Evidence-based strategies for the treatment of sleep apnea: a systematic literature review

David Landais; Carmen Maribel Bento Teixeira; Ana Isabel Pacheco Teixeira

doi:10.48797/sl.2026.393

Authors

David Landais University Institute of Health Sciences (IUCS), CESPU, CRL, 4585-116 Gandra, Portugal
Carmen Maribel Bento Teixeira Associate Laboratory i4HB - Institute for Health and Bioeconomy, University Institute of Health Sciences - CESPU, 4585-116 Gandra, Portugal; UCIBIO - Applied Molecular Biosciences Unit, Translational Toxicology Research Laboratory, University Institute of Health Sciences (1H-TOXRUN, IUCS-CESPU), 4585-116 Gandra, Portugal
Ana Isabel Pacheco Teixeira Associate Laboratory i4HB - Institute for Health and Bioeconomy, University Institute of Health Sciences - CESPU, 4585-116 Gandra, Portugal; UCIBIO - Applied Molecular Biosciences Unit, Translational Toxicology Research Laboratory, University Institute of Health Sciences (1H-TOXRUN, IUCS-CESPU), 4585-116 Gandra, Portugal https://orcid.org/0000-0002-3254-5326

DOI:

https://doi.org/10.48797/sl.2026.393

Keywords:

obstructive sleep apnea, continuous positive airway pressure, oxygen therapy, pharmaceutical interventions, adherence

Abstract

Obstructive sleep apnea is a common sleep disorder characterized by repeated upper airway obstruction during sleep, causing intermittent oxygen desaturation, sleep fragmentation, and reduced quality of life. Among the main treatments, continuous positive airway pressure and nocturnal oxygen therapy are widely used. Despite their efficacy, both have limitations, including poor long-term adherence, device-induced discomfort, and the need for regular monitoring. The pharmacist can play a key role in improving therapeutic support and adherence. This review aims to evaluate the effectiveness and safety of continuous positive airway pressure and nocturnal oxygen therapy in the treatment of obstructive sleep apnea and to identify pharmaceutical interventions to optimize adherence and manage adverse effects. This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and included studies from PubMed, Cochrane Library, and ScienceDirect involving adults treated with these therapies. Thirty-one studies were included. Across the included studies, continuous positive airway pressure therapy consistently reduced the apnea-hypopnea index by approximately 15 to 30 events per hour, often corresponding to a relative reduction exceeding 50% from baseline. Improvements in nocturnal oxygenation were also observed, with increases in mean SpO₂ ranging from 2 to 9 percentage points. In cardiovascular outcomes, the use of continuous positive airway pressure was associated with reductions in nocturnal systolic blood pressure typically ranging from 3 to 7 mmHg among adherent patients. Oxygen therapy improved oxygenation but showed variable effects on respiratory events and adherence. In conclusion, continuous positive airway pressure remains the reference treatment, while pharmacist interventions may strengthen adherence and optimize management.

References

Lattimore, J. o-D.L.; Celermajer, D.S.; Wilcox, I. Obstructive Sleep Apnea and Cardiovascular Disease. J. Am. Coll. Cardiol. 2003, 41, 1429–1437, doi:10.1016/S0735-1097(03)00184-0.

Maniaci, A.; Lavalle, S.; Parisi, F.M.; Barbanti, M.; Cocuzza, S.; Iannella, G.; Magliulo, G.; Pace, A.; Lentini, M.; Masiello, E.; et al. Impact of Obstructive Sleep Apnea and Sympathetic Nervous System on Cardiac Health: A Comprehensive Review. J. Cardio-vasc. Dev. Dis. 2024, 11, 204, doi:10.3390/jcdd11070204.

Lavie, L. Editorial: Intermittent Hypoxia: From Basic Mechanisms to Clinical Insights and Therapeutics. Front. Neurol. 2020, 11, doi:10.3389/fneur.2020.00647.

Kohli, P.; Balachandran, J.S.; Malhotra, A. Obstructive Sleep Apnea and the Risk for Cardiovascular Disease. Curr. Atheroscler. Rep. 2011, 13, 138–146, doi:10.1007/s11883-011-0161-8.

