Obstructive sleep apnea syndrome: who should be treated?

Most, if not all patients referred for assessment require some form of therapeutic intervention. In particular, general lifestyle advice, sleep hygiene, and weight reduction in overweight patients should always be promoted, even where additional specific therapy such as NCPAP is also being considered. Treatment decisions are relatively easy at the extremes of the clinical spectrum, but there is an increasing choice of therapeutic options available for those patients in the mid-range of severity. Criteria based on AHI levels are inappropriate to dictate treatment choice, particularly NCPAP.