Long-term results in the treatment of obstructive sleep apnea

No recent update is available on long-term results of the various types of treatment of obstructive sleep apnea (OSA) which can help the physician in evaluating the individually tailored treatment for patients with OSA in the long term. We arbitrarily defined "long-term" results as those after at le ast 3 years and reviewed the literature from the past 25 years for reports on conservative, apparative, and surgical therapy of OSA in children and ad ults. Another inclusion criterion was that the diagnosis was also confirmed by polysomnography before treatment and at follow-up. Only relatively few long-term studies meeting the criteria of 'evidence based medicine' were fo und, comparing the findings of these was difficult or impossible due to var ying criteria for success. Long-term data were available about the effect o f weight reduction, nasal ventilation therapy, oral devices, tonsillectomy, uvulopalatopharyngoplasty, maxillomandibular advancement osteotomies, and tracheotomy. After approx. 25 years many treatment modalities in sleep medi cine are still experimental concerning the long-term use for the individual . In particular, randomized controlled trials in surgery are lacking. Late results show that at least 50% of patients with OSA can be treated effectiv ely by one or a combination of treatments. Nasal continuous positive airway pressure, tracheotomy, maxillomandibular advancement osteotomy, and tonsil lectomy are the most effective treatments of OSA.