP may be considered as an alternative if high pressure is needed only intermittently, if the patient cannot tolerate fixed-level CPAP, or if telemonitoring is not feasible, provided it is cost-equivalent or cheaper ².

Heated humidification can be considered for patients experiencing upper airway side effects such as nasal or mouth dryness ².

Long-term adherence can be supported through educational and supportive interventions delivered by trained staff, and treatment efficacy should be monitored regularly through symptom assessment, adherence data, and sleep studies if treatment is stopped or symptoms recur ¹,².