0478 CLINICAL PRACTICE GUIDELINE FOR DIAGNOSTIC TESTING FOR ADULT OBSTRUCTIVE SLEEP APNEA; AN UPDATE FOR 2016: AN AMERICAN ACADEMY OF SLEEP MEDICINE CLINICAL PRACTICE GUIDELINE

Abstract

The American Academy of Sleep Medicine commissioned a task force of experts in sleep medicine to develop updated clinical practice recommendations based on a systematic review of the literature. 1. We recommend that polysomnography, or home sleep apnea testing with a technically adequate device, be used to diagnose OSA in uncomplicated adult patients presenting with signs and symptoms that indicate an increased risk of moderate to severe OSA. (STRONG) 2. We recommend that if a single home sleep apnea test is negative, inconclusive or technically inadequate, PSG be performed for the diagnosis of OSA in symptomatic patients. (STRONG) 3. We recommend that polysomnography, rather than home sleep apnea testing, be used for the diagnosis of OSA in patients with significant cardiorespiratory disease, neuromuscular disease with respiratory muscle impairment, awake hypoventilation or high risk of sleep related hypoventilation, chronic opioid medication use, or severe insomnia. (STRONG) 4. We suggest that, if clinically appropriate, a split-night diagnostic protocol, rather than a full-night diagnostic protocol for polysomnography be used for the diagnosis of OSA. (WEAK) 5. We suggest that when the initial polysomnogram is negative and there is still clinical suspicion for OSA, a second polysomnogram be considered for the diagnosis of OSA in symptomatic patients. (WEAK) 6. We recommend that clinical tools, questionnaires and prediction algorithms not be used to diagnose OSA in adults, in the absence of objective sleep testing. (STRONG)