> In the UK positive pressure machines are only recommended after lifestyle interventions have been tried. The medical opinion in the US is that CPAP is the fi

> In the UK positive pressure machines are only recommended after lifestyle interventions have been tried. The medical opinion in the US is that CPAP is the first-line treatment to be done in parallel with any necessary lifestyle adjustments in all cases of OSA. http://annals.org/article.aspx?articleid=1742606 http://annals.org/article.aspx?articleid=1742606 > Recommendation 1: ACP recommends that all overweight and obese patients diagnosed with OSA should be encouraged to lose weight. (Grade: strong recommendation; low-quality evidence) > Recommendation 2: ACP recommends continuous positive airway pressure treatment as initial therapy for patients diagnosed with OSA. (Grade: strong recommendation; moderate-quality evidence) Though not explicitly stated in the paper, the general consensus I have heard from physicians here (and others in this sub-thread have stated) is that lifestyle intervention is much more likely to fail if CPAP is not initiated in parallel.