Cunningham, J.; Hunter, M.; Budgeon, C.; Murray, K.; Knuiman, M.; Hui, J.; Hillman, D.; Singh, B.; James, A. The Prevalence and Comorbidities of Obstructive Sleep Apnea in Middle-Aged Men and Women: The Busselton Healthy Ageing Study. Journal of Clinical Sleep Medicine 2021, 17, 2029–2039, doi:10.5664/jcsm.9378.

Soori, R.; Baikunje, N.; D’sa, I.; Bhushan, N.; Nagabhushana, B.; Hosmane, G.B. Pitfalls of AHI System of Severity Grading in Obstructive Sleep Apnoea. Sleep Science 2022, 15, 285–288, doi:10.5935/1984-0063.20220001.

Brożyna-Tkaczyk, K.; Myśliński, W.; Mosiewicz, J. The Assessment of Endothelial Dysfunction among OSA Patients after CPAP Treatment. Medicina (B. Aires). 2021, 57, 310, doi:10.3390/medicina57040310.

Phillips, C.L.; Grunstein, R.R.; Darendeliler, M.A.; Mihailidou, A.S.; Srinivasan, V.K.; Yee, B.J.; Marks, G.B.; Cistulli, P.A. Health Outcomes of Continuous Positive Airway Pressure versus Oral Appliance Treatment for Obstructive Sleep Apnea. Am. J. Respir. Crit. Care Med. 2013, 187, 879–887, doi:10.1164/rccm.201212-2223OC.

Sutherland, K.; Phillips, C.L.; Cistulli, P.A. Efficacy versus Effectiveness in the Treatment of Obstructive Sleep Apnea: CPAP and Oral Appliances. J. Dent. Sleep Med. 2015, 02, 175–181, doi:10.15331/jdsm.5120.

Patil, S.P.; Ayappa, I.A.; Caples, S.M.; Kimoff, R.J.; Patel, S.R.; Harrod, C.G. Treatment of Adult Obstructive Sleep Apnea With Positive Airway Pressure: An American Academy of Sleep Medicine Systematic Review, Meta-Analysis, and GRADE Assessment. Journal of Clinical Sleep Medicine 2019, 15, 301–334, doi:10.5664/jcsm.7638.

Sun, X.; Luo, J.; Wang, Y. Comparing the Effects of Supplemental Oxygen Therapy and Continuous Positive Airway Pressure on Patients with Obstructive Sleep Apnea: A Meta-Analysis of Randomized Controlled Trials. Sleep and Breathing 2021, 25, 2231–2240, doi:10.1007/s11325-020-02245-4.

Phyu, S.L.; Ercan, S.; Harriss, E.; Turnbull, C. Nocturnal Oxygen Therapy in Obstructive Sleep Apnoea: A Systematic Review and Meta-Analysis. Eur. Respir. Rev. 2024, 33, 230173, doi:10.1183/16000617.0173-2023.

Riha, R.L. Oxygen for the Treatment of Obstructive Sleep Apnoea Hypopnoea Syndrome. Breathe 2019, 15, e104–e107, doi:10.1183/20734735.0206-2019.

Carneiro-Barrera, A.; Amaro-Gahete, F.J.; Guillén-Riquelme, A.; Jurado-Fasoli, L.; Sáez-Roca, G.; Martín-Carrasco, C.; Buela-Casal, G.; Ruiz, J.R. Effect of an Interdisciplinary Weight Loss and Lifestyle Intervention on Obstructive Sleep Apnea Se-verity. The INTERAPNEA Randomized Clinical Trial. JAMA Netw. Open 2022, 5, e228212, doi:10.1001/jamanetworkopen.2022.8212.

Malhotra, A.; Heilmann, C.R.; Banerjee, K.K.; Dunn, J.P.; Bunck, M.C.; Bednarik, J. Weight Reduction and the Impact on Ap-nea-Hypopnea Index: A Systematic Meta-Analysis. Sleep Med. 2024, 121, 26–31, doi:10.1016/j.sleep.2024.06.014.

