ERS/ESRS guideline differentiates CPAP recommendations by obstructive sleep apnoea subgroup

The European Respiratory Society and European Sleep Research Society have issued a joint clinical practice guideline on continuous positive airway pressure (CPAP) for adult obstructive sleep apnoea (OSA). The task force systematically reviewed CPAP versus no treatment or sham treatment across patient subgroups, assessing patient-centred and prognostically relevant outcomes. Evidence certainty was evaluated using GRADE, with recommendations developed through Evidence-to-Decision frameworks and consensus voting.

The guideline generally suggests CPAP because of benefits for sleepiness, other patient-reported outcomes and blood pressure; these recommendations are conditional. It strongly recommends CPAP for patients with excessive daytime sleepiness. Specific conditional recommendations also address moderate-to-severe OSA, older adults, and patients with arterial or treatment-resistant hypertension.

For patients without excessive daytime sleepiness, the task force suggests either CPAP or no treatment, while considering other OSA-related symptoms. It similarly suggests either option when the aim is reducing atrial fibrillation recurrence or improving glycaemic control in patients with impaired glucose metabolism. These distinctions support tailoring treatment discussions to symptoms and intended outcomes rather than assuming uniform benefit. The supplied abstract provides no study counts, pooled effect sizes or subgroup-specific evidence-certainty ratings; full guideline details were unavailable.