The American College of Chest Physicians (CHEST) just released a clinical practice guideline featuring clinical recommendations regarding pregnant patients who live with obstructive sleep apnea (OSA). The guideline, Obstructive Sleep Apnea (OSA) in Pregnancy, features recommendations assembled following a review of the latest literature. A total of nine recommendations were formed by an expert panel based on the available evidence and panel consensus.

Today, we’re outlining those nine recommendations below. All recommendations in the guideline are conditional recommendations with very low certainty of evidence. For the most thorough look at the following recommendations from the 2026 CHEST guideline Obstructive Sleep Apnea (OSA) in Pregnancy, view the full-text version.

Recommendations from the 2026 CHEST Guideline on OSA in Pregnancy:
  • In pregnant individuals on CPAP for OSA prior to pregnancy, we suggest APAP be used rather than continued CPAP.
  • In pregnant individuals, we suggest screening for OSA.
  • In pregnant individuals being screened for OSA, we suggest screening using either a pregnancy-specific tool or a standard screening tool.
  • In pregnant individuals undergoing evaluation for OSA, we suggest either at home diagnostic devices or lab-based diagnostics be used.
  • In pregnant individuals diagnosed with OSA during pregnancy, we suggest that treatment be offered for those with an AHI of 5-15 when accompanied by symptoms, sequelae, or comorbidities/ additional risk factors (e.g. hypertension, diabetes, stroke). For AHI >15, PAP therapy is recommended regardless of symptoms or comorbidities.
  • In pregnant individuals diagnosed with OSA during pregnancy in whom treatment is recommended, we suggest that any form of PAP treatment be used over no treatment.
  • In pregnant individuals diagnosed with OSA during pregnancy for whom treatment is recommended, we suggest using PAP therapy rather than alternative therapies.
  • In pregnant individuals with residual sleepiness currently on PAP therapy for OSA, we suggest using scheduled naps whenever possible, and only using stimulants on an as-needed basis after failure of scheduled naps.
  • In individuals previously diagnosed with OSA during pregnancy, we suggest reassessment for OSA after delivery.

Check out our other sleep medicine-related content and be sure to sign up for alerts to stay informed on the latest published guidelines and articles.