European Respiratory Society guideline on non-CPAP therapies for obstructive sleep apnoea.
Winfried Randerath, Johan Verbraecken, Christel A L de Raaff, Jan Hedner, Simon Herkenrath, Winfried Hohenhorst, Tina Jakob, Oreste Marrone, Marie Marklund, Walter T McNicholas, Rebecca L Morgan, Jean-Louis Pepin, Sofia Schiza, Nicole Skoetz, Dan Smyth, Jörg Steier, Thomy Tonia, Wojciech Trzepizur, Piet-Heijn van Mechelen, Peter Wijkstra
Author Information
Winfried Randerath: Bethanien Hospital, Clinic of Pneumology and Allergology, Center for Sleep Medicine and Respiratory Care, Institute of Pneumology at the University of Cologne, Solingen, Germany randerath@klinik-bethanien.de. ORCID
Johan Verbraecken: Antwerp University Hospital and University of Antwerp, Edegem (Antwerp), Belgium. ORCID
Christel A L de Raaff: Amsterdam UMC, Dept of Surgery, Amsterdam, The Netherlands.
Jan Hedner: Dept of Sleep Medicine, Respiratory Medicine and Allergology, Sahlgrenska University Hospital, Gothenburg, Sweden.
Simon Herkenrath: Bethanien Hospital, Clinic of Pneumology and Allergology, Center for Sleep Medicine and Respiratory Care, Institute of Pneumology at the University of Cologne, Solingen, Germany.
Winfried Hohenhorst: Alfried Krupp Hospital, Dept of Otolaryngology, Essen, Germany.
Tina Jakob: Evidence-based Oncology, Dept I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
Oreste Marrone: National Research Council of Italy, Institute for Biomedical Research and Innovation, Palermo, Italy.
Marie Marklund: Dept of Odontology, Faculty of Medicine, Umeå University, Umeå, Sweden.
Walter T McNicholas: School of Medicine, University College Dublin, Dublin, Ireland. ORCID
Rebecca L Morgan: Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada. ORCID
Jean-Louis Pepin: EFCR Sleep and Respiration Unit CHU Grenoble, Grenoble, France.
Sofia Schiza: Sleep Disorders Unit, Dept of Respiratory Medicine, Medical School, University of Crete, Greece.
Nicole Skoetz: Evidence-based Oncology, Dept I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
Dan Smyth: European Lung Foundation, Sheffield, UK.
Jörg Steier: Lane Fox Unit and Sleep Disorders Centre at Guy's & St Thomas' NHS Foundation Trust, Centre for Human & Applied Physiological Sciences, King's College London, London, UK. ORCID
Thomy Tonia: Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
Wojciech Trzepizur: Dept of Respiratory and Sleep Medicine, Angers University hospital, Angers, France.
Piet-Heijn van Mechelen: European Lung Foundation, Sheffield, UK.
Peter Wijkstra: Dept of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Treatment of obstructive sleep apnoea (OSA) in adults is evolving, as new therapies have been explored and introduced in clinical practice, while other approaches have been refined or reconsidered. In this European Respiratory Society (ERS) guideline on non-continuous positive airway pressure (CPAP) therapies for OSA, we present recommendations determined by a systematic review of the literature. It is an update of the 2011 ERS statement on non-CPAP therapies, advanced into a clinical guideline. A multidisciplinary group of experts, including pulmonary, surgical, dentistry and ear-nose-throat specialists, methodologists and patient representatives considered the most relevant clinical questions (for both clinicians and patients) relating to the management of OSA. Eight key clinical questions were generated and a systematic review was conducted to identify published randomised clinical trials that answered these questions. We used the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach to assess the quality of the evidence and the strength of recommendations. The resulting guideline addresses gastric bypass surgery, custom-made dual-block mandibular advancement devices, hypoglossal nerve stimulation, myofunctional therapy, maxillo-mandibular osteotomy, carbonic anhydrase inhibitors and positional therapy. These recommendations can be used to benchmark quality of care for people with OSA across Europe and to improve outcomes.
References
Sleep Med Rev. 2020 Dec;54:101354
[PMID: 32755811]
