Screening for Obstructive Sleep Apnea: Important to Find, but How Hard Should We Look? | Pulmonary Medicine | JAMA Internal Medicine | JAMA Network
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Editorial
April 2017

Screening for Obstructive Sleep Apnea: Important to Find, but How Hard Should We Look?

Author Affiliations
  • 1Department of Community Health Sciences, O’Brien Institute of Public Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
  • 2Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
JAMA Intern Med. 2017;177(4):463-464. doi:10.1001/jamainternmed.2016.9538

The US Preventive Services Task Force (USPSTF) recommendation on screening for obstructive sleep apnea (OSA) was recently released1 along with its supporting evidence report and systematic review.2 The USPSTF concludes that “the current evidence is insufficient to assess the balance of benefits and harms of screening for OSA in asymptomatic adults (I statement),”1 including those with previously unrecognized symptoms. The I statement indicates that the evidence is lacking, of poor quality, or conflicting, and the balance of benefits and harms cannot be determined. With this statement, the USPSTF recommends that if the service is offered, patients should understand the uncertainty about the balance of benefits and harms.3 While screening for OSA is an important area to have considered, this recommendation leaves front-line clinicians who are trying to provide evidence-informed primary care wondering what is the right thing to do. In this Editorial, we outline why primary care physicians should identify OSA and other sleep disorders in symptomatic patients, but we caution that with the current level of evidence, screening for OSA in asymptomatic patients is likely to lead to unnecessary diagnostic testing and higher health care costs without clear evidence of benefit.

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