Kirsten Bibbins-Domingo1, David C Grossman2, Susan J Curry3, Karina W Davidson4, John W Epling5, Francisco A R García6, Jessica Herzstein7, Alex R Kemper8, Alex H Krist9, Ann E Kurth10, C Seth Landefeld11, Carol M Mangione12, William R Phillips13, Maureen G Phipps14, Michael P Pignone15, Michael Silverstein16, Chien-Wen Tseng17. 1. University of California, San Francisco. 2. Group Health Research Institute, Seattle, Washington. 3. University of Iowa, Iowa City. 4. Columbia University, New York, New York. 5. State University of New York Upstate Medical University, Syracuse. 6. Pima County Department of Health, Tucson, Arizona. 7. Independent consultant, Washington, DC. 8. Duke University, Durham, North Carolina. 9. Fairfax Family Practice Residency, Fairfax, Virginia10Virginia Commonwealth University, Richmond. 10. Yale University, New Haven, Connecticut. 11. University of Alabama at Birmingham. 12. University of California, Los Angeles. 13. University of Washington, Seattle. 14. Brown University, Providence, Rhode Island. 15. University of Texas at Austin. 16. Boston University, Boston, Massachusetts. 17. University of Hawaii, Manoa.
Abstract
IMPORTANCE: Based on data from the 1990s, estimated prevalence of obstructive sleep apnea (OSA) in the United States is 10% for mild OSA and 3.8% to 6.5% for moderate to severe OSA; current prevalence may be higher, given the increasing prevalence of obesity. Severe OSA is associated with increased all-cause mortality, cardiovascular disease and cerebrovascular events, diabetes, cognitive impairment, decreased quality of life, and motor vehicle crashes. OBJECTIVE: To issue a new US Preventive Services Task Force (USPSTF) recommendation on screening for OSA in asymptomatic adults. EVIDENCE REVIEW: The USPSTF reviewed the evidence on the accuracy, benefits, and potential harms of screening for OSA in asymptomatic adults seen in primary care, including those with unrecognized symptoms. The USPSTF also evaluated the evidence on the benefits and harms of treatment of OSA on intermediate and final health outcomes. FINDINGS: The USPSTF found insufficient evidence on screening for or treatment of OSA in asymptomatic adults or adults with unrecognized symptoms. Therefore, the USPSTF was unable to determine the magnitude of the benefits or harms of screening for OSA or whether there is a net benefit or harm to screening. CONCLUSIONS AND RECOMMENDATION: The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for OSA in asymptomatic adults. (I statement).
IMPORTANCE: Based on data from the 1990s, estimated prevalence of obstructive sleep apnea (OSA) in the United States is 10% for mild OSA and 3.8% to 6.5% for moderate to severe OSA; current prevalence may be higher, given the increasing prevalence of obesity. Severe OSA is associated with increased all-cause mortality, cardiovascular disease and cerebrovascular events, diabetes, cognitive impairment, decreased quality of life, and motor vehicle crashes. OBJECTIVE: To issue a new US Preventive Services Task Force (USPSTF) recommendation on screening for OSA in asymptomatic adults. EVIDENCE REVIEW: The USPSTF reviewed the evidence on the accuracy, benefits, and potential harms of screening for OSA in asymptomatic adults seen in primary care, including those with unrecognized symptoms. The USPSTF also evaluated the evidence on the benefits and harms of treatment of OSA on intermediate and final health outcomes. FINDINGS: The USPSTF found insufficient evidence on screening for or treatment of OSA in asymptomatic adults or adults with unrecognized symptoms. Therefore, the USPSTF was unable to determine the magnitude of the benefits or harms of screening for OSA or whether there is a net benefit or harm to screening. CONCLUSIONS AND RECOMMENDATION: The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for OSA in asymptomatic adults. (I statement).
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