International Consensus Statement on Obstructive Sleep Apnea
Jolie L. Chang, Andrew N. Goldberg, Jeremiah A. Alt, Mohammed Alzoubaidi, Liza Ashbrook, Dennis Auckley, Indu Ayappa, H. Bakhtiar, José E. Barrera, Bethany L. Bartley, Martha E. Billings, Maurits Boon, Pien F. N. Bosschieter, Itzhak Braverman, Kara D. Brodie, Cristina Cabrera‐Muffly, Ray Caesar, Michel Burihan Cahali, Yi Cai, Michelle Cao, Robson Capasso, Sean M. Caples, Lana M. Chahine, Corissa P. Chang, Katherine W. Chang, Nilika Chaudhary, Crystal Cheong, Susmita Chowdhuri, Peter A. Cistulli, David M. Claman, Jacob Collen, Kevin Coughlin, Jennifer Creamer, Eric M. Davis, Kara Dupuy-McCauley, Megan L. Durr, Mohan Dutt, Mazen El Ali, Nabil Elkassabany, Lawrence J. Epstein, Justin A. Fiala, Neil Freedman, Kirat Gill, M. Boyd Gillespie, Lea Golisch, Nalaka S. Gooneratne, Daniel J. Gottlieb, Katherine K. Green, Arushi Gulati, Indira Gurubhagavatula, Nathan Hayward, Paul Hoff, Oliver M. G. Hoffmann, Steven Holfinger, Jennifer Hsia, Colin Huntley, Kevin C. Huoh, Phillip Huyett, Sanjana Inala, Stacey L. Ishman, Tarun K. Jella, Aesha M. Jobanputra, Andrew P. Johnson, Mithri R. Junna, Jenna T. Kado, Thomas M. Kaffenberger, Vishesh K. Kapur, Eric J. Kezirian, Meena Khan, Douglas B. Kirsch, Alan Kominsky, Meir H. Kryger, Andrew D. Krystal, Clete A. Kushida, Thomas J. Kuzniar, Derek J. Lam, Christopher J. Lettieri, Diane C Lim, Hsin‐Ching Lin, Stanley Yung‐Chuan Liu, Stuart G. MacKay, Ulysses J. Magalang, Atul Malhotra, Meghna P. Mansukhani, Joachim T. Maurer, Anna M. May, Ron B. Mitchell, Babak Mokhlesi, Anna Mullins, Eman Nada, Sreelatha Naik, Brandon Nokes, Michael D. Olson, Allan I Pack, Edward B. Pang, Kenny P. Pang, Susheel P. Patil, Eli Van de Perck, Jay F. Piccirillo, Grace W. Pien
Abstract
BACKGROUND: Evaluation and interpretation of the literature on obstructive sleep apnea (OSA) allows for consolidation and determination of the key factors important for clinical management of the adult OSA patient. Toward this goal, an international collaborative of multidisciplinary experts in sleep apnea evaluation and treatment have produced the International Consensus statement on Obstructive Sleep Apnea (ICS:OSA). METHODS: Using previously defined methodology, focal topics in OSA were assigned as literature review (LR), evidence-based review (EBR), or evidence-based review with recommendations (EBR-R) formats. Each topic incorporated the available and relevant evidence which was summarized and graded on study quality. Each topic and section underwent iterative review and the ICS:OSA was created and reviewed by all authors for consensus. RESULTS: The ICS:OSA addresses OSA syndrome definitions, pathophysiology, epidemiology, risk factors for disease, screening methods, diagnostic testing types, multiple treatment modalities, and effects of OSA treatment on multiple OSA-associated comorbidities. Specific focus on outcomes with positive airway pressure (PAP) and surgical treatments were evaluated. CONCLUSION: This review of the literature consolidates the available knowledge and identifies the limitations of the current evidence on OSA. This effort aims to create a resource for OSA evidence-based practice and identify future research needs. Knowledge gaps and research opportunities include improving the metrics of OSA disease, determining the optimal OSA screening paradigms, developing strategies for PAP adherence and longitudinal care, enhancing selection of PAP alternatives and surgery, understanding health risk outcomes, and translating evidence into individualized approaches to therapy.