Wong, A.-M.; Barnes, H.N.; Joosten, S.A.; Landry, S.A.; Dabscheck, E.; Mansfield, D.R.; Dharmage, S.C.; Senaratna, C. V.; Edwards, B.A.; Hamilton, G.S. The Effect of Surgical Weight Loss on Obstructive Sleep Apnoea: A Systematic Review and Meta-Analysis. Sleep Med. Rev. 2018, 42, 85–99, doi:10.1016/j.smrv.2018.06.001.

de Vries, G.E.; Hoekema, A.; Doff, M.H.J.; Kerstjens, H.A.M.; Meijer, P.M.; van der Hoeven, J.H.; Wijkstra, P.J. Usage of Positional Therapy in Adults with Obstructive Sleep Apnea. Journal of Clinical Sleep Medicine 2015, 11, 131–137, doi:10.5664/jcsm.4458.

Olson, M.D.; Junna, M.R. Hypoglossal Nerve Stimulation Therapy for the Treatment of Obstructive Sleep Apnea. Neurothera-peutics 2021, 18, 91–99, doi:10.1007/s13311-021-01012-x.

Perraudin, C.; Fleury, B.; Pelletier‐Fleury, N. Effectiveness of Intervention Led by a Community Pharmacist for Improving Recognition of Sleep Apnea in Primary Care – a Cohort Study. J. Sleep Res. 2015, 24, 167–173, doi:10.1111/jsr.12230.

Cawley, M.J.; Warning, W.J. A Systematic Review of Pharmacists Performing Obstructive Sleep Apnea Screening Services. Int. J. Clin. Pharm. 2016, 38, 752–760, doi:10.1007/s11096-016-0319-0.

Shoukry, G.; Wong, K.; Bartlett, D.; Saini, B. Treatment Experience of People with Obstructive Sleep Apnoea Seeking Continuous Positive Airways Pressure Device Provision through Community Pharmacies – a Role for Pharmacists? Int. J. Pharm. Pract 2011, 19, 318–327, doi:10.1111/j.2042-7174.2011.00120.x.

Tan, L.; Li, T.; Luo, L.; Zhang, Y.; Xue, X.; He, J.; Lei, F.; Tang, X. Clinical, Polysomnographic, and Heart Rate Variability in Highland Obstructive Sleep Apnea Patients Responding to One-Night Nocturnal Oxygen Supplementation: A Post-Hoc Analysis from a Randomized, Crossover Trial. Sleep Med. 2023, 110, 146–153, doi:10.1016/j.sleep.2023.08.003.

Ni, Y.-N.; Lei, F.; Tang, X.; Liang, Z.; Thomas, R.J. The Association between the Effective Apnea-Hypopnea Index and Blood Pressure Reduction Efficacy Following CPAP/Oxygen Treatment. Sleep Med. 2024, 117, 46–52, doi:10.1016/j.sleep.2024.02.046.

Tan, L.; Latshang, T.D.; Aeschbacher, S.S.; Huber, F.; Flueck, D.; Lichtblau, M.; Ulrich, S.; Hasler, E.D.; Scheiwiller, P.M.; Ulrich, S.; et al. Effect of Nocturnal Oxygen Therapy on Nocturnal Hypoxemia and Sleep Apnea Among Patients With Chronic Obstructive Pulmonary Disease Traveling to 2048 Meters. JAMA Netw. Open 2020, 3, e207940, doi:10.1001/jamanetworkopen.2020.7940.

Joosten, S.A.; Tan, M.; Wong, A.-M.; Landry, S.A.; Leong, P.; Sands, S.A.; Beatty, C.; Thomson, L.; Stonehouse, J.; Turton, A.; et al. A Randomized Controlled Trial of Oxygen Therapy for Patients Who Do Not Respond to Upper Airway Surgery for Obstructive Sleep Apnea. J. Clin. Sleep Med. 2021, 17, 445–452, doi:10.5664/jcsm.8920.

Turnbull, C.D.; Sen, D.; Kohler, M.; Petousi, N.; Stradling, J.R. Effect of Supplemental Oxygen on Blood Pressure in Obstructive Sleep Apnea (SOX): A Randomized Continuous Positive Airway Pressure Withdrawal Trial. Am. J. Respir. Crit. Care Med. 2019, 199, 211–219, doi:10.1164/rccm.201802-0240OC.

dos Santos Neto, J.M.; de Carvalho, C.C.; de Andrade, L.B.; Dos Santos, T.G.B.; Andrade, R.G.A. da C.; Fernandes, R.A.M.L.; de Orange, F.A. Continuous Positive Airway Pressure to Reduce the Risk of Early Peripheral Oxygen Desaturation after Onset of Apnoea in Children: A Double-Blind Randomised Controlled Trial. PLoS One 2021, 16, e0256950, doi:10.1371/journal.pone.0256950.

