In a groundbreaking study led by Monash University and Harvard University, researchers have discovered that combining treatments for obstructive sleep apnoea (OSA) yields better results than using single treatments. The findings, published in the European Respiratory Journal, highlight the potential of dual-targeted therapies to significantly reduce the severity of OSA.
Obstructive sleep apnoea, a condition affecting an estimated five percent of Australians, is characterized by narrowed airways and unstable breathing. The study marks the first randomized trial to address both causes simultaneously, offering a new approach to managing this common sleep disorder.
Understanding the Dual Causes of Sleep Apnoea
Associate Professor Brad Edwards from the Monash University School of Psychological Sciences explains that OSA is not solely due to anatomical issues, such as the tendency of the upper airway to narrow or collapse during sleep. It also involves instability in the regulation of breathing. This dual causality has historically been underexplored in treatment strategies.
“We know that OSA is due to a combination of anatomical and non-anatomical causes,” said Edwards. “The mandibular advancement device (MAD) targets the anatomical cause, while supplemental oxygen addresses a leading but underappreciated non-anatomical cause.”
The Study’s Innovative Approach
The multicentre randomised crossover trial involved 41 patients with moderate-to-severe OSA. Participants underwent a comprehensive overnight sleep study with four different interventions: supplemental oxygen, MAD, combination therapy, and a sham treatment using room air. The results were compelling.
“Combining a ventilatory control intervention (supplemental oxygen) with an upper airway intervention (MAD) is a promising approach to markedly attenuate OSA severity beyond that offered by each intervention alone,” the researchers concluded.
Senior author Scott Sands, an Associate Professor of Medicine from Brigham and Women’s Hospital in Boston, emphasized the significance of the findings. “Targeting multiple causes of OSA significantly decreased severity, measured using a number of different metrics, compared to each therapy alone,” he stated.
Implications for Future Treatment
The study’s findings could revolutionize the approach to treating OSA, much like the multi-drug regimens used for managing high blood pressure. “If widely adopted, it could be a bit like people with high blood pressure taking 2-3 medications to control it, with each targeting different biological pathways,” Sands explained.
However, the researchers caution that larger trials are necessary to confirm these results and identify the patients who would benefit most from this combined treatment approach. The study provides a promising foundation for further research and potential changes in clinical practice.
Looking Forward
The announcement comes as healthcare professionals continue to seek more effective ways to manage sleep disorders, which can have significant health impacts if left untreated. The study’s innovative approach offers hope for improved patient outcomes and a better understanding of the complex mechanisms underlying OSA.
For more detailed insights, the full research paper is available at https://doi.org/10.1183/13993003.01320-2025.
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