University of California, San Francisco.
Group Health Research Institute, Seattle, Washington.
JAMA. 2017 Jan 24;317(4):407-414. doi: 10.1001/jama.2016.20325.
Based on data from the 1990s, estimated prevalence of obstructive sleep apnea (OSA) in the United States is 10% for mild OSA and 3.8% to 6.5% for moderate to severe OSA; current prevalence may be higher, given the increasing prevalence of obesity. Severe OSA is associated with increased all-cause mortality, cardiovascular disease and cerebrovascular events, diabetes, cognitive impairment, decreased quality of life, and motor vehicle crashes.
To issue a new US Preventive Services Task Force (USPSTF) recommendation on screening for OSA in asymptomatic adults.
The USPSTF reviewed the evidence on the accuracy, benefits, and potential harms of screening for OSA in asymptomatic adults seen in primary care, including those with unrecognized symptoms. The USPSTF also evaluated the evidence on the benefits and harms of treatment of OSA on intermediate and final health outcomes.
The USPSTF found insufficient evidence on screening for or treatment of OSA in asymptomatic adults or adults with unrecognized symptoms. Therefore, the USPSTF was unable to determine the magnitude of the benefits or harms of screening for OSA or whether there is a net benefit or harm to screening.
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).
根据 20 世纪 90 年代的数据，美国阻塞性睡眠呼吸暂停（OSA）的估计患病率为轻度 OSA 为 10%，中度至重度 OSA 为 3.8%至 6.5%；鉴于肥胖症的患病率不断上升，目前的患病率可能更高。重度 OSA 与全因死亡率、心血管疾病和脑血管事件、糖尿病、认知障碍、生活质量下降以及机动车事故增加有关。
发布美国预防服务工作组（USPSTF）关于在无症状成年人中筛查 OSA 的新建议。
USPSTF 审查了在初级保健中筛查无症状成年人（包括无症状患者）中 OSA 的准确性、益处和潜在危害的证据。USPSTF 还评估了治疗 OSA 对中间和最终健康结果的益处和危害的证据。
USPSTF 发现，在无症状成年人或有未识别症状的成年人中筛查或治疗 OSA 的证据不足。因此，USPSTF 无法确定筛查 OSA 的益处或危害的程度，也无法确定筛查是否存在净收益或危害。
USPSTF 得出结论，目前的证据不足以评估在无症状成年人中筛查 OSA 的利弊平衡。（I 级声明）。
