PT - JOURNAL ARTICLE AU - Winfried Randerath AU - Johan Verbraecken AU - Christel A.L. de Raaff AU - Jan Hedner AU - Simon Herkenrath AU - Winfried Hohenhorst AU - Tina Jakob AU - Oreste Marrone AU - Marie Marklund AU - Walter T. McNicholas AU - Rebecca L. Morgan AU - Jean-Louis Pepin AU - Sofia Schiza AU - Nicole Skoetz AU - Dan Smyth AU - Jörg Steier AU - Thomy Tonia AU - Wojciech Trzepizur AU - Piet-Heijn van Mechelen AU - Peter Wijkstra TI - European Respiratory Society guideline on non-CPAP therapies for obstructive sleep apnoea AID - 10.1183/16000617.0200-2021 DP - 2021 Dec 31 TA - European Respiratory Review PG - 210200 VI - 30 IP - 162 4099 - http://err.ersjournals.com/content/30/162/210200.short 4100 - http://err.ersjournals.com/content/30/162/210200.full SO - EUROPEAN RESPIRATORY REVIEW2021 Dec 31; 30 AB - 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.OSA-patients who refuse/don't adhere to CPAP can profit from established/emerging treatment options. High scientific evidence is lacking. Patients’ values/preference may weigh heavy in the decision for non-CPAP options, while health inequity is a concern. https://bit.ly/3o0tJeP