European Respiratory Society statement on advanced telemedicine for obstructive sleep apnoea (e-Sleep)

Johan Verbraecken^{1

2}, Emanuele Amodio³, Ozen K Basoglu⁴, Riccardo Bellazzi^{5

6}, Matteo Bradicich⁷, Marie Bruyneel⁸, Refika Hamutcu Ersu⁹, Francesco Fanfulla¹⁰, Brigitte Fauroux¹¹, Ludger Grote¹², Carolina Lombardi^{13

14}, Walter T McNicholas¹⁵, Carla Miltz¹⁶, Yüksel Peker^{12

17

18

19}, Sofia Schiza²⁰, Monique Carolina Suarez²¹, Renaud Tamisier²², Hui-Leng Tan²³, Dries Testelmans²⁴, Thomy Tonia²⁵, Piet-Heijn van Mechelen¹⁶, Bart Vrijsen²⁴, Maria R Bonsignore^{3

26

2}

Affiliations

¹ Antwerp University Hospital and University of Antwerp, Edegem, Belgium johan.verbraecken@uza.be.
² Co-chaired the task force.
³ Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties "G. D'Alessandro" (PROMISE), University of Palermo, Palermo, Italy.
⁴ Department of Respiratory Medicine, Ege University, Izmir, Turkey.
⁵ Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy.
⁶ IRCCS ICS Maugeri, Pavia, Italy.
⁷ Department of Pulmonology and Sleep Disorders Centre, University Hospital Zurich, Zurich, Switzerland.
⁸ Department of Pneumology, CHU Saint Pierre, Université Libre de Bruxelles, Brussels, Belgium.
⁹ Children's Hospital of Eastern Ontario, University of Ottawa, CHEO Research Institute, Ottawa, ON, Canada.
¹⁰ Sleep and Respiratory Function Unit of the Pavia and Montescano Institutes, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy.
¹¹ AP-HP, Hôpital Necker, Pediatric Noninvasive Ventilation and Sleep Unit, and Université de Paris, EA 7330 VIFASOM, Paris, France.
¹² Department of Sleep Medicine, Respiratory Medicine and Allergology, Sahlgrenska University Hospital, Gothenburg, Sweden.
¹³ Sleep Disorder Center, Cardiology Department, Istituto Auxologico Italiano IRCCS, Ospedale San Luca, Milan, Italy.
¹⁴ Department of Medicine and Surgery, University of Milano Bicocca, Milan, Italy.
¹⁵ School of Medicine and the Conway Research Institute, University College Dublin, Department of Respiratory and Sleep Medicine, St. Vincent's Hospital Group, Dublin, Ireland.
¹⁶ European Lung Foundation, Sheffield, UK.
¹⁷ Department of Pulmonary Medicine, Koc University School of Medicine, Istanbul, Turkey.
¹⁸ Department of Clinical Sciences, Respiratory Medicine and Allergology, Faculty of Medicine, Lund University, Lund, Sweden.
¹⁹ Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
²⁰ Sleep Disorders Unit, Department of Respiratory Medicine, Medical School, University of Crete, Heraklion, Greece.
²¹ Sleep Unit, Hospital Joan XXIII, Tarragona, Spain.
²² University Grenoble Alpes, Inserm 1300, HP2, Grenoble, France.
²³ Royal Brompton Hospital, and Harefield NHS Foundation Trust, London, UK.
²⁴ Department of Pulmonology and Leuven University Centre for Sleep and Wake Disorders (LUCS), University Hospitals Leuven, Leuven, Belgium.
²⁵ Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
²⁶ CNR Institute of Translational Pharmacology (IFT) Palermo, Palermo, Italy.

PMID: 40907996
DOI: 10.1183/13993003.00557-2025

Review

European Respiratory Society statement on advanced telemedicine for obstructive sleep apnoea (e-Sleep)

Johan Verbraecken et al. Eur Respir J. 2025.

. 2025 Nov 25;66(5):2500557.

doi: 10.1183/13993003.00557-2025. Print 2025 Nov.

Authors

Affiliations

¹ Antwerp University Hospital and University of Antwerp, Edegem, Belgium johan.verbraecken@uza.be.
² Co-chaired the task force.
³ Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties "G. D'Alessandro" (PROMISE), University of Palermo, Palermo, Italy.
⁴ Department of Respiratory Medicine, Ege University, Izmir, Turkey.
⁵ Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy.
⁶ IRCCS ICS Maugeri, Pavia, Italy.
⁷ Department of Pulmonology and Sleep Disorders Centre, University Hospital Zurich, Zurich, Switzerland.
⁸ Department of Pneumology, CHU Saint Pierre, Université Libre de Bruxelles, Brussels, Belgium.
⁹ Children's Hospital of Eastern Ontario, University of Ottawa, CHEO Research Institute, Ottawa, ON, Canada.
¹⁰ Sleep and Respiratory Function Unit of the Pavia and Montescano Institutes, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy.
¹¹ AP-HP, Hôpital Necker, Pediatric Noninvasive Ventilation and Sleep Unit, and Université de Paris, EA 7330 VIFASOM, Paris, France.
¹² Department of Sleep Medicine, Respiratory Medicine and Allergology, Sahlgrenska University Hospital, Gothenburg, Sweden.
¹³ Sleep Disorder Center, Cardiology Department, Istituto Auxologico Italiano IRCCS, Ospedale San Luca, Milan, Italy.
¹⁴ Department of Medicine and Surgery, University of Milano Bicocca, Milan, Italy.
¹⁵ School of Medicine and the Conway Research Institute, University College Dublin, Department of Respiratory and Sleep Medicine, St. Vincent's Hospital Group, Dublin, Ireland.
¹⁶ European Lung Foundation, Sheffield, UK.
¹⁷ Department of Pulmonary Medicine, Koc University School of Medicine, Istanbul, Turkey.
¹⁸ Department of Clinical Sciences, Respiratory Medicine and Allergology, Faculty of Medicine, Lund University, Lund, Sweden.
¹⁹ Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
²⁰ Sleep Disorders Unit, Department of Respiratory Medicine, Medical School, University of Crete, Heraklion, Greece.
²¹ Sleep Unit, Hospital Joan XXIII, Tarragona, Spain.
²² University Grenoble Alpes, Inserm 1300, HP2, Grenoble, France.
²³ Royal Brompton Hospital, and Harefield NHS Foundation Trust, London, UK.
²⁴ Department of Pulmonology and Leuven University Centre for Sleep and Wake Disorders (LUCS), University Hospitals Leuven, Leuven, Belgium.
²⁵ Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
²⁶ CNR Institute of Translational Pharmacology (IFT) Palermo, Palermo, Italy.

PMID: 40907996
DOI: 10.1183/13993003.00557-2025

Abstract

Telemedicine as a means of remote patient-physician interaction is gaining popularity in nearly every field, and (respiratory) sleep medicine is no exception. Because obstructive sleep apnoea (OSA) is a chronic condition, and requires a continuous treatment and monitoring of therapy success, telematic communications could be useful to establish diagnostic and therapeutic strategies. This statement summarises the evidence and efficacy of telemedicine options in OSA. An interdisciplinary European Respiratory Society (ERS) task force evaluated the scientific literature based on a systematic search and two-step screening process (title/abstract and full text). Although the task force does not make recommendations for clinical practice, it describes its current practice of telemedicine applications in OSA. The literature shows that telemedicine has been studied in different areas of OSA management, with potential benefits. Telemedicine also served as a major research tool to provide big data related to positive airway pressure therapy. Telemedicine results in similar or improved compliance when compared with traditional face-to-face encounters. Telemedicine-based targeted troubleshooting and support based on individual patient data, and a combination via smartphone apps or coaching websites, are feasible and effective. Expanding evidence suggests that telemedicine is probably cost-effective. However, data do not consistently support staff time savings through telemedicine-based solutions. The potential benefits of telemedicine include improved access to healthcare, and increased adherence to (chronic illness) treatment plans. Benefits should be weighed against the overall costs of telemedicine and risks related to suboptimal compliance.

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Conflict of interest statement

Conflict of interest: J. Verbraecken reports grants from SomnoMed, AirLiquide, AstraZeneca, Atos Medical, AuroBindo, Azelis, Vivisol, Mediq, Natus Micromed OSG, Bioprojet, Desitin, Epilog, Idorsa, Inspire Medical Systems, Löwenstein Medical, Nyxoah, Philips, ProSomnus, ResMed, Sefam, SD Worx, SOS Oxygène, Tilman, Total Care, Westfalen Medical, Vlaamse Gemeenschap, Vlerick, Withings and Zoll Itamar, consultancy fees from Bioprojet and Epilog, payment or honoraria for lectures, presentations, manuscript writing or educational events from Atos Medical, DEME, Bioprojet, Inspire Medical Systems, Idorsia, SD Worx, Vlaamse Gemeenschap, Vlerick, Total Care, and Azelis, and support for attending meetings from Bioprojet. R. Bellazzi reports participation on a data safety monitoring board or advisory board with Merck Healthcare, and stock (or stock options) with Biomeris s.r.l and Engenome s.r.l. M. Bradicich reports payment or honoraria for lectures, presentations, manuscript writing or educational events from ERS International Congress (2022, 2023, 2024), and is the ERS ECM Representative for Assembly 4 (2020–2023). M. Bruyneel reports grants from AstraZeneca, Chiesi, GlaxoSmithKline, ResMed and Philips, payment or honoraria for lectures, presentations, manuscript writing or educational events from AstraZeneca, Chiesi, Resmed, Philips and GlaxoSmithKline, support for attending meetings from GlaxoSmithKline, Sanofi, and Vivisol, and participation on a data safety monitoring board or advisory board with AstraZeneca and GlaxoSmithKline. R.H. Ersu reports grants from Children's Hospital of Eastern Ontario Research Institute and Canadian Health Research Institute. F. Fanfulla reports payment or honoraria for lectures, presentations, manuscript writing or educational events from Idorsia, Sapio, GlaxoSmithKline and Jazz, and support for attending meetings from Vivisol. L. Grote reports grants from Swedish Heart and Lung Foundation, Regional research support (ALF), and EU Horizon 2020 grant “Sleep Revolution”, royalties or licences from Desitin, consultancy fees from Onera, payment or honoraria for lectures, presentations, manuscript writing or educational events from Resmed, Lundbeck, Löwenstein, and AstraZeneca, participation on a data safety monitoring board or advisory board with Onera, and leadership role with National guideline committee for OSA in adults, National quality registry for OSA in adults (SESAR), and CRC ESADA of the ERS, and is shareholder in a company with a license agreement with Desitin GMBH for drug treatment in OSA. W.T. McNicholas reports support for the present study from Horizon 2020 research and innovation programme “Sleep Revolution”, payment or honoraria for lectures, presentations, manuscript writing or educational events from Bioprojet, and leadership role with Work Package relating to ESRS in Horizon 2020 research and innovation programme “Sleep Revolution”. Y. Peker reports grants from ResMed Foundation. R. Tamisier reports grants from Bioprojet, ResMed, Vitalaire, Philips, Mutualia and the AGPMC Foundation, consultancy fees from Bioprojet, Jazz Pharmaceuticals, Resmed, Navigant, Inspire and Idorsia, payment or honoraria for lectures, presentations, manuscript writing or educational events from Jazz Pharmaceuticals, Bioprojet, Resmed, Idorsia, Inspire and Elivie, support for attending meetings from Agiradom, and participation on a data safety monitoring board or advisory board with Bioprojet and Narval (Resmed). D. Testelmans reports payment or honoraria for lectures, presentations, manuscript writing or educational events from Resmed, Inspire Medical Systems and Nyxoah. T. Tonia acts as ERS methodologist. P-H. van Mechelen reports payment or honoraria for lectures, presentations, manuscript writing or educational events from Slaapcursus der Lage Landen Antwerp, and support for attending meetings from MedTech Forum Barcelona and ERS-ESRS S&B Conference Prague. M.R. Bonsignore reports consultancy fees from Takeda and Eli Lilly, payment or honoraria for lectures, presentations, manuscript writing or educational events from Bioprojet, and participation on a data safety monitoring board or advisory board with Bioprojet. The remaining authors have no potential conflicts of interest to disclose.

Comment in

How far are we with telemedicine in sleep apnoea and chronic respiratory failure?
Wijkstra P, Pépin JL. Wijkstra P, et al. Eur Respir J. 2025 Nov 25;66(5):2501636. doi: 10.1183/13993003.01636-2025. Print 2025 Nov. Eur Respir J. 2025. PMID: 41290321 No abstract available.

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European Respiratory Society statement on advanced telemedicine for obstructive sleep apnoea (e-Sleep)

Affiliations

European Respiratory Society statement on advanced telemedicine for obstructive sleep apnoea (e-Sleep)

Authors

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Abstract

Conflict of interest statement

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