Upper airway surgery should not be first line treatment for obstructive sleep apnoea in adults

Upper airway surgery for obstructive sleep apnoea in adults is resource intensive with low and inconsistent clinical effectiveness. Continuous positive airway pressure (CPAP) plus conservative weight and alcohol management should be first line treatment. When CPAP treatment fails, mandibular advancement devices may be considered (with conservative management) as second line treatment. Surgery for obstructive sleep apnoea should be done within controlled clinical trials; patients should be informed about the trial, as well as of the inconsistent results of surgery, its potential side effects, and the potential for relapse.