The risk of developing obstructive sleep apnea steadily increases an adult reaches their 70s. | File photo
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Keri Carbaugh | Feb 1, 2017

Obstructive sleep apnea screening has limits, task force says

A recommendation statement and evidence report by the U.S. Preventative Services Task Force (USPSTF) stated that more needs to be done in assessing asymptomatic adults for obstructive sleep apnea (OSA).

This evidence does not apply to assessments of OSA for people with symptoms, concerns, increased risk of OSA, or to people who have been referred for evaluation. The review did not include children, teens or pregnant women.

The USPSTF assigned an ‘I’ grade to the report, indicating that the evidence available is insufficient to assess the benefits and harms of OSA screenings.

“This is the first time that the task force has reviewed the evidence on screening for OSA,” USPSTF member Dr. Alex Krist said. “OSA represents a major health concern; it affects 10 to 15 percent of the U.S. population and is associated with heart disease, diabetes, reduced quality of life and increased risk of death. Primary care doctors want to know if screening is beneficial for patients. Unfortunately, right now, there is not enough evidence to know.”

Although evidence is insufficient according to the USPSTF, the study did find that OSA is more common in men than women. The risk of developing OSA steadily increases with age until an adult reaches their 70s when the risk appears to plateau.

Mandeep Ghuman, an attending physician at the Dignity Health Family Medicine Residency Program at Northridge Hospital in Northridge, California, said it makes sense that there is insufficient evidence for asymptomatic patients because there is still a lot to be done in terms of assessment for symptomatic patients.

"We still don't have great screening tools in primary care for symptomatic patients to make a diagnosis of OSA, so the benefit of screening asymptomatic patients is probably going to be minimal at best," Ghuman said. "Since there is a lack of evidence on improvement in long-term health outcomes with treating OSA (both in symptomatic and asymptomatic patients) and no adequate screening tool for use in a primary care setting for asymptomatic patients, it would be difficult for me to institute the screening of asymptomatic patients within my primary care clinic setting."

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