International consensus statement on obstructive sleep apnea

Jolie L. Chang; Andrew N. Goldberg; Jeremiah A. Alt; Lisa Ashbrook; Dennis Auckley; Indu Ayappa; Hira Bakhtiar; José E. Barrera; Bethany L. Bartley; Martha E. Billings; Maurits S. Boon; Pien Bosschieter; Itzhak Braverman; Kara Brodie; Cristina Cabrera-Muffly; Ray Caesar; Michel B. Cahali; Yi Cai; Michelle Cao; Robson Capasso; Sean M. Caples; Lana M. Chahine; Corissa P. Chang; Katherine W. Chang; Nilika Chaudhary; Crystal S.J. Cheong; Susmita Chowdhuri; Peter A. Cistulli; David Claman; Jacob Collen; Kevin Coughlin; Jennifer Creamer; Eric M. Davis; Kara L. Dupuy-McCauley; Megan L. Durr; Mohan Dutt; Mazen El Ali; Nabil M. Elkassabany; Lawrence J. Epstein; Justin A. Fiala; Neil Freedman; Kirat Gill; M. Boyd Gillespie; Lea Golisch; Nalaka Gooneratne; Daniel J. Gottlieb; Katherine K. Green; Arushi Gulati; Indira Gurubhagavatula; Nathan Hayward; Paul T. Hoff; Oliver M.G. Hoffmann; Steven J. Holfinger; Jennifer Hsia; Colin Huntley; Kevin C. Huoh; Phillip Huyett; Sanjana Inala; Stacey Ishman; Tarun K. Jella; Aesha M. Jobanputra; Andrew P. Johnson; Mithri R. Junna; Jenna T. Kado; Thomas M. Kaffenberger; Vishesh K. Kapur; Eric J. Kezirian; Meena Khan; Douglas B. Kirsch; Alan Kominsky; Meir Kryger; Andrew D. Krystal; Clete A. Kushida; Thomasz J. Kuzniar; Derek J. Lam; Christopher J. Lettieri; Diane C. Lim; Hsin Ching Lin; Stanley Y.C. Liu; Stuart G. MacKay; Ulysses J. Magalang; Atul Malhotra; Joachim T. Maurer; Anna M. May; Ron B. Mitchell; Babek Mokhlesi; Anna E. Mullins; Eman M. Nada; Sreelatha Naik; Brandon Nokes; Michael D. Olson; Allan I. Pack; Edward B. Pang; Kenny P. Pang; Susheel P. Patil; Eli Van de Perck; Jay F. Piccirillo; Grace W. Pien; Amanda J. Piper; Andrea Plawecki; Mark Quigg; Madeline J.L. Ravesloot; Susan Redline; Brian W. Rotenberg; Armand Ryden; Kathleen F. Sarmiento; Firas Sbeih; Amy E. Schell; Christopher N. Schmickl; Helena M. Schotland; Richard J. Schwab; Jiyeon Seo; Neomi Shah; Anita Valanju Shelgikar; Isaac Shochat; Ryan J. Soose; Toby O. Steele; Erika Stephens; Carl Stepnowsky; Kingman P. Strohl; Kate Sutherland; Maria V. Suurna; Erica Thaler; Sritika Thapa; Olivier M. Vanderveken; Nico de Vries; Edward M. Weaver; Ian D. Weir; Lisa F. Wolfe; B. Tucker Woodson; Christine H.J. Won; Josie Xu; Pratyusha Yalamanchi; Kathleen Yaremchuk; Yerem Yeghiazarians; Jason L. Yu; Michelle Zeidler; Ilene M. Rosen