Batool‐Anwar, S.; Goodwin, J.L.; Kushida, C.A.; Walsh, J.A.; Simon, R.D.; Nichols, D.A.; Quan, S.F. Impact of Continuous Posi-tive Airway Pressure (CPAP) on Quality of Life in Patients with Obstructive Sleep Apnea (OSA). J. Sleep Res. 2016, 25, 731–738, doi:10.1111/jsr.12430.

Peker, Y.; Glantz, H.; Eulenburg, C.; Wegscheider, K.; Herlitz, J.; Thunström, E. Effect of Positive Airway Pressure on Cardiovas-cular Outcomes in Coronary Artery Disease Patients with Nonsleepy Obstructive Sleep Apnea. The RICCADSA Randomized Controlled Trial. Am. J. Respir. Crit. Care Med. 2016, 194, 613–620, doi:10.1164/rccm.201601-0088OC.

McEvoy, R.D.; Antic, N.A.; Heeley, E.; Luo, Y.; Ou, Q.; Zhang, X.; Mediano, O.; Chen, R.; Drager, L.F.; Liu, Z.; et al. CPAP for Pre-vention of Cardiovascular Events in Obstructive Sleep Apnea. N Engl J Med 2016, 375, 919–931, doi:10.1056/NEJMoa1606599.

O’Donnell, C.; Crilly, S.; O’Mahony, A.; O’Riordan, B.; Traynor, M.; Gitau, R.; McDonald, K.; Ledwidge, M.; O’Shea, D.; Murphy, D.J.; et al. Continuous Positive Airway Pressure But Not GLP1-Mediated Weight Loss Improves Early Cardiovascular Disease in Obstructive Sleep Apnea: A Randomized Proof-of-Concept Study. Ann. Am. Thorac. Soc. 2024, 21, 464–473, doi:10.1513/AnnalsATS.202309-821OC.

Xu, H.; Liu, Y.; Li, C.; Li, X.; Shen, L.; Wang, H.; Liu, F.; Zou, J.; Xia, Y.; Huang, W.; et al. Effects of Continuous Positive Airway Pressure on Neuroimaging Biomarkers and Cognition in Adult Obstructive Sleep Apnea: A Randomized Controlled Trial. Am. J. Respir. Crit. Care Med. 2025, 211, 628–636, doi:10.1164/rccm.202406-1170OC.

Facco, F.L.; Wolsk, J.; Patel, S.R.; Hubel, C.; Gallaher, M.; Cashmere, J.D.; Wisniewski, S. A Trial of Positive Airway Pressure for the Treatment of Sleep Apnea in Pregnancy. Am. J. Obstet. Gynecol. MFM 2023, 5, 100840, doi:10.1016/j.ajogmf.2022.100840.

Fox, H.; Bitter, T.; Sauzet, O.; Rudolph, V.; Oldenburg, O. Automatic Positive Airway Pressure for Obstructive Sleep Apnea in Heart Failure with Reduced Ejection Fraction. Clin Res Cardiol 2021, 110, 983–992, doi:10.1007/s00392-020-01701-1.

Xiao, S.; Bastianpillai, J.; Ratneswaran, C.; Pengo, M.F.; Luo, Y.; Jolley, C.J.; Moxham, J.; Steier, J. Continuous Positive Airway Pressure and Breathlessness in Obese Patients with Obstructive Sleep Apnea: A Pilot Study. Sleep 2016, 39, 1201–1210, doi:10.5665/sleep.5832.

Sánchez-de-la-Torre, M.; Gracia-Lavedan, E.; Benítez, I.D.; Zapater, A.; Torres, G.; Sánchez-de-la-Torre, A.; Aldoma, A.; de Batlle, J.; Targa, A.; Abad, J.; et al. Long-Term Effect of Obstructive Sleep Apnea and Continuous Positive Airway Pressure Treatment on Blood Pressure in Patients with Acute Coronary Syndrome: A Clinical Trial. Ann. Am. Thorac. Soc. 2022, 19, 1750–1759, doi:10.1513/AnnalsATS.202203-260OC.

