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JAMA Patient Page
January 24/31, 2017

Screening for Obstructive Sleep Apnea in Adults

JAMA. 2017;317(4):450. doi:10.1001/jama.2016.20362

The US Preventive Services Task Force (USPSTF) has published a recommendation on screening for obstructive sleep apnea in adults.

What Is Obstructive Sleep Apnea?

Obstructive sleep apnea is a condition in which breathing during sleep is abnormal. People with obstructive sleep apnea often stop breathing for short periods or have decreased airflow with breathing during sleep because of a blockage in the airway. This blockage can be related to obesity, a small lower face, a large tongue, or enlarged tonsils. The major symptoms of obstructive sleep apnea are loud snoring and daytime sleepiness or fatigue. Sometimes people who have these symptoms do not recognize them as being a problem. Treatment with a continuous positive airway pressure (CPAP) machine or wearing a mouthpiece while sleeping can reduce some symptoms of obstructive sleep apnea such as daytime sleepiness. Weight loss can also help in people who are obese.

What Tests Are Used to Screen for Obstructive Sleep Apnea?

Screening for obstructive sleep apnea can be done via questionnaires that ask about symptoms. If the questionnaire answers suggest obstructive sleep apnea, a formal sleep study can be done as a diagnostic test.

What Is the Patient Population Under Consideration for Screening for Obstructive Sleep Apnea?

The USPSTF recommendation applies to adults who have no symptoms or unrecognized symptoms of obstructive sleep apnea in the primary care setting. It does not apply to children or pregnant women.

What Are the Potential Benefits and Harms of Screening for Obstructive Sleep Apnea?

The potential benefit of screening for obstructive sleep apnea is earlier treatment, which can improve breathing during sleep and decrease daytime sleepiness, thereby improving sleep-related quality of life. However, there is a lack of evidence on whether this benefit is significant in populations detected by screening questionnaires as opposed to those referred for sleep study testing by their doctors.

Potential harms of screening for obstructive sleep apnea also include treatment, which includes side effects from CPAP treatment, such as discomfort in the nose or mouth area from using the CPAP mask. No studies have directly looked at harms of screening for obstructive sleep apnea.

How Strong Is the Recommendation to Screen for Obstructive Sleep Apnea?

Evidence is lacking for both potential benefits and potential harms of obstructive sleep apnea screening in adults in the primary care setting, and there is not enough evidence to show that the benefits of screening, early detection, and treatment of obstructive sleep apnea outweigh the harms. Therefore, the USPSTF is unable to make a recommendation for or against screening.

Bottom Line: Current Recommendation for Screening for Obstructive Sleep Apnea

The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for obstructive sleep apnea in adults (an “I” recommendation).

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Article Information

Source: US Preventive Services Task Force. Screening for obstructive sleep apnea in adults: US Preventive Services Task Force recommendation statement. doi:10.1001/jama.2016.20325

Topic: Preventive Medicine

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