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 There is insufficient evidence to say whether doctors should be
routinely screening for obstructive sleep apnea in people who don't
have any symptoms, said Dr. Alexander Krist, a member of the U.S.
Preventive Services Task Force (USPSTF).
Obstructive sleep apnea occurs when the airway collapses and keeps
air out for seconds to minutes at a time. The condition is linked
with increased blood pressure, cardiovascular disease and other
health conditions.
Data from the 1990s suggests about one in 10 people in the U.S. have
mild obstructive sleep apnea while about 4 to 7 percent of people
have more severe forms of the disease, according to the USPSTF. The
disorder may be more common now due to higher rates of obesity.
To see whether the existing research on obstructive sleep apnea
supports screening everyone for the disorder, the USPSTF
commissioned a systematic review of the scientific literature.
No studies have examined whether using questionnaires to screen
people for the disorder led to changes in their health, according to
the USPSTF's statement published in JAMA.
People who were treated for obstructive sleep apnea with continuous
positive airway pressure - known as CPAP - and mandibular
advancement devices did have some improvement in their blood
pressure, daytime sleepiness and the severity of their disorder.
Whether those benefits would apply to people screened without
symptoms of the disorder is unknown.
As for harms, there was some evidence that CPAP and mandibular
advancement devices may cause nasal dryness, nose bleeds, mucus, eye
or skin irritations and discomfort.
While the USPSTF can't recommend that everyone be screened for
obstructive sleep apnea, Krist said it shouldn't stop people with
symptoms from being tested.
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Loud and chronic snoring, choking during the night, morning
headaches, cognition problems, mood changes, frequent nighttime
bathroom use and dry mouth or sore throats in the morning are all
symptoms of the disorder, according to the National Institutes of
Health.
"If someone is suffering from that, they should talk to their doctor
about whether sleep apnea is something they should be concerned
about," said Krist, who is also a family physician affiliated with
Virginia Commonwealth University in Richmond.
The new statement from the USPSTF is a call for more research into
the disorder, he told Reuters Health.
SOURCE: http://bit.ly/2jyrL1h and http://bit.ly/2jyfvhq JAMA, online
January 24, 2017.
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