Management of Obstructive Sleep Apnea in Adults
Authors: Paul Shekelle, Jon-Erik C. Holty, Douglas K. Owens, Amir Qaseem
Journal: Annals of Internal Medicine (2014)

Letters4 March 2014Management of Obstructive Sleep Apnea in AdultsPaul Shekelle, MD, PhD, Jon-Erik C. Holty, MD, MS, Douglas K. Owens, MD, MS, and Amir Qaseem, MD, PhD, MHAPaul Shekelle, MD, PhDFrom Greater Los Angeles Veterans Affairs Health Center and RAND Corporation, Los Angeles, California; Veterans Affairs Palo Alto Health Care System, Palo Alto, California; and American College of Physicians, Philadelphia, Pennsylvania., Jon-Erik C. Holty, MD, MSFrom Greater Los Angeles Veterans Affairs Health Center and RAND Corporation, Los Angeles, California; Veterans Affairs Palo Alto Health Care System, Palo Alto, California; and American College of Physicians, Philadelphia, Pennsylvania., Douglas K. Owens, MD, MSFrom Greater Los Angeles Veterans Affairs Health Center and RAND Corporation, Los Angeles, California; Veterans Affairs Palo Alto Health Care System, Palo Alto, California; and American College of Physicians, Philadelphia, Pennsylvania., and Amir Qaseem, MD, PhD, MHAFrom Greater Los Angeles Veterans Affairs Health Center and RAND Corporation, Los Angeles, California; Veterans Affairs Palo Alto Health Care System, Palo Alto, California; and American College of Physicians, Philadelphia, Pennsylvania.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L14-5005-2 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Evidence shows that CPAP improves Epworth Sleepiness Scale scores, decreases the Apnea–Hypopnea Index and arousal index scores, and increases oxygen saturation. Furthermore, we do not state that surgery has no benefit. Rather, we state that "[e]vidence to evaluate the relative efficacy of surgical interventions for OSA treatment was insufficient."The Agency for Healthcare Research and Quality's comparative effectiveness review (1) identified a single high-quality, short-term RCT of OSA surgery (2) but concluded that there was no statistically significant difference in Epworth Sleepiness Scale or Apnea–Hypopnea Index scores, minimum oxygen saturation, or quality of life. Therefore, the benefit of ...References1. 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 Scholar2. 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 Scholar3. Qaseem A, Snow V, Owens DK, Shekelle P; Clinical Guidelines Committee of the American College of Physicians. The development of clinical practice guidelines and guidance statements of the American College of Physicians: summary of methods. Ann Intern Med. 2010;153:194-9. [PMID: 20679562] LinkGoogle Scholar4. Moseley JB, O'Malley K, Petersen NJ, Menke TJ, Brody BA, Kuykendall DH, et al. A controlled trial of arthroscopic surgery for osteoarthritis of the knee. N Engl J Med. 2002;347:81-8. [PMID: 12110735] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Paul Shekelle, MD, PhD; Jon-Erik C. Holty, MD, MS; Douglas K. Owens, MD, MS; Amir Qaseem, MD, PhD, MHAAffiliations: From Greater Los Angeles Veterans Affairs Health Center and RAND Corporation, Los Angeles, California; Veterans Affairs Palo Alto Health Care System, Palo Alto, California; and American College of Physicians, Philadelphia, Pennsylvania.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M12-3188. 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 Robson Capasso , Eric Kezirian , Ofer Jacobowitz , and Edward M. Weaver Management of Obstructive Sleep Apnea in Adults Robson Capasso , Eric Kezirian , Ofer Jacobowitz , and Edward M. Weaver Metrics Cited byAssociation Between Obstructive Sleep Apnea and Barrett's Esophagus: A Systematic Review and Meta-AnalysisAutomated identification of the predominant site of upper airway collapse in obstructive sleep apnoea patients using snore signalIdentifying the Predominant Site of Upper Airway Collapse in Obstructive Sleep Apnoea Patients Using Snore SignalsStrategies in the clinical diagnosis and surgical treatment of OSAHS with multilevel obstructionSystemic Complications of Acromegaly and the Impact of the Current Treatment Landscape: An UpdateBook Review: First, Do Less Harm: Confronting the Inconvenient Problems of Patient Safety by Ross Koppel and Suzanne Gordon 4 March 2014Volume 160, Issue 5Page: 367-368KeywordsObservational studiesObstructive sleep apneaOverweightOxygenPopulation statisticsQuality of lifeResearch quality assessmentSleep apneaSurgery ePublished: 4 March 2014 Issue Published: 4 March 2014 Copyright & PermissionsCopyright © 2014 by American College of Physicians. 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