Vincent Mysliwiec1, Jennifer L Martin2, Christi S Ulmer3, Susmita Chowdhuri4, Matthew S Brock5, Christopher Spevak6, James Sall7. 1. University of Texas Health Science Center at San Antonio, San Antonio, Texas (V.M.). 2. David Geffen School of Medicine at UCLA and VA Greater Los Angeles Healthcare System, Los Angeles, California (J.L.M.). 3. Durham VA Healthcare System and Duke University School of Medicine, Durham, North Carolina (C.S.U.). 4. John D. Dingell VA Sleep Wake Disorders Center and Wayne State University, Detroit, Michigan (S.C.). 5. U.S. Army SAMHS Sleep Medicine Service, San Antonio, Texas, and Wilford Hall Ambulatory Surgical Center, Lackland Air Force Base, Texas (M.S.B.). 6. Walter Reed National Military Medical Center/Defense Health Agency, Bethesda, Maryland (C.S.). 7. Department of Veterans Affairs, Washington, DC (J.S.).
Abstract
Description: In September 2019, the U.S. Department of Veterans Affairs (VA) and the U.S. Department of Defense (DoD) approved a new joint clinical practice guideline for assessing and managing patients with chronic insomnia disorder and obstructive sleep apnea (OSA). This guideline is intended to give health care teams a framework by which to screen, evaluate, treat, and manage the individual needs and preferences of VA and DoD patients with either of these conditions. Methods: In October 2017, the VA/DoD Evidence-Based Practice Work Group initiated a joint VA/DoD guideline development effort that included clinical stakeholders and conformed to the Institute of Medicine's tenets for trustworthy clinical practice guidelines. The guideline panel developed key questions, systematically searched and evaluated the literature, created three 1-page algorithms, and advanced 41 recommendations using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system. Recommendations: This synopsis summarizes the key recommendations of the guideline in 3 areas: diagnosis and assessment of OSA and chronic insomnia disorder, treatment and management of OSA, and treatment and management of chronic insomnia disorder. Three clinical practice algorithms are also included.
Description: In September 2019, the U.S. Department of Veterans Affairs (VA) and the U.S. Department of Defense (DoD) approved a new joint clinical practice guideline for assessing and managing patients with chronic insomnia disorder and obstructive sleep apnea (OSA). This guideline is intended to give health care teams a framework by which to screen, evaluate, treat, and manage the individual needs and preferences of VA and DoD patients with either of these conditions. Methods: In October 2017, the VA/DoD Evidence-Based Practice Work Group initiated a joint VA/DoD guideline development effort that included clinical stakeholders and conformed to the Institute of Medicine's tenets for trustworthy clinical practice guidelines. The guideline panel developed key questions, systematically searched and evaluated the literature, created three 1-page algorithms, and advanced 41 recommendations using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system. Recommendations: This synopsis summarizes the key recommendations of the guideline in 3 areas: diagnosis and assessment of OSA and chronic insomnia disorder, treatment and management of OSA, and treatment and management of chronic insomnia disorder. Three clinical practice algorithms are also included.
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