The European respiratory journal
October 11, 2026 · via Europe PMC
ERS/ESRS clinical practice guideline for continuous positive airway pressure for the treatment of adult obstructive sleep apnoea.
Testelmans D, Schwarz EI, Anttalainen U, +21 more, Randerath W.
AI summary — for doctors, generated from the abstract only
The ERS/ESRS guideline generally suggests CPAP for adult OSA, with a strong recommendation in those with excessive daytime sleepiness.
What was studied
A joint ERS/ESRS clinical practice guideline built on PICO questions, a systematic review of CPAP effects, GRADE certainty assessment and Evidence-to-Decision frameworks, with consensus by discussion and voting among a multidisciplinary Task Force including patient representatives.
Key findings
- CPAP is generally suggested for OSA because of benefits on sleepiness, other patient-reported outcomes and blood pressure (conditional recommendations)
- CPAP is strongly recommended for patients with excessive daytime sleepiness
- Conditional recommendations are given for moderate-to-severe OSA, the elderly and arterial or treatment-resistant hypertension
- Either CPAP or no treatment is suggested in patients without sleepiness, with atrial fibrillation (to reduce recurrence) or with impaired glucose metabolism
Clinical relevance
Gives clinicians subgroup-specific guidance for shared decisions on starting CPAP, especially when sleepiness is absent or the aim is cardiometabolic.
Who should care
Limitations
The abstract does not give certainty ratings or effect sizes for individual outcomes; most recommendations are conditional, reflecting uncertainty.
CPAP is effective for adult OSA, but how strongly it is recommended depends on symptoms and comorbidities.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Background
Continuous positive airway pressure (CPAP) is the primary treatment for obstructive sleep apnoea (OSA), although its effectiveness may vary across OSA subtypes. This joint European Respiratory Society (ERS)/European Sleep Research Society (ESRS) clinical practice guideline evaluates CPAP's impact on patient-centred and prognostically relevant outcomes, comparing it to no or sham treatment in different OSA subgroups.
Methods
The joint ERS/ESRS Task Force consisted of experts in pulmonology, cardiology and respiratory sleep medicine, patient representatives and methodologists. Questions were formulated using the PICO (Population, Intervention, Comparator, Outcomes) framework. A systematic review assessing the effects of CPAP on critical outcomes was performed. The certainty of evidence for all outcomes was assessed using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. Consensus on the direction and strength of the recommendation was informed by Evidence-to-Decision frameworks and achieved through discussions and voting.
Recommendations
The Task Force generally suggests CPAP treatment for OSA because of its beneficial effects on sleepiness, other patient-reported outcomes and blood pressure (conditional recommendations). CPAP is recommended in patients with excessive daytime sleepiness (EDS) (strong recommendation). Additional specific conditional recommendations are given for patients with moderate-to severe OSA, the elderly, and patients with arterial and treatment-resistant hypertension. The Task Force suggests either CPAP or no treatment in patients without EDS (but taking into account other OSA-related symptoms), in patients with atrial fibrillation with the aim of reducing its recurrence and in patients with impaired glucose metabolism to improve glycaemic control.
Conclusion
CPAP is an effective treatment for adults with OSA. However, recommendations for its use vary across different patient subgroups.
DOI
10.1183/13993003.01186-2026
PMID
42860272
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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