Screening Programs for Obstructive Sleep Apnea

Abstract

The aim of this article is to describe the literature on the rationale, methods, and outcomes of screening programs for obstructive sleep apnea (OSA). The evidence does not support screening for OSA in the general population. Instead, targeted case finding is advised among the following high-risk groups: patients with obesity, congestive heart failure, atrial fibrillation, treatment refractory hypertension, type 2 diabetes, stroke, nocturnal dysrhythmias, and pulmonary hypertension. However, the method of screening remains unclear with some studies suggesting the use of questionnaires to identify risk for OSA prior to polysomnography (PSG), while others recommend 2-step screening involving questionnaires and portable monitors. Commercial motor vehicle (CMV) drivers should undergo universal screening. There is a clear rationale for screening, and target populations for screening have been identified. However, the method of screening is not yet clear. Randomized trials should be done to compare the outcomes of screening versus no screening for OSA among the high-risk populations.