Friday, 22 Mar 2019

You are here

AASM Guidelines for Sleep Apnea Testing

A task force from the American Academy of Sleep Medicine (AASM) performed a systematic review of the scientific literature on obstructive sleep apnea and screening tests.

Nearly 30 million adults in the United States have OAS. Moreover the majority of OSA remains undiagnosed.  It is  characterized by recurrent complete (apnea) or partial (hypopnea) obstruction of the upper airway during sleep, resulting in snoring, intermittent hypoxemia and hypercapnia, and sleep fragmentation.

Major recommendations

  • Screening questionnaires and prediction algorithms should not be used to diagnose OSA in the absence of polysomnography or home sleep apnea testing (HSAT) (moderate evidence; strong recommendation).
  • Facility-based polysomnography or HSAT with a technically adequate device should be used for diagnosis of OSA in uncomplicated adult cases with suspected moderate to severe OSA (moderate evidence; strong recommendation).
  • Facility-based polysomnography, rather than HSAT, should be used for diagnosis of OSA in complicated cases (those with significant cardiorespiratory disease, potential respiratory muscle weakness due to neuromuscular condition, awake hypoventilation or suspected sleep-related hypoventilation, chronic opioid medication use, history of stroke, or severe insomnia) (very weak evidence; strong recommendation).
  • When facility-based polysomnography is used, a split-night (rather than full-night) diagnostic protocol should be used for diagnosis of OSA (low evidence; weak recommendation).

The US Preventive Services Task Force has stated that there is insufficient evidence to support routine screening for OSA in asymptomatic adults.

Disclosures: 
The author has no conflicts of interest to disclose related to this subject

Add new comment

More Like This

New Sleep Medicine Guidelines for Obstructive Sleep Apnea

The American Academy of Sleep Medicine (AASM) has established new guidelines for the evaluation and treatment of sleep-disordered breathing in adults, specifically guiding the use of positive airway pressure (PAP) in the treatment of obstructive sleep apnea (OSA) in adults. 

Pain Drives the Use of Medical Marijuana

A report from the University of Michigan examined state-wide medical marijuana showing most of it is used for chronic pain.

The authors include Kevin Boehnke, Ph.D., Daniel J. Clauw, M.D., Rebecca L. Haffajee, Ph.D., and Saurav Gangopadhyay, M.P.H. undertook this investigation to to assess why people are using cannabis medically. 

Compounded Pain Creams - Expensive Placebos?

The Annals of Internal Medicine reports that the growth and use of compounded pain creams is unwarranted as they were no better than placebo in a randomized controlled trial, suggesting their higher costs are unjustifiable compared to other topical commercially available agents (lidocaine, diclofenac, capsaicin, etc.). (Citation source: https://buff.ly/2BkTj58)

Opioids Double Rates of Suicides and Overdoses

An article in the New England Journal of Medicine reports that the rates of suicide and drug overdoses has doubled in the last 17 years, and that opioids are largely to blame.

Using data from the Centers for Disease Control and Prevention databases, researchers show that the sheer number of deaths from suicides and unintentional overdoses together rose from 41,364 in the year 2000 to 110,749 in 2017.

Cryotherapy Never FDA Approved

Another injury related to whole body cryotherapy (WBC) has been reported by practitioners in Philadelphia, serving as yet another warning of WBC's potential to cause serious adverse effects.