doi:10.1002/alr.23079

International consensus statement on obstructive sleep apnea

Jolie L. Chang, Andrew N. Goldberg, Jeremiah A. Alt, Lisa Ashbrook, Dennis Auckley, Indu Ayappa, Hira Bakhtiar, José E. Barrera, Bethany L. Bartley, Martha E. Billings, Maurits S. Boon, Pien Bosschieter, Itzhak Braverman, Kara Brodie, Cristina Cabrera-Muffly, Ray Caesar, Michel B. Cahali, Yi Cai, Michelle Cao, Robson CapassoSean M. Caples, Lana M. Chahine, Corissa P. Chang, Katherine W. Chang, Nilika Chaudhary, Crystal S.J. Cheong, Susmita Chowdhuri, Peter A. Cistulli, David Claman, Jacob Collen, Kevin Coughlin, Jennifer Creamer, Eric M. Davis, Kara L. Dupuy-McCauley, Megan L. Durr, Mohan Dutt, Mazen El Ali, Nabil M. Elkassabany, Lawrence J. Epstein, Justin A. Fiala, Neil Freedman, Kirat Gill, M. Boyd Gillespie, Lea Golisch, Nalaka Gooneratne, Daniel J. Gottlieb, Katherine K. Green, Arushi Gulati, Indira Gurubhagavatula, Nathan Hayward, Paul T. Hoff, Oliver M.G. Hoffmann, Steven J. Holfinger, Jennifer Hsia, Colin Huntley, Kevin C. Huoh, Phillip Huyett, Sanjana Inala, Stacey Ishman, Tarun K. Jella, Aesha M. Jobanputra, Andrew P. Johnson, Mithri R. Junna, Jenna T. Kado, Thomas M. Kaffenberger, Vishesh K. Kapur, Eric J. Kezirian, Meena Khan, Douglas B. Kirsch, Alan Kominsky, Meir Kryger, Andrew D. Krystal, Clete A. Kushida, Thomasz J. Kuzniar, Derek J. Lam, Christopher J. Lettieri, Diane C. Lim, Hsin Ching Lin, Stanley Y.C. Liu, Stuart G. MacKay, Ulysses J. Magalang, Atul Malhotra, Joachim T. Maurer, Anna M. May, Ron B. Mitchell, Babek Mokhlesi, Anna E. Mullins, Eman M. Nada, Sreelatha Naik, Brandon Nokes, Michael D. Olson, Allan I. Pack, Edward B. Pang, Kenny P. Pang, Susheel P. Patil, Eli Van de Perck, Jay F. Piccirillo, Grace W. Pien, Amanda J. Piper, Andrea Plawecki, Mark Quigg, Madeline J.L. Ravesloot, Susan Redline, Brian W. Rotenberg, Armand Ryden, Kathleen F. Sarmiento, Firas Sbeih, Amy E. Schell, Christopher N. Schmickl, Helena M. Schotland, Richard J. Schwab, Jiyeon Seo, Neomi Shah, Anita Valanju Shelgikar, Isaac Shochat, Ryan J. Soose, Toby O. Steele, Erika Stephens, Carl Stepnowsky, Kingman P. Strohl, Kate Sutherland, Maria V. Suurna, Erica Thaler, Sritika Thapa, Olivier M. Vanderveken, Nico de Vries, Edward M. Weaver, Ian D. Weir, Lisa F. Wolfe, B. Tucker Woodson, Christine H.J. Won, Josie Xu, Pratyusha Yalamanchi, Kathleen Yaremchuk, Yerem Yeghiazarians, Jason L. Yu, Michelle Zeidler, Ilene M. Rosen

