Therapy management of patients with obstructive sleep apnea

Abstract The standard therapy for obstructive sleep apnea (OSA) is continuous positive airway pressure therapy (CPAP). CPAP and other therapies such as mandibular advancement splints or hypoglossal nerve stimulation lead to positive effects in terms of sleep quality, disease-specific quality of life, and neurocognitive function. The treatment of symptomatic OSA therefore requires effective therapy over the entire duration of the disease/lifespan. However, 30–50% of patients discontinue CPAP therapy within the first 5 years after initiation. Despite this, only about 1–2% of affected patients currently receive second-line therapy. Effective therapy management of patients with OSA aims for the shortest possible “time to effective therapy” and the longest possible “time on effective therapy” over the entire duration of the disease/lifespan. The S-O-S questionnaire, which measures patient satisfaction (= S), reduction in apnea burden (Outcome = O), and symptoms (= S; S‑O‑S criteria), is presented as a contribution to a strategy for the structured long-term care of patients with OSA therapy. In long-term care, patients with OSA whose therapy needs to be optimized or is unsuitable should be identified at an early stage and thus treated promptly. New strategies for the long-term care of OSA patients with the aim of extending the time on effective therapy of OSA over the entire duration of the lifespan should be evaluated in the context of care studies.