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Diagnosis and Management of Obstructive Sleep Apnea
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<blockquote data-quote="madman" data-source="post: 235256" data-attributes="member: 13851"><p><strong>Box. Commonly Asked Questions About Obstructive Sleep Apnea (OSA) </strong></p><p><strong></strong></p><p><strong>What is the most sensitive and specific question for identifying OSA? </strong></p><p><em>“Do you snore” is the most sensitive and “Do you stop breathing during sleep” is the most specific question to identify a patient at risk for OSA.</em></p><p></p><p></p><p><strong>Does every patient with overweight or obesity need to be referred for a sleep study? </strong></p><p><em>Although overweight and obesity are strong risk factors for OSA, not every patient overweight or obese needs to undergo a sleep study. However, they should be questioned for OSA-related signs and symptoms. Most asymptomatic patients do not need to be referred for a sleep study.</em></p><p></p><p></p><p><strong>Do patients need to spend a night in the sleep laboratory for diagnosis and management of OSA?</strong></p><p><em>For most patients in whom OSA is suspected, the diagnosis can be made with a home sleep apnea test, in which a sleep apnea monitor is worn overnight in the patient’s home. If OSA is confirmed by the home test, positive airway pressure (PAP) therapy can usually be initiated at home using an automatic titrating PAP device. If there is a high suspicion of OSA and the home test findings are negative for OSA, laboratory-based polysomnography should be recommended.</em></p><p></p><p></p><p><strong>What are the benefits of managing OSA? </strong></p><p><em>Daytime sleepiness, fatigue, quality of life, and blood pressure have all been documented to improve the management of OSA. Current evidence suggests that treatment does not reduce the risk of cardiovascular disease, stroke, or metabolic abnormalities in asymptomatic patients.</em></p><p></p><p></p><p><strong>What should a patient with OSA do if they need to have surgery? </strong></p><p></p><p><em>Patients with known OSA should inform all clinicians involved in their perioperative care, including their surgeon and anesthesiologist, of their OSA diagnosis. Patients using PAP should continue this therapy in the perioperative period. Patients with known or suspected OSA should be monitored closely during the perioperative period, and the use of opiate analgesics should be minimized or avoided if possible.</em></p><p></p><p></p><p><strong>Are there nonsurgical alternatives for patients who are unable to tolerate PAP therapy? </strong></p><p><em>Mandibular advancement devices, weight loss, exercise, avoiding sleep in the supine position, and abstaining from alcohol can be beneficial for patients who are unable to tolerate PAP therapy. There are no medications currently approved for the management of OSA.</em></p></blockquote><p></p>
[QUOTE="madman, post: 235256, member: 13851"] [B]Box. Commonly Asked Questions About Obstructive Sleep Apnea (OSA) What is the most sensitive and specific question for identifying OSA? [/B] [I]“Do you snore” is the most sensitive and “Do you stop breathing during sleep” is the most specific question to identify a patient at risk for OSA.[/I] [B]Does every patient with overweight or obesity need to be referred for a sleep study? [/B] [I]Although overweight and obesity are strong risk factors for OSA, not every patient overweight or obese needs to undergo a sleep study. However, they should be questioned for OSA-related signs and symptoms. Most asymptomatic patients do not need to be referred for a sleep study.[/I] [B]Do patients need to spend a night in the sleep laboratory for diagnosis and management of OSA?[/B] [I]For most patients in whom OSA is suspected, the diagnosis can be made with a home sleep apnea test, in which a sleep apnea monitor is worn overnight in the patient’s home. If OSA is confirmed by the home test, positive airway pressure (PAP) therapy can usually be initiated at home using an automatic titrating PAP device. If there is a high suspicion of OSA and the home test findings are negative for OSA, laboratory-based polysomnography should be recommended.[/I] [B]What are the benefits of managing OSA? [/B] [I]Daytime sleepiness, fatigue, quality of life, and blood pressure have all been documented to improve the management of OSA. Current evidence suggests that treatment does not reduce the risk of cardiovascular disease, stroke, or metabolic abnormalities in asymptomatic patients.[/I] [B]What should a patient with OSA do if they need to have surgery? [/B] [I]Patients with known OSA should inform all clinicians involved in their perioperative care, including their surgeon and anesthesiologist, of their OSA diagnosis. Patients using PAP should continue this therapy in the perioperative period. Patients with known or suspected OSA should be monitored closely during the perioperative period, and the use of opiate analgesics should be minimized or avoided if possible.[/I] [B]Are there nonsurgical alternatives for patients who are unable to tolerate PAP therapy? [/B] [I]Mandibular advancement devices, weight loss, exercise, avoiding sleep in the supine position, and abstaining from alcohol can be beneficial for patients who are unable to tolerate PAP therapy. There are no medications currently approved for the management of OSA.[/I] [/QUOTE]
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Diagnosis and Management of Obstructive Sleep Apnea
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