Paul Shekelle, MD, PhD; Jon-Erik C. Holty, MD, MS; Douglas K. Owens, MD, MS; Amir Qaseem, MD, PhD, MHA
Potential Conflicts of Interest: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M12-3188.
Shekelle P., Holty J., Owens D., Qaseem A.; Management of Obstructive Sleep Apnea in Adults. Ann Intern Med. 2014;160:367-368. doi: 10.7326/L14-5005-2
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Published: Ann Intern Med. 2014;160(5):367-368.
Evidence shows that CPAP improves Epworth Sleepiness Scale scores, decreases the Apnea–Hypopnea Index and arousal index scores, and increases oxygen saturation. Furthermore, we do not state that surgery has no benefit. Rather, we state that “[e]vidence to evaluate the relative efficacy of surgical interventions for OSA treatment was insufficient.”
The Agency for Healthcare Research and Quality's comparative effectiveness review (1) identified a single high-quality, short-term RCT of OSA surgery (2) but concluded that there was no statistically significant difference in Epworth Sleepiness Scale or Apnea–Hypopnea Index scores, minimum oxygen saturation, or quality of life. Therefore, the benefit of surgery is uncertain because no RCTs showed benefit.
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