Management of Obstructive Sleep Apnea in Adults
Authors: Robson Capasso, Eric Kezirian, Ofer Jacobowitz, Edward M. Weaver
Journal: Annals of Internal Medicine (2014)

Letters4 March 2014Management of Obstructive Sleep Apnea in AdultsRobson Capasso, MD, Eric Kezirian, MD, MPH, Ofer Jacobowitz, MD, PhD, and Edward M. Weaver, MD, MPHRobson Capasso, MDFrom Stanford University, Palo Alto, California; University of Southern California, Los Angeles, California; Mount Sinai School of Medicine, New York, New York; and Veterans Affairs Puget Sound Health Care System, University of Washington, Seattle, Washington.Search for more papers by this author, Eric Kezirian, MD, MPHFrom Stanford University, Palo Alto, California; University of Southern California, Los Angeles, California; Mount Sinai School of Medicine, New York, New York; and Veterans Affairs Puget Sound Health Care System, University of Washington, Seattle, Washington.Search for more papers by this author, Ofer Jacobowitz, MD, PhDFrom Stanford University, Palo Alto, California; University of Southern California, Los Angeles, California; Mount Sinai School of Medicine, New York, New York; and Veterans Affairs Puget Sound Health Care System, University of Washington, Seattle, Washington.Search for more papers by this author, and Edward M. Weaver, MD, MPHFrom Stanford University, Palo Alto, California; University of Southern California, Los Angeles, California; Mount Sinai School of Medicine, New York, New York; and Veterans Affairs Puget Sound Health Care System, University of Washington, Seattle, Washington.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L14-5005 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Qaseem and colleagues’ clinical practice guideline on obstructive sleep apnea (OSA) (1) states, “no randomized trials evaluated the long-term clinical outcomes of [continuous positive airway pressure (CPAP)] use, such as death or cardiovascular illness, and evidence showing the effect of CPAP on quality of life was inconsistent and therefore inconclusive.” Nevertheless, the guideline strongly recommends CPAP as initial therapy for OSA.We agree that surgery is usually used after CPAP failure but disagree that “[c]urrent evidence evaluating surgery was limited and insufficient to show the benefits of surgery for OSA.” This statement contrasts with their recommendation of ...References1. Qaseem A, Holty JE, Owens DK, Dallas P, Starkey M, Shekelle P; for the Clinical Guidelines Committee of the American College of Physicians. Management of Obstructive Sleep Apnea in Adults: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2013;:. [PMID: 24061345] MedlineGoogle Scholar2. Balk EM, Moorthy D, Obadan NO, Patel K, Ip S, Chung M, et al. Diagnosis and Treatment of Obstructive Sleep Apnea in Adults. Comparative Effectiveness Review no. 32. AHRQ Publication no. 11-EHC052-EF. Rockville, MD: Agency for Healthcare Research and Quality; 2011. Google Scholar3. Woodson BT, Steward DL, Weaver EM, Javaheri S. A randomized trial of temperature-controlled radiofrequency, continuous positive airway pressure, and placebo for obstructive sleep apnea syndrome. Otolaryngol Head Neck Surg. 2003;128:848-61. [PMID: 12825037] CrossrefMedlineGoogle Scholar4. Weaver EM, Maynard C, Yueh B. Survival of veterans with sleep apnea: continuous positive airway pressure versus surgery. Otolaryngol Head Neck Surg. 2004;130:659-65. [PMID: 15195049] CrossrefMedlineGoogle Scholar5. Solomon MJ, McLeod RS. Should we be performing more randomized controlled trials evaluating surgical operations? Surgery. 1995;118:459-67. [PMID: 7652679] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Stanford University, Palo Alto, California; University of Southern California, Los Angeles, California; Mount Sinai School of Medicine, New York, New York; and Veterans Affairs Puget Sound Health Care System, University of Washington, Seattle, Washington.Disclaimer: The opinions expressed in this letter are those of the authors and do not necessarily represent the official views of the Department of Veterans Affairs.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L13-1150. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoManagement of Obstructive Sleep Apnea in Adults: A Clinical Practice Guideline From the American College of Physicians Amir Qaseem , Jon-Erik C. Holty , Douglas K. Owens , Paul Dallas , Melissa Starkey , Paul Shekelle , and Management of Obstructive Sleep Apnea in Adults Paul Shekelle , Jon-Erik C. Holty , Douglas K. Owens , and Amir Qaseem Management of Obstructive Sleep Apnea in Adults Paul Shekelle , Jon-Erik C. Holty , Douglas K. Owens , and Amir Qaseem Metrics Cited ByNational Institutes of Health Funding for Obstructive Sleep ApneaImpact of Successful Treatment of Acromegaly on Overnight Heart Rate Variability and Sleep Apnea 4 March 2014Volume 160, Issue 5Page: 367KeywordsContinuous positive airway pressureObservational studiesQuality of lifeResearch quality assessmentSleep apneaSurgeryTreatment guidelines ePublished: 4 March 2014 Issue Published: 4 March 2014 CopyrightCopyright © 2014 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...