ArticleBMJ open respiratory research2026
Therapeutic options for patients with obstructive sleep apnoea: a retrospective review of difficult-to-treat cases in a multidisciplinary approach.
Article in BMJ open respiratory research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionContinuous positive airway pressure (CPAP) is the first-line treatment for obstructive sleep apnoea (OSA) but long-term adherence is limited. This study evaluates the implementation and outcomes of a multidisciplinary team approach to managing CPAP-intolerant patients using alternative therapies.
methodsA retrospective review was conducted on 'difficult-to-treat' OSA cases discussed at multidisciplinary team meetings at the Guy's and St Thomas' NHS Foundation Trust Sleep Disorders Centre (project number 17 160). Patient demographics, comorbidities, OSA severity (Apnoea-Hypopnoea Index (AHI), Epworth Sleepiness Scale (ESS), 3% Oxygen Desaturation Index (ODI)), management plans and outcomes were extracted from meeting minutes and clinical records. Statistical analysis included analysis of variance (ANOVA) to compare baseline characteristics (AHI, age, body mass index (BMI)) across treatment groups and paired t-tests to assess pre-treatment and post-treatment changes in OSA indices (p<0.05).
resultsWe reviewed a cohort of 138 patients (103/138 male, age 51 (17) years, BMI 29.5 (5.1) kg/m
conclusionA multidisciplinary approach enables structured delivery of evidence-based treatment selection for patients with OSA who failed first-line therapy. Observed improvements in a subset of patients suggest potential benefit of tailored non-CPAP strategies and super-regional accessibility.
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