Sleep HealthCenters, Brighton, MA 02135, USA.
J Clin Sleep Med. 2009 Jun 15;5(3):263-76.
Obstructive sleep apnea (OSA) is a common chronic disorder that often requires lifelong care. Available practice parameters provide evidence-based recommendations for addressing aspects of care.
This guideline is designed to assist primary care providers as well as sleep medicine specialists, surgeons, and dentists who care for patients with OSA by providing a comprehensive strategy for the evaluation, management and long-term care of adult patients with OSA.
The Adult OSA Task Force of the American Academy of Sleep Medicine (AASM) was assembled to produce a clinical guideline from a review of existing practice parameters and available literature. All existing evidence-based AASM practice parameters relevant to the evaluation and management of OSA in adults were incorporated into this guideline. For areas not covered by the practice parameters, the task force performed a literature review and made consensus recommendations using a modified nominal group technique.
Questions regarding OSA should be incorporated into routine health evaluations. Suspicion of OSA should trigger a comprehensive sleep evaluation. The diagnostic strategy includes a sleep-oriented history and physical examination, objective testing, and education of the patient. The presence or absence and severity of OSA must be determined before initiating treatment in order to identify those patients at risk of developing the complications of sleep apnea, guide selection of appropriate treatment, and to provide a baseline to establish the effectiveness of subsequent treatment. Once the diagnosis is established, the patient should be included in deciding an appropriate treatment strategy that may include positive airway pressure devices, oral appliances, behavioral treatments, surgery, and/or adjunctive treatments. OSA should be approached as a chronic disease requiring long-term, multidisciplinary management. For each treatment option, appropriate outcome measures and long-term follow-up are described.
阻塞性睡眠呼吸暂停（OSA）是一种常见的慢性疾病，通常需要终身护理。现有的实践参数提供了针对护理各个方面的循证建议。
本指南旨在通过为评估、管理和长期护理 OSA 成年患者提供全面策略，帮助初级保健提供者以及治疗 OSA 的睡眠医学专家、外科医生和牙医。
美国睡眠医学学会（AASM）的成人 OSA 工作组为制定本指南，对现有的实践参数和可用文献进行了回顾，从而产生了一个临床指南。本指南纳入了所有与成人 OSA 评估和管理相关的、基于证据的 AASM 现有实践参数。对于实践参数未涵盖的领域，工作组使用改良的名义小组技术进行了文献回顾并提出了共识建议。
应将 OSA 相关问题纳入常规健康评估中。怀疑患有 OSA 应触发全面的睡眠评估。诊断策略包括睡眠导向的病史和体格检查、客观测试以及对患者的教育。在开始治疗之前，必须确定 OSA 的存在与否及其严重程度，以便识别那些有发生睡眠呼吸暂停并发症风险的患者，指导选择适当的治疗方法，并为随后的治疗效果提供基线。一旦诊断确立，患者应参与决定适当的治疗策略，该策略可能包括正压通气设备、口腔矫治器、行为治疗、手术和/或辅助治疗。应将 OSA 视为一种需要长期多学科管理的慢性疾病。对于每种治疗选择，都描述了适当的疗效指标和长期随访。
