osa screening

the us preventive services task force (uspstf) has published a recommendation on screening for obstructive sleep apnea in adults. people with obstructive sleep apnea often stop breathing for short periods or have decreased airflow with breathing during sleep because of a blockage in the airway. the major symptoms of obstructive sleep apnea are loud snoring and daytime sleepiness or fatigue. treatment with a continuous positive airway pressure (cpap) machine or wearing a mouthpiece while sleeping can reduce some symptoms of obstructive sleep apnea such as daytime sleepiness. screening for obstructive sleep apnea can be done via questionnaires that ask about symptoms.




the uspstf recommendation applies to adults who have no symptoms or unrecognized symptoms of obstructive sleep apnea in the primary care setting. the potential benefit of screening for obstructive sleep apnea is earlier treatment, which can improve breathing during sleep and decrease daytime sleepiness, thereby improving sleep-related quality of life. potential harms of screening for obstructive sleep apnea also include treatment, which includes side effects from cpap treatment, such as discomfort in the nose or mouth area from using the cpap mask. evidence is lacking for both potential benefits and potential harms of obstructive sleep apnea screening in adults in the primary care setting, and there is not enough evidence to show that the benefits of screening, early detection, and treatment of obstructive sleep apnea outweigh the harms. the uspstf concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for obstructive sleep apnea in adults (an “i” recommendation). screening for obstructive sleep apnea in adults: us preventive services task force recommendation statement.

obstructive sleep apnea (osa) severity category definitions follow those provided in table 1. for the meta-analysis of severe osa, 2 studies were included that provided data for participants with severe osa combined with some or all participants with moderate osa (marshall et al153 and gooneratne et al147). to inform a recommendation by the us preventive services task force (uspstf), the evidence on test accuracy and benefits and harms of screening and treatment for osa in populations and settings relevant to us primary care was reviewed. studies of people referred to sleep laboratories because of concern for osa were excluded, and studies in which only a subgroup (usually the highest-risk group) underwent polysomnography were excluded because of concern for verification bias. for the association between ahi and health outcomes (kq6), prospective cohort studies that followed up participants for at least 1 year were included. three studies were included (table 3).28-30 one evaluated the berlin questionnaire,28 and 2 evaluated the multivariable apnea prediction (mvap) score, alone and when followed by in-home portable monitoring.29,30 details of the questions and scoring are reported in the ebackground in the supplement. most trials lasted for 12 weeks or less, but 5 trials treated participants for 24 weeks or longer,70,96,97,99,107 including 2 that followed up participants for 52 weeks96,107 and 1 that did so for a median of 4 years.97 mean age was 40s to 50s in most studies (range, 42-71). most were 12 weeks or less in duration; 5 followed up participants for 24 weeks,70,99 48 to 52 weeks,96,107 or longer.97 the meta-analyses found that cpap was associated with reduction of ess scores compared with sham cpap (wmd, −2.0 [95% ci, −2.6 to −1.4]; 22 trials, 2721 participants) and other controls (wmd, −2.2 [95% ci, −2.8 to −1.6]; 12 trials, 2488 participants) (efigures 3 and 4 in the supplement).

sample sizes ranged from 32123 to 67.124 overall, the trials provided limited evidence and found no significant reduction in ahi, ess scores, or blood pressure, with the exception of the trials of uvulopalatopharyngoplasty124 and laser-assisted uvulopalatoplasty,126 which found greater reductions in ahi for surgery than for no treatment (−26.4 [95% ci, −36.2 to −16.6] and −10.5 [95% ci, −16.9 to −4.1], respectively). eight rcts reported on the incidence of 1 or more cardiovascular and cerebrovascular events (etable 29 in the supplement).63,70,76,93,97,99,103,107 overall, too few cardiovascular and cerebrovascular events were observed to draw conclusions. reporting of harms in the included studies was sparse. very few eligible studies evaluated the accuracy of questionnaires or prediction tools for distinguishing people in the general population who are more or less likely to have osa. in general, the adverse events related to cpap treatment were likely short-lived and could be alleviated with discontinuation of cpap or additional interventions. the ability to describe the direct evidence on the effectiveness or harms of screening was inadequate, because no studies comparing screened and unscreened populations were identified. comments from reviewers were presented to the uspstf during its deliberation of the evidence and were considered in preparing the final evidence review.

screening symptoms and signs obstructive sleep apnea (osa)? please answer the following questions osa – intermediate risk : yes to 3 – 4 questions there are four screening tools widely recognized as being fairly easy to administer: stop, stop-bang (sb), epworth sleepiness scale (ess), and 4 the stop-bang questionnaire is one of the most widely accepted screening tools for osa. osa (obstructive sleep apnea) is associated with increased risk of, stop bang osa, stop bang osa, sleep apnea screening tool pdf, stop-bang questionnaire pdf, stop-bang score 5.

observational studies have reported an association between severe osa and mortality risk. in theory, screening for osa could improve mortality screening for obstructive sleep apnea can be done via questionnaires that ask about symptoms. if the questionnaire answers suggest obstructive sleep apnea, screening to identify unrecognized osa followed by appropriate treatment might improve sleep quality and normalize the ahi and oxygen saturation, stop-bang score anesthesia, stop-bang meaning, stop-bang score interpretation, obstructive sleep apnea.

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