Sterling, K.L.; Pépin, J.-L.; Linde-Zwirble, W.; Chen, J.; Benjafield, A. V.; Cistulli, P.A.; Cole, K. V.; Emami, H.; Woodford, C.; Armitstead, J.P.; et al. Impact of Positive Airway Pressure Therapy Adherence on Outcomes in Patients with Obstructive Sleep Apnea and Chronic Obstructive Pulmonary Disease. Am. J. Respir. Crit. Care Med. 2022, 206, 197–205, doi:10.1164/rccm.202109-2035OC.

Cukierman, D.S.; Perez, M.; Guerra-Londono, J.J.; Carlson, R.; Hagan, K.; Ghebremichael, S.; Hagberg, C.; Ge, P.S.; Raju, G.S.; Rhim, A.; et al. Nasal Continuous Positive Pressure versus Simple Face Mask Oxygenation for Adult Obese and Obstructive Sleep Apnea Patients Undergoing Colonoscopy under Propofol-Based General Anesthesia without Tracheal Intubation: A Ran-domized Controlled Trial. J. Clin. Anesth. 2023, 89, 111196, doi:10.1016/j.jclinane.2023.111196.

Hoyos, C.M.; Cross, N.E.; Terpening, Z.; D’Rozario, A.L.; Yee, B.J.; LaMonica, H.; Marshall, N.S.; Grunstein, R.R.; Naismith, S.L. Continuous Positive Airway Pressure for Cognition in Sleep Apnea and Mild Cognitive Impairment: A Pilot Randomized Crossover Clinical Trial. Am. J. Respir. Crit. Care Med. 2022, 205, 1479–1482, doi:10.1164/rccm.202111-2646LE.

Gentina, T.; Bailly, S.; Jounieaux, F.; Verkindre, C.; Broussier, P.-M.; Guffroy, D.; Prigent, A.; Gres, J.-J.; Kabbani, J.; Kedziora, L.; et al. Marital Quality, Partner’s Engagement and Continuous Positive Airway Pressure Adherence in Obstructive Sleep Apnea. Sleep Med. 2019, 55, 56–61, doi:10.1016/j.sleep.2018.12.009.

Khan, N.N.S.; Todem, D.; Bottu, S.; Badr, M.S.; Olomu, A. Impact of Patient and Family Engagement in Improving Continuous Positive Airway Pressure Adherence in Patients with Obstructive Sleep Apnea: A Randomized Controlled Trial. J. Clin. Sleep Med. 2022, 18, 181–191, doi:10.5664/jcsm.9534.

Khadadah, S.; Kimoff, R.J.; Duquette, P.; Jobin, V.; Lapierre, Y.; Benedetti, A.; Johara, F.T.; Robinson, A.; Roger, E.; Bar-Or, A.; et al. Effect of Continuous Positive Airway Pressure Treatment of Obstructive Sleep Apnea-Hypopnea in Multiple Sclerosis: A Randomized, Double-Blind, Placebo-Controlled Trial (SAMS-PAP Study). Multiple Sclerosis Journal 2022, 28, 82–92, doi:10.1177/13524585211010390.

Chalkiadaki, E.; Andreanos, K.; Karmiris, E.; Mani, A.; Kastanakis, E.; Amfilochiou, A.; Papaconstantinou, D.; Koutsandrea, C.; Georgalas, I. Effects of Continuous Positive Airway Pressure Treatment for Obstructive Sleep Apnea–Hypopnea Syndrome on Corneal Morphological Characteristics. Cornea 2021, 40, 988–994, doi:10.1097/ICO.0000000000002581.

Gupta, A.; Shukla, G.; Afsar, M.; Poornima, S.; Pandey, R.M.; Goyal, V.; Srivastava, A.; Vibha, D.; Behari, M. Role of Positive Airway Pressure Therapy for Obstructive Sleep Apnea in Patients With Stroke: A Randomized Controlled Trial. Journal of Clin-ical Sleep Medicine 2018, 14, 511–521, doi:10.5664/jcsm.7034.

