CPAP for sleep apnoea: strongly for the sleepy, a choice for the rest

The edition in brief

The ERS/ESRS guideline on CPAP for adult obstructive sleep apnoea, published 11 October, strongly recommends CPAP for patients with excessive daytime sleepiness and conditionally suggests it more broadly for its effects on sleepiness, other patient-reported outcomes and blood pressure, with specific conditional advice for moderate-to-severe disease, older adults and resistant hypertension; in patients without sleepiness, with atrial fibrillation or with impaired glucose metabolism, it suggests either CPAP or no treatment. In a Chinese trial randomising 2,485 patients with subpleural lung lesions, contrast-enhanced ultrasound guidance gave higher diagnostic yield (88.8%) than CT (78.9%) or plain ultrasound (76.0%), with the fewest complications (4.6% vs 15.8% with CT). A meta-analysis of bronchial thermoplasty found modest gains in asthma quality of life and control in mostly unblinded trials, with a 3.5-fold rise in hospitalisation during treatment. Across 16 trials, remimazolam for bronchoscopy roughly halved respiratory depression and hypotension compared with other sedatives.