Research output: Contribution to journal › Review article › peer-review

4 Scopus citations

Abstract

Background: Evaluation and interpretation of the literature on obstructive sleep apnea is needed to consolidate and summarize key factors important for clinical management of the OSA adult patient. Toward this goal, an international collaborative of multidisciplinary experts in sleep apnea evaluation and treatment have produced the International Consensus statement on Obstructive Sleep Apnea (ICS:OSA). Methods: Using previously defined methodology, focal topics in OSA were assigned as literature review (LR), evidence-based review (EBR), or evidence-based review with recommendations (EBR-R) formats. Each topic incorporated the available and relevant evidence which was summarized and graded on study quality. Each topic and section underwent iterative review and the ICS:OSA was created and reviewed by all authors for consensus. Results: The ICS:OSA addresses OSA syndrome definitions, pathophysiology, epidemiology, risk factors for disease, screening methods, diagnostic testing types, multiple treatment modalities, and effects of OSA and treatment on the multiple comorbidities. Specific focus on outcomes with positive airway pressure (PAP) and surgical treatments were evaluated. Conclusion: This review of the literature in OSA consolidates the available knowledge and identifies the limitations of the current evidence. This effort aims to highlight the basis of OSA evidence-based practice and identify future research needs. Knowledge gaps and opportunities for improvement include improving the metrics of OSA disease, determining the optimal OSA screening paradigms, developing strategies for PAP adherence and longitudinal care, enhancing selection of PAP alternatives and surgery, understanding health risk outcomes, and translating evidence into individualized approaches to therapy. This article is protected by copyright. All rights reserved.

Original language	English
Journal	International Forum of Allergy and Rhinology
DOIs	https://doi.org/10.1002/alr.23079
State	Accepted/In press - 2023

Keywords

Obstructive sleep apnea
PAP adherence
atrial fibrillation
cardiovascular event
cerebrovascular disease
consensus
dementia
evidence-based medicine
home sleep apnea testing
hypertension
hypoglossal nerve stimulation
mortality
motor vehicle accidents
neurocognitive function
perioperative management
polysomnography
positive airway pressure
screening
sleep
sleep disordered breathing
sleep surgery
sleepiness
surgical outcomes
systematic review
treatment outcomes
uvulopalatopharyngoplasty

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10.1002/alr.23079

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Chang, J. L., Goldberg, A. N., Alt, J. A., Ashbrook, L., Auckley, D., Ayappa, I., Bakhtiar, H., Barrera, J. E., Bartley, B. L., Billings, M. E., Boon, M. S., Bosschieter, P., Braverman, I., Brodie, K., Cabrera-Muffly, C., Caesar, R., Cahali, M. B., Cai, Y., Cao, M., ... Rosen, I. M. (Accepted/In press). International consensus statement on obstructive sleep apnea. International Forum of Allergy and Rhinology. https://doi.org/10.1002/alr.23079

@article{b5ae4dcc5b1e48dfa4d4d1667be13d4e,

title = "International consensus statement on obstructive sleep apnea",

abstract = "Background: Evaluation and interpretation of the literature on obstructive sleep apnea is needed to consolidate and summarize key factors important for clinical management of the OSA adult patient. Toward this goal, an international collaborative of multidisciplinary experts in sleep apnea evaluation and treatment have produced the International Consensus statement on Obstructive Sleep Apnea (ICS:OSA). Methods: Using previously defined methodology, focal topics in OSA were assigned as literature review (LR), evidence-based review (EBR), or evidence-based review with recommendations (EBR-R) formats. Each topic incorporated the available and relevant evidence which was summarized and graded on study quality. Each topic and section underwent iterative review and the ICS:OSA was created and reviewed by all authors for consensus. Results: The ICS:OSA addresses OSA syndrome definitions, pathophysiology, epidemiology, risk factors for disease, screening methods, diagnostic testing types, multiple treatment modalities, and effects of OSA and treatment on the multiple comorbidities. Specific focus on outcomes with positive airway pressure (PAP) and surgical treatments were evaluated. Conclusion: This review of the literature in OSA consolidates the available knowledge and identifies the limitations of the current evidence. This effort aims to highlight the basis of OSA evidence-based practice and identify future research needs. Knowledge gaps and opportunities for improvement include improving the metrics of OSA disease, determining the optimal OSA screening paradigms, developing strategies for PAP adherence and longitudinal care, enhancing selection of PAP alternatives and surgery, understanding health risk outcomes, and translating evidence into individualized approaches to therapy. This article is protected by copyright. All rights reserved.",

keywords = "Obstructive sleep apnea, PAP adherence, atrial fibrillation, cardiovascular event, cerebrovascular disease, consensus, dementia, evidence-based medicine, home sleep apnea testing, hypertension, hypoglossal nerve stimulation, mortality, motor vehicle accidents, neurocognitive function, perioperative management, polysomnography, positive airway pressure, screening, sleep, sleep disordered breathing, sleep surgery, sleepiness, surgical outcomes, systematic review, treatment outcomes, uvulopalatopharyngoplasty",

author = "Chang, {Jolie L.} and Goldberg, {Andrew N.} and Alt, {Jeremiah A.} and Lisa Ashbrook and Dennis Auckley and Indu Ayappa and Hira Bakhtiar and Barrera, {Jos{\'e} E.} and Bartley, {Bethany L.} and Billings, {Martha E.} and Boon, {Maurits S.} and Pien Bosschieter and Itzhak Braverman and Kara Brodie and Cristina Cabrera-Muffly and Ray Caesar and Cahali, {Michel B.} and Yi Cai and Michelle Cao and Robson Capasso and Caples, {Sean M.} and Chahine, {Lana M.} and Chang, {Corissa P.} and Chang, {Katherine W.} and Nilika Chaudhary and Cheong, {Crystal S.J.} and Susmita Chowdhuri and Cistulli, {Peter A.} and David Claman and Jacob Collen and Kevin Coughlin and Jennifer Creamer and Davis, {Eric M.} and Dupuy-McCauley, {Kara L.} and Durr, {Megan L.} and Mohan Dutt and Ali, {Mazen El} and Elkassabany, {Nabil M.} and Epstein, {Lawrence J.} and Fiala, {Justin A.} and Neil Freedman and Kirat Gill and Gillespie, {M. Boyd} and Lea Golisch and Nalaka Gooneratne and Gottlieb, {Daniel J.} and Green, {Katherine K.} and Arushi Gulati and Indira Gurubhagavatula and Nathan Hayward and Hoff, {Paul T.} and Hoffmann, {Oliver M.G.} and Holfinger, {Steven J.} and Jennifer Hsia and Colin Huntley and Huoh, {Kevin C.} and Phillip Huyett and Sanjana Inala and Stacey Ishman and Jella, {Tarun K.} and Jobanputra, {Aesha M.} and Johnson, {Andrew P.} and Junna, {Mithri R.} and Kado, {Jenna T.} and Kaffenberger, {Thomas M.} and Kapur, {Vishesh K.} and Kezirian, {Eric J.} and Meena Khan and Kirsch, {Douglas B.} and Alan Kominsky and Meir Kryger and Krystal, {Andrew D.} and Kushida, {Clete A.} and Kuzniar, {Thomasz J.} and Lam, {Derek J.} and Lettieri, {Christopher J.} and Lim, {Diane C.} and Lin, {Hsin Ching} and Liu, {Stanley Y.C.} and MacKay, {Stuart G.} and Magalang, {Ulysses J.} and Atul Malhotra and Maurer, {Joachim T.} and May, {Anna M.} and Mitchell, {Ron B.} and Babek Mokhlesi and Mullins, {Anna E.} and Nada, {Eman M.} and Sreelatha Naik and Brandon Nokes and Olson, {Michael D.} and Pack, {Allan I.} and Pang, {Edward B.} and Pang, {Kenny P.} and Patil, {Susheel P.} and {de Perck}, {Eli Van} and Piccirillo, {Jay F.} and Pien, {Grace W.} and Piper, {Amanda J.} and Andrea Plawecki and Mark Quigg and Ravesloot, {Madeline J.L.} and Susan Redline and Rotenberg, {Brian W.} and Armand Ryden and Sarmiento, {Kathleen F.} and Firas Sbeih and Schell, {Amy E.} and Schmickl, {Christopher N.} and Schotland, {Helena M.} and Schwab, {Richard J.} and Jiyeon Seo and Neomi Shah and Shelgikar, {Anita