International Consensus Statement on Obstructive Sleep Apnea
Authors: Chang Jolie L. , Goldberg Andrew N. , Alt Jeremiah A. , Mohammed Alzoubaidi , Ashbrook Liza , Auckley Dennis , Ayappa Indu , Bakhtiar Hira , Barrera José E. , Bartley Bethany L. , Billings Martha E. , Boon Maurits S. , Bosschieter Pien , Braverman Itzhak , Brodie Kara , Cabrera‐Muffly Cristina , Caesar Ray , Cahali Michel B. , Cai Yi , Cao Michelle , Capasso Robson , Caples Sean M. , Chahine Lana M. , Chang Corissa P. , Chang Katherine W. , Chaudhary Nilika , Cheong Crystal S. J. , Chowdhuri Susmita , Cistulli Peter A. , Claman David , Collen Jacob , Coughlin Kevin C. , Creamer Jennifer , Davis Eric M. , Dupuy‐McCauley Kara L. , Durr Megan L. , Dutt Mohan , Ali Mazen El , Elkassabany Nabil M. , Epstein Lawrence J. , Fiala Justin A. , Freedman Neil , Gill Kirat , Gillespie M. Boyd , Golisch Lea , Gooneratne Nalaka , Gottlieb Daniel J. , Green Katherine K. , Gulati Arushi , Gurubhagavatula Indira , Hayward Nathan , Hoff Paul T. , Hoffmann Oliver M.G. , Holfinger Steven J. , Hsia Jennifer , Huntley Colin , Huoh Kevin C. , Huyett Phillip , Inala Sanjana , Ishman Stacey L. , Jella Tarun K. , Jobanputra Aesha M. , Johnson Andrew P. , Junna Mithri R. , Kado Jenna T. , Kaffenberger Thomas M. , Kapur Vishesh K. , Kezirian Eric J. , Khan Meena , Kirsch Douglas B. , Kominsky Alan , Kryger Meir , Krystal Andrew D. , Kushida Clete A. , Kuzniar Thomas J. , Lam Derek J. , Lettieri Christopher J. , Lim Diane C. , Lin Hsin‐Ching , Liu Stanley Y.C. , MacKay Stuart G. , Magalang Ulysses J. , Malhotra Atul , Mansukhani Meghna P. , Maurer Joachim T. , May Anna M. , Mitchell Ron B. , Mokhlesi Babak , Mullins Anna E. , Nada Eman M. , Naik Sreelatha , Nokes Brandon , Olson Michael D. , Pack Allan I. , Pang Edward B. , Pang Kenny P. , Patil Susheel P. , Van de Perck Eli , Piccirillo Jay F. , Pien Grace W. , Piper Amanda J. , Plawecki Andrea , Quigg Mark , Ravesloot Madeline J.L. , Redline Susan , Rotenberg Brian W. , Ryden Armand , Sarmiento Kathleen F. , Sbeih Firas , Schell Amy E. , Schmickl Christopher N. , Schotland Helena M. , Schwab Richard J. , Seo Jiyeon , Shah Neomi , Shelgikar Anita Valanju , Shochat Isaac , Soose Ryan J. , Steele Toby O. , Stephens Erika , Stepnowsky Carl , Strohl Kingman P. , Sutherland Kate , Suurna Maria V. , Thaler Erica , Thapa Sritika , Vanderveken Olivier M. , de Vries Nico , Weaver Edward M. , Weir Ian D. , Wolfe Lisa F. , Woodson B. Tucker , Won Christine H.J. , Xu Josie , Yalamanchi Pratyusha , Yaremchuk Kathleen , Yeghiazarians Yerem , Yu Jason L. , Zeidler Michelle , Rosen Ilene M. 
Published: September 2022

Background

Evaluation and interpretation of the literature on obstructive sleep apnea (OSA) allows for consolidation and determination of the key factors important for clinical management of the adult OSA patient. Toward this goal, an international collaborative of multidisciplinary experts in sleep apnea evaluation and treatment have produced the International Consensus statement on Obstructive Sleep Apnea (ICS:OSA).

Methods

Using previously defined methodology, focal topics in OSA were assigned as literature review (LR), evidence‐based review (EBR), or evidence‐based review with recommendations (EBR‐R) formats. Each topic incorporated the available and relevant evidence which was summarized and graded on study quality. Each topic and section underwent iterative review and the ICS:OSA was created and reviewed by all authors for consensus.

Results

The ICS:OSA addresses OSA syndrome definitions, pathophysiology, epidemiology, risk factors for disease, screening methods, diagnostic testing types, multiple treatment modalities, and effects of OSA treatment on multiple OSA‐associated comorbidities. Specific focus on outcomes with positive airway pressure (PAP) and surgical treatments were evaluated.

Conclusion

This review of the literature consolidates the available knowledge and identifies the limitations of the current evidence on OSA. This effort aims to create a resource for OSA evidence‐based practice and identify future research needs. Knowledge gaps and research opportunities include improving the metrics of OSA disease, determining the optimal OSA screening paradigms, developing strategies for PAP adherence and longitudinal care, enhancing selection of PAP alternatives and surgery, understanding health risk outcomes, and translating evidence into individualized approaches to therapy.