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New OSA Testing Guideline, Summarized

New OSA Testing Guideline, Summarized


  • The worst thing in the world is to try to sleep and not to.—F. Scott Fitzgerald

  • No Other Tools Without Polysomnography. Do not use clinical tools, questionnaires, and prediction algorithms for the diagnosis of OSA in adults in the absence of polysomnography or home sleep apnea testing (strong recommendation).

  • Test When Risk is Increased. Use polysomnography or home sleep apnea testing with a technically adequate device for the diagnosis of OSA in uncomplicated adult patients who present with signs and symptoms that indicate an increased risk of moderate to severe OSA (strong recommendation).

  • If a Single Test Result is Negative. Perform polysomnography for the diagnosis of OSA If a single home sleep apnea test result is negative, inconclusive, or technically inadequate (strong recommendation).

  • Strong Candidates for Polysomnography. Use polysomnography, not home sleep apnea testing, for the diagnosis in patients with significant cardiorespiratory disease, potential respiratory muscle weakness resulting from a neuromuscular condition, awake hypoventilation or suspicion of sleep related hypoventilation, chronic opioid medication use, a history of stroke, or severe insomnia (strong recommendation).

  • Split-night Diagnostic Protocol. If clinically appropriate, use a split-night diagnostic protocol rather than a full-night diagnostic protocol for polysomnography for the diagnosis of OSA (weak recommendation).

  • Consider a Second Polysomnogram. When the initial polysomnography result is negative and clinical suspicion for OSA remains, consider a second polysomnogram for the diagnosis of OSA (weak recommendation).

  • Good Practice Statements. The task force adopted foundational recommendations from previous guidelines that establish the basis for appropriate and effective OSA diagnosis: (1) Diagnostic testing for OSA should be performed in conjunction with a comprehensive sleep evaluation and adequate follow-up. (2) Polysomnography is the standard diagnostic test for the diagnosis of OSA in adult patients in whom there is a concern for OSA based on a comprehensive sleep evaluation.

Six clinical practice recommendations for the diagnosis of obstructive sleep apnea (OSA) in adults are offered in a new clinical practice guideline from the American Academy of Sleep Medicine (AASM).

An estimated 30 million adults in the United States have OSA, the AASM noted, and the risk of numerous other health problems—including hypertension and cardiovascular disease—is greater in these patients.

Scroll through the slides above for the AASM’s new clinical practice recommendations and “good practice statements.”

 

SOURCES

AASM publishes new guideline for diagnostic testing for adult sleep apnea

Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline

 

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