Treatment of Adult Obstructive Sleep Apnea with Positive Airway Pressure

Publication Date: February 1, 2019
Last Updated: March 14, 2022

RECOMMENDATIONS

We recommend that clinicians use PAP, compared to no therapy, to treat OSA in adults with excessive sleepiness. (Strong)
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We suggest that clinicians use PAP, compared to no therapy, to treat OSA in adults with impaired sleep-related quality of life. (Conditional)
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We suggest that clinicians use PAP, compared to no therapy, to treat OSA in adults with comorbid hypertension. (Conditional)
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We recommend that PAP therapy be initiated using either APAP at home or in-laboratory PAP titration in adults with OSA and no significant comorbidities. (Strong)
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We recommend that clinicians use either CPAP or APAP for ongoing treatment of OSA in adults. (Strong)
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We suggest that clinicians use CPAP or APAP over BPAP in the routine treatment of OSA in adults. (Conditional)
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We recommend that educational interventions be given with initiation of PAP therapy in adults with OSA. (Strong)
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We suggest that behavioral and/or troubleshooting interventions be given during the initial period of PAP therapy in adults with OSA. (Conditional)
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We suggest that clinicians use telemonitoring-guided interventions during the initial period of PAP therapy in adults with OSA. (Conditional)
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GOOD PRACTICE STATEMENTS

  1. Treatment of OSA with PAP therapy should be based on a diagnosis of OSA established using objective sleep apnea testing.

  2. Adequate follow-up, including troubleshooting and monitoring of objective efficacy and usage data to ensure adequate treatment and adherence, should occur following PAP therapy initiation and during treatment of OSA.

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Recommendation Grading

Disclaimer

Overview

Title

Treatment of Adult Obstructive Sleep Apnea with Positive Airway Pressure

Authoring Organization

Publication Month/Year

February 1, 2019

Last Updated Month/Year

June 12, 2023

Document Type

Guideline

External Publication Status

Published

Country of Publication

US

Document Objectives

This guideline establishes clinical practice recommendations for positive airway pressure (PAP) treatment of obstructive sleep apnea (OSA) in adults and is intended for use in conjunction with other American Academy of Sleep Medicine (AASM) guidelines in the evaluation and treatment of sleep-disordered breathing in adults.

Target Patient Population

Patients with Obstructive sleep apnea

Inclusion Criteria

Female, Male, Adolescent, Adult, Older adult

Health Care Settings

Ambulatory, Outpatient

Intended Users

Nurse, nurse practitioner, physician, physician assistant

Scope

Assessment and screening, Management, Treatment

Diseases/Conditions (MeSH)

D020181 - Sleep Apnea, Obstructive, D045422 - Continuous Positive Airway Pressure

Keywords

obstructive sleep apnea, sleep apnea

Supplemental Methodology Resources

Systematic Review Document