Zhao, Y.Y.; Wang, R.; Gleason, K.J.; Lewis, E.F.; Quan, S.F.; Toth, C.M.; Song, Y.; Morrical, M.; Rueschman, M.; Mittleman, M.A.; et al. Effect of Continuous Positive Airway Pressure Treatment on Ambulatory Blood Pressures in High-Risk Sleep Apnea Pa-tients: A Randomized Controlled Trial. Journal of Clinical Sleep Medicine 2022, 18, 1899–1907, doi:10.5664/jcsm.10012.

Lorenzi-Filho, G.; Cruz, F.C.S.G.; Queiróz, D.B.C.; Vieira, M.L.C.; Pedrosa, R.P.; Couto Patriota, T.L.G.; Righi, C.G.; Martinez, D.; da Silva, G.A.; Silva, G. V.; et al. Effects of Continuous Positive Airway Pressure on Central and Peripheral Blood Pressure in Pa-tients with Uncontrolled Hypertension and Obstructive Sleep Apnea: The Randomized Controlled MORPHEOS Clinical Trial. Ann. Am. Thorac. Soc. 2025, 22, 757–767, doi:10.1513/AnnalsATS.202407-688OC.

Hoyos, C.M.; Yee, B.J.; Wong, K.K.; Grunstein, R.R.; Phillips, C.L. Treatment of Sleep Apnea With CPAP Lowers Central and Peripheral Blood Pressure Independent of the Time-of-Day: A Randomized Controlled Study. Am. J. Hypertens. 2015, 28, 1222–1228, doi:10.1093/ajh/hpv023.

Shirahama, R.; Tanigawa, T.; Ida, Y.; Fukuhisa, K.; Tanaka, R.; Tomooka, K.; Lan, F.-Y.; Ikeda, A.; Wada, H.; Kales, S.N. Long-Term Effect of Continuous Positive Airway Pressure Therapy on Blood Pressure in Patients with Obstructive Sleep Apnea. Sci. Rep. 2021, 11, 19101, doi:10.1038/s41598-021-98553-0.

Hu, S.-T.; Yu, C.-C.; Liu, C.-Y.; Tsao, L.-I. The Effects of Integrated Nursing Education on Quality of Life and Health-Related Out-comes among Obstructive Sleep Apnea Patients Receiving Continuous Positive Airway Pressure Therapy. Sleep and Breathing 2017, 21, 845–852, doi:10.1007/s11325-017-1480-y.

Lisan, Q.; Van Sloten, T.; Marques Vidal, P.; Haba Rubio, J.; Heinzer, R.; Empana, J.P. Association of Positive Airway Pressure Prescription With Mortality in Patients With Obesity and Severe Obstructive Sleep Apnea. JAMA Otolaryngology–Head & Neck Surgery 2019, 145, 509, doi:10.1001/jamaoto.2019.0281.

Zhao, Y.Y.; Wang, R.; Gleason, K.J.; Lewis, E.F.; Quan, S.F.; Toth, C.M.; Morrical, M.; Rueschman, M.; Weng, J.; Ware, J.H.; et al. Effect of Continuous Positive Airway Pressure Treatment on Health-Related Quality of Life and Sleepiness in High Cardiovas-cular Risk Individuals With Sleep Apnea: Best Apnea Interventions for Research (BestAIR) Trial. Sleep 2017, 40, doi:10.1093/sleep/zsx040.

Azarbarzin, A.; Zinchuk, A.; Wellman, A.; Labarca, G.; Vena, D.; Gell, L.; Messineo, L.; White, D.P.; Gottlieb, D.J.; Redline, S.; et al. Cardiovascular Benefit of Continuous Positive Airway Pressure in Adults with Coronary Artery Disease and Obstructive Sleep Apnea without Excessive Sleepiness. Am. J. Respir. Crit. Care Med. 2022, 206, 767–774, doi:10.1164/rccm.202111-2608OC.

JBI Critical Appraisal Tools | JBI Available online: https://jbi.global/critical-appraisal-tools (accessed on 25 September 2025).

Franco, A.; Vidigal, M.T.C.; Oliveira, M.N. de; Nascimento, C.T. de J.S.; Silva, R.F. da; Paranhos, L.R. Evidence-Based Mapping of Third Molar Techniques for Age Estimation Applied to Brazilian Adolescents – a Systematic Review. Research, Society and De-velopment 2020, 9, e9339109395, doi:10.33448/rsd-v9i10.9395.

O’Driscoll, B.R.; Howard, L.S.; Earis, J.; Mak, V. British Thoracic Society Guideline for Oxygen Use in Adults in Healthcare and Emergency Settings. BMJ Open Respir. Res. 2017, 4, e000170, doi:10.1136/bmjresp-2016-000170.

Wood, M.H.; Hailwood, M.; Koutelos, K. Reducing the Risk of Oxygen-Related Fires and Explosions in Hospitals Treating Covid-19 Patients. Process Safety and Environmental Protection 2021, 153, 278–288, doi:10.1016/j.psep.2021.06.023.

Fu, E.S.; Downs, J.B.; Schweiger, J.W.; Miguel, R. V.; Smith, R.A. Supplemental Oxygen Impairs Detection of Hypoventilation by Pulse Oximetry. Chest 2004, 126, 1552–1558, doi:10.1378/chest.126.5.1552.

Weaver, T.E.; Grunstein, R.R. Adherence to Continuous Positive Airway Pressure Therapy: The Challenge to Effective Treatment. Proc. Am. Thorac. Soc. 2008, 5, 173–178, doi:10.1513/pats.200708-119MG.

Ghadiri, M.; Grunstein, R.R. Clinical Side Effects of Continuous Positive Airway Pressure in Patients with Obstructive Sleep Apnoea. Respirology 2020, 25, 593–602, doi:10.1111/resp.13808.

Genta, P.R.; Kaminska, M.; Edwards, B.A.; Ebben, M.R.; Krieger, A.C.; Tamisier, R.; Ye, L.; Weaver, T.E.; Vanderveken, O.M.; Lo-renzi-Filho, G.; et al. The Importance of Mask Selection on Continuous Positive Airway Pressure Outcomes for Obstructive Sleep Apnea. An Official American Thoracic Society Workshop Report. Ann. Am. Thorac. Soc. 2020, 17, 1177–1185, doi:10.1513/AnnalsATS.202007-864ST.

Miyamoto, K.; Nishimura, M. Nasal Dryness Discomfort in Individuals Receiving Dry Oxygen Via Nasal Cannula. Respir. Care 2008, 53, 503–504, doi:10.4187/respcare.08530503.

Weaver, T.E.; Maislin, G.; Dinges, D.F.; Bloxham, T.; George, C.F.P.; Greenberg, H.; Kader, G.; Mahowald, M.; Younger, J.; Pack, A.I. Relationship Between Hours of CPAP Use and Achieving Normal Levels of Sleepiness and Daily Functioning. Sleep 2007, 30, 711–719, doi:10.1093/sleep/30.6.711.

Kribbs, N.B.; Pack, A.I.; Kline, L.R.; Smith, P.L.; Schwartz, A.R.; Schubert, N.M.; Redline, S.; Henry, J.N.; Getsy, J.E.; Dinges, D.F. Objective Measurement of Patterns of Nasal CPAP Use by Patients with Obstructive Sleep Apnea. American Review of Respirato-ry Disease 1993, 147, 887–895, doi:10.1164/ajrccm/147.4.887.

Au, T.H.; Castillo, S.L.; Morrow, L.E.; Malesker, M.A. Obstructive Sleep Apnea and Continuous Positive Airway Pressure: A Pri-mer for Pharmacists. U.S. Pharmacist (25.01.2015) 2015, 40, 30–33, Available online: https://www.uspharmacist.com/article/obstructive-sleep-apnea-and-continuous-positive-airway-pressure-a-primer-for-pharmacists.

Aalaei, S.; Amini, M.; Mazaheri Habibi, M.R.; Shahraki, H.; Eslami, S. A Telemonitoring System to Support CPAP Therapy in Patients with Obstructive Sleep Apnea: A Participatory Approach in Analysis, Design, and Evaluation. BMC Med. Inform. Decis. Mak. 2022, 22, 168, doi:10.1186/s12911-022-01912-8.

Rapelli, G.; Pietrabissa, G.; Manzoni, G.M.; Bastoni, I.; Scarpina, F.; Tovaglieri, I.; Perger, E.; Garbarino, S.; Fanari, P.; Lombardi, C.; et al. Improving CPAP Adherence in Adults With Obstructive Sleep Apnea Syndrome: A Scoping Review of Motivational In-terventions. Front. Psychol. 2021, 12, 705364, doi:10.3389/fpsyg.2021.705364.

Huh, G.; Han, K. do; Park, Y.-M.; Park, C.-S.; Lee, K.; Lee, E.Y.; Cho, J.-H. Comorbidities Associated with High-Risk Obstructive Sleep Apnea Based on the STOP-BANG Questionnaire: A Nationwide Population-Based Study. Korean J. Intern. Med. 2023, 38, 80–92, doi:10.3904/kjim.2022.198.

Pharmacotherapy in Obesity Management | University Hospitals | Cleveland, Ohio | University Hospitals Available online: https://www.uhhospitals.org/for-clinicians/articles-and-news/articles/2025/06/pharmacotherapy-in-obesity-management

Mohiuddin, A.K. Clinical Pharmacists in Chronic Care [Part 2]. Arch. Biomed. Eng. Biotechnol. 2020, 3, 1–41, doi:10.33552/ABEB.2020.03.000566.

Brown, T.J.; Todd, A.; O’Malley, C.; Moore, H.J.; Husband, A.K.; Bambra, C.; Kasim, A.; Sniehotta, F.F.; Steed, L.; Smith, S.; et al. Community Pharmacy-Delivered Interventions for Public Health Priorities: A Systematic Review of Interventions for Alcohol Reduction, Smoking Cessation and Weight Management, Including Meta-Analysis for Smoking Cessation. BMJ Open 2016, 6, e009828, doi:10.1136/bmjopen-2015-009828.

Dusart, C.; Andre, S.; Mettay, T.; Bruyneel, M. Telemonitoring for the Follow-Up of Obstructive Sleep Apnea Patients Treated with CPAP: Accuracy and Impact on Therapy. Sensors 2022, 22, 2782, doi:10.3390/s22072782.

Drigo, R.; Ballarin, A.; Menzella, F.; Romagnoli, M.; Salasnich, M.; Marino, L.; Lucernoni, P.; Chizzolini, M.; Tondo, P. Manage-ment of CPAP Follow-up by Telemonitoring in Obstructive Sleep Apnea: The PROTEUS Project. Nat. Sci. Sleep 2025, Volume 17, 357–363, doi:10.2147/NSS.S501341.

Pharmaceutical Society of Australia (PSA). Practice Guidelines for the Provision of Sleep Apnoea Services within Pharmacy Available online: https://my.psa.org.au/s/article/Sleep-Apnoea-Guidelines.

Stong, C. Preventing CPAP Nonadherence in OSA: Follow Up Earlier Than 30 to 90 Days Available online: https://www.sleepwakeadvisor.com/news/prevent-cpap-nonadherence-in-osa-with-earlier-follow-up/.

Li, M.; Lin, H.; Yang, Q.; Zhang, X.; Zhou, Q.; Shi, J.; Ge, F. Glucagon-like Peptide-1 Receptor Agonists for the Treatment of Ob-structive Sleep Apnea: A Meta-Analysis. Sleep 2025, 48, 1–8, doi:10.1093/sleep/zsae280.

Dragonieri, S.; Portacci, A.; Quaranta, V.N.; Carratu, P.; Lazar, Z.; Carpagnano, G.E.; Bikov, A. Therapeutic Potential of Gluca-gon-like Peptide-1 Receptor Agonists in Obstructive Sleep Apnea Syndrome Management: A Narrative Review. Diseases 2024, 12, 224, doi:10.3390/diseases12090224.

Alrubasy, W.A.; Abuawwad, M.T.; Taha, M.J.J.; Khurais, M.; Sayed, M.S.; Dahik, A.M.; Keshk, N.; Abdelhadi, S.; Serhan, H.A. Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea in Adults: An Updated Systematic Review and Meta-Analysis. Respir. Med. 2024, 234, 107826, doi:10.1016/j.rmed.2024.107826.

Schwartz, A.R.; Jacobowitz, O.; Eisele, D.W.; Mickelson, S.A.; Miller, M.B.; Oliven, A.; Certal, V.; Hopp, M.L.; Winslow, D.H.; Huntley, T.C.; et al. Targeted Hypoglossal Nerve Stimulation for Patients With Obstructive Sleep Apnea. JAMA Otolaryngology–Head & Neck Surgery 2023, 149, 512, doi:10.1001/jamaoto.2023.0161.