Treatment

Document Overview

Design and created by Guideline Central in participation with the American Thoracic Society.

Role of Weight Management in the Treatment of Adult Obstructive Sleep Apnea

American Thoracic Society

Publication Date: Oct 2, 2018

Page Last Updated: May 5, 2026

Grading of Recommendations, Assessment, Development, and Evaluation (GRADE)-Based Recommendations

Implications for:	Strong Recommendation (S)	Conditional Recommendation (C)
Patients	Most individuals in this situation would want the recommended course of action, and only a small proportion would not.	The majority of individuals in this situation would want the suggested course of action, but many would not.
Clinicians	Most individuals should receive the intervention. Adherence to this recommendation according to the guideline could be used as a quality criterion or performance indicator. Formal decision aids are not likely to be needed to help individuals make decisions consistent with their values and preferences.	Recognize that different choices will be appropriate for individual patients and that you must help each patient arrive at a management decision consistent with his or her values and preferences. Decision aids may be useful in helping individuals to make decisions consistent with their values and preferences.
Policy	The recommendation can be adopted as policy in most situations.	Policymaking will require substantial debate and involvement of various stakeholders.

Certainty in the Evidence
High	H	Low	L
Moderate	M	Very Low	VL

Source: Grading of Recommendations Assessment, Development and Evaluation Working Group (Schunemann HJ et al. Am J Respir Crit Care Med. 2006;174:605-14. Guyatt GH et al. BMJ 2008;336:924-6).

Document Overview

Document Title: Role of Weight Management in the Treatment of Adult Obstructive Sleep Apnea

Authoring Society: American Thoracic Society

Document Publication Date: Oct 2, 2018

Page Last Reviewed/Updated: May 5, 2026

Document Type: Guideline

Country of Publication: United States

Full Text Freely Available: Yes

Full Text Guideline: www.atsjournals.org/doi/full/10.1164/rccm.201807-1326ST

Source Citation: Hudgel DW et al. The Role of Weight Management in the Treatment of Adult Obstructive Sleep Apnea. Am J Respir Crit Care Med. 2018;198(6):e70–e87.

Supplemental Implementation Resources

Document Scope, Criteria, and Use Cases

Document Objectives: Overweight/obesity is a common, reversible risk factor for obstructive sleep apnea severity (OSA). The purpose of this guideline is to provide evidence-based recommendations for the management of overweight/obesity in patients with OSA.

Scope: Management, Treatment

Keywords: OSA, bariatric surgery, obesity, obstructive sleep apnea, overweight

Target Patient Population: patients with obstructive sleep apnea severity (OSA)

Inclusion Criteria: Male, Female, Adult, Older Adult

Health Care Settings: Ambulatory

Intended Users: Nurse, Nurse Practitioner, Physician, Physician Assistant

Recommendation Development Processes & Methodology

PICO Questions

Should a Reduced-Calorie Diet Be Recommended (Rather Than No Diet) to Patients with OSA Who Are Overweight or Obese?
Should Exercise/Increased Physical Activity Be Recommended (Rather Than No Exercise) to Patients with OSA Who Are Overweight or Obese?
Should Both a Reduced-Calorie Diet and Exercise/Increased Physical Activity Be Recommended (Rather Than a Reduced-Calorie Diet Alone) to Patients with OSA Who Are Overweight or Obese?

Supplemental Methodology Resource: Data Supplement

Number of Source Documents: 181

Includes peer/external review process?: Yes

Includes public comment process?: No

Methodologist involvement?: Yes

Patient involvement?: Yes

Includes multi-disciplinary group?: Yes

Includes systematic review?: Yes

Grades quality of strength of evidence?: Yes

Grades quality of strength of recommendation?: Yes

Discloses funding source?: Yes

Discloses conflicts of interest?: Yes

Includes benefits/harms analysis with recommendations?: Yes