International Consensus Statement on Obstructive Sleep Apnea

Jolie L. Chang*, Andrew N. Goldberg, Jeremiah A. Alt, Alzoubaidi Mohammed, Liza Ashbrook, Dennis Auckley, Indu Ayappa, Hira Bakhtiar, José E. Barrera, Bethany L. Bartley, Martha E. Billings, Maurits S. Boon, Pien Bosschieter, Itzhak Braverman, Kara Brodie, Cristina Cabrera-Muffly, Ray Caesar, Michel B. Cahali, Yi Cai, Michelle CaoRobson Capasso, Sean M. Caples, Lana M. Chahine, Corissa P. Chang, Katherine W. Chang, Nilika Chaudhary, Crystal S.J. Cheong, Susmita Chowdhuri, Peter A. Cistulli, David Claman, Jacob Collen, Kevin C. Coughlin, Jennifer Creamer, Eric M. Davis, Kara L. Dupuy-McCauley, Megan L. Durr, Mohan Dutt, Mazen El Ali, Nabil M. Elkassabany, Lawrence J. Epstein, Justin A. Fiala, Neil Freedman, Kirat Gill, M. Boyd Gillespie, Lea Golisch, Nalaka Gooneratne, Daniel J. Gottlieb, Katherine K. Green, Arushi Gulati, Indira Gurubhagavatula, Nathan Hayward, Paul T. Hoff, Oliver M.G. Hoffmann, Steven J. 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 Kryger, Andrew D. Krystal, Clete A. Kushida, Thomas J. Kuzniar, Derek J. Lam, Christopher J. Lettieri, Diane C. Lim, Hsin Ching Lin, Stanley Y.C. Liu, Stuart G. MacKay, Ulysses J. Magalang, Atul Malhotra, Meghna P. Mansukhani, Joachim T. Maurer, Anna M. May, Ron B. Mitchell, Babak Mokhlesi, Anna E. Mullins, Eman M. 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, Amanda J. Piper, Andrea Plawecki, Mark Quigg, Madeline J.L. Ravesloot, Susan Redline, Brian W. Rotenberg, Armand Ryden, Kathleen F. Sarmiento, Firas Sbeih, Amy E. Schell, Christopher N. Schmickl, Helena M. Schotland, Richard J. Schwab, Jiyeon Seo, Neomi Shah, Anita Valanju Shelgikar, Isaac Shochat, Ryan J. Soose, Toby O. Steele, Erika Stephens, Carl Stepnowsky, Kingman P. Strohl, Kate Sutherland, Maria V. Suurna, Erica Thaler, Sritika Thapa, Olivier M. Vanderveken, Nico de Vries, Edward M. Weaver, Ian D. Weir, Lisa F. Wolfe, B. Tucker Woodson, Christine H.J. Won, Josie Xu, Pratyusha Yalamanchi, Kathleen Yaremchuk, Yerem Yeghiazarians, Jason L. Yu, Michelle Zeidler, Ilene M. Rosen

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

65 Scopus citations

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.

Original languageEnglish
Pages (from-to)1061-1482
Number of pages422
JournalInternational Forum of Allergy and Rhinology
Volume13
Issue number7
DOIs
StatePublished - Jul 2023
Externally publishedYes

Keywords

  • PAP adherence
  • atrial fibrillation
  • cardiovascular event
  • cerebrovascular disease
  • consensus
  • dementia
  • evidence-based medicine
  • home sleep apnea testing
  • hypertension
  • hypoglossal nerve stimulation
  • mortality
  • motor vehicle accidents
  • neurocognitive function
  • obstructive sleep apnea
  • outcomes
  • perioperative management
  • polysomnography
  • positive airway pressure
  • screening
  • sleep
  • sleep disordered breathing
  • sleep surgery
  • sleepiness
  • surgical outcomes
  • systematic review
  • treatment outcomes
  • uvulopalatopharyngoplasty

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