What are the indications for referring a patient with sleep apnea for continuous positive airway pressure (CPAP) therapy?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 22 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Indications for referring a patient with sleep apnea for CPAP therapy include:

  • Adults diagnosed with moderate or severe obstructive sleep apnoea/hypopnoea syndrome (OSAHS) who are symptomatic should be offered fixed-level CPAP therapy alongside lifestyle advice.
  • CPAP is recommended particularly when symptoms affect usual daytime activities and the patient has moderate or severe OSAHS.
  • If a patient with mild OSAHS is symptomatic and unable to tolerate or declines CPAP, alternative treatments such as mandibular advancement splints may be considered, but CPAP remains the primary treatment for moderate to severe cases.
  • Telemonitoring is advised for patients on CPAP for up to 12 months to support treatment adherence and effectiveness.

CPAP is considered an aerosol-generating procedure, so infection control precautions should be taken if there is a risk of airborne infection.

These recommendations are based on NICE technology appraisal guidance and clinical evidence for the treatment of OSAHS.

References:

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