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 NICE CKS.
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 NICE NG202.
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 NICE NG202.
Telemonitoring with CPAP is recommended for up to 12 months, with consideration for ongoing use beyond that period NICE NG202.
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 NICE NG202.
Heated humidification can be considered for patients experiencing upper airway side effects such as nasal or mouth dryness NICE NG202.
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 NICE CKS,NICE NG202.