Advances in ventilatory treatment for OSAS

Continuous positive airway pressure (CPAP) is the most widely used treatment for obstructive sleep apnea (OSA), and was established four decades ago. An alternative option is to use bilevel ventilation, in order to improve compliance to treatment especially in patients who need a high therapeutic pressure to prevent nocturnal respiratory events. Automatic CPAP or bilevel ventilation are also established among OSA therapeutic choices, and are generally indicated in cases of highly variable therapeutic pressure. The major advances in the field regard OSAS in the context of uncomplicated obesity hypoventilation syndrome (OHS), in which either CPAP or bilevel ventilation yield comparable results, and the increasingly popular use of telemedicine in OSA management. The COVID-19 pandemic has been a major determinant of the shift from traditional clinic-based management to using telemedicine whenever possible. In addition, availability of CPAP data recorded in millions of patients has allowed big-data studies on adherence to CPAP or bilevel ventilation over prolonged periods of time. It can be foreseen that e-Health programs will soon be used for most of the clinical activities in the OSA field.