USPSTF finds insufficient evidence for widespread obstructive sleep apnea screening

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Sleep Disorders

The USPSTF gave existing evidence an “I” recommendation.
The USPSTF gave existing evidence an “I” recommendation.

The USPSTF has found insufficient evidence to assess the balance of benefits and harms of screening for obstructive sleep apnea (OSA) in asymptomatic adults.

The estimated prevalence of mild OSA is 10% and 3.8% to 6.5% for moderate to severe OSA, and although OSA is linked to increased all-cause mortality, the exact role that OSA plays in this is unclear. The USPSTF identified existing evidence on the use of screening questionnaires in asymptomatic adults to potentially identify who may benefit from OSA testing to be inadequate.

Additionally, the USPSTF found no studies that evaluated the effect of OSA screening on health outcomes. Adequate evidence was found that indicates treatment with a continuous positive airway pressure (CPAP) machine or a mandibular advancement device (MAD) may improve intermediate outcomes, and inadequate evidence was found to suggest that CPAP or MAD treatment can improve other health outcomes such as cognitive impairment or cardiovascular or cerebrovascular events. Inadequate evidence exists to assess any potential harms of OSA screening.

“Overall, the USPSTF found insufficient evidence on screening for OSA in … adults with unrecognized symptoms. No studies directly evaluated the benefits or harms of screening for OSA. Few studies evaluated the accuracy of specific screening tools … [and] although numerous studies evaluated the effectiveness to treatment with CPAP or MAD to improve intermediate outcomes … the clinical significance of these changes and applicability of this evidence is unclear,” the report concluded.

Reference

  1. Obstructive Sleep Apnea in Adults: Screening [draft recommendation statement]. Rockville, MD: US Preventive Services Task Force. Accessed June 15, 2016. 
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