The American College of Physicians (ACP) has released a new evidence-based clinical practice guideline for the diagnosis of obstructive sleep apnea (OSA) in adults. Daytime sleepiness is essentially the lynchpin of the new guidelines.
The guideline was published in the Aug. 5 issue of the Annals of Internal Medicine. Amir Qaseem, MD, PhD, from the ACP in Philadelphia, and colleagues developed a guideline, based on published literature from 1966 through May 2013, to provide clinical recommendations for the diagnosis of OSA in adults.
“The researchers found low-quality evidence supporting a weak recommendation for performing a sleep study in patients with unexplained daytime sleepiness,” write reporters at doctorslounge. “A second weak recommendation, based on moderate-quality evidence, advises diagnostic testing with polysomnography in patients suspected of having OSA. When polysomnography is not available, diagnostic testing with portable sleep monitors may be used as an alternative in patients without serious comorbidities.”
Specific recommendations include: Clinicians should target their assessment of OSA to individuals with unexplained daytime sleepiness. This assessment should include evaluation of the risk factors and common presenting symptoms for OSA. The best-documented risk factor for OSA is obesity. Clinical symptoms for OSA include unintentional sleep episodes during wakefulness, daytime sleepiness, unrefreshing sleep, fatigue, insomnia, and snoring.