Robson Capasso, MD; Eric Kezirian, MD, MPH; Ofer Jacobowitz, MD, PhD; Edward M. Weaver, MD, MPH
Disclaimer: The opinions expressed in this letter are those of the authors and do not necessarily represent the official views of the Department of Veterans Affairs.
Potential Conflicts of Interest: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L13-1150.
Capasso R, Kezirian E, Jacobowitz O, Weaver EM. Management of Obstructive Sleep Apnea in Adults. Ann Intern Med. 2014;160:367. doi: 10.7326/L14-5005
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Published: Ann Intern Med. 2014;160(5):367.
TO THE EDITOR:
Qaseem and colleagues’ clinical practice guideline on obstructive sleep apnea (OSA) (1) states, “no randomized trials evaluated the long-term clinical outcomes of [continuous positive airway pressure (CPAP)] use, such as death or cardiovascular illness, and evidence showing the effect of CPAP on quality of life was inconsistent and therefore inconclusive.” Nevertheless, the guideline strongly recommends CPAP as initial therapy for OSA.
We agree that surgery is usually used after CPAP failure but disagree that “[c]urrent evidence evaluating surgery was limited and insufficient to show the benefits of surgery for OSA.” This statement contrasts with their recommendation of CPAP despite its similar evidence limitations.
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