Clinical Guideline for the Evaluation, Management and Long-term Care of Obstructive Sleep Apnea in Adults Adult Obstructive Sleep Apnea Task Force of the American Academy of Sleep Medicine

Abstract

10 Winthrop-University Hospital, Mineola, NY Background: Obstructive sleep apnea (OSA) is a common chronic disorder that often requires lifelong care. Available practice param- eters provide evidence-based recommendations for addressing as- pects of care. Objective: This guideline is designed to assist primary care provid- ers as well as sleep medicine specialists, surgeons, and dentists who care for patients with OSA by providing a comprehensive strategy for the evaluation, management and long-term care of adult patients with OSA. Methods: The Adult OSA Task Force of the American Academy of Sleep Medicine (AASM) was assembled to produce a clinical guideline from a review of existing practice parameters and available literature. All existing evidence-based AASM practice parameters relevant to the evaluation and management of OSA in adults were incorporated into this guideline. For areas not covered by the practice parameters, the task force performed a literature review and made consensus recom- mendations using a modified nominal group technique. recommendations: Questions regarding OSA should be incorpo- rated into routine health evaluations. Suspicion of OSA should trigger a comprehensive sleep evaluation. The diagnostic strategy includes a sleep-oriented history and physical examination, objective testing, and education of the patient. The presence or absence and severity of OSA must be determined before initiating treatment in order to identify those patients at risk of developing the complications of sleep apnea, guide selection of appropriate treatment, and to provide a baseline to establish the effectiveness of subsequent treatment. Once the diag- nosis is established, the patient should be included in deciding an ap- propriate treatment strategy that may include positive airway pressure devices, oral appliances, behavioral treatments, surgery, and/or ad- junctive treatments. OSA should be approached as a chronic disease requiring long-term, multidisciplinary management. For each treat- ment option, appropriate outcome measures and long-term follow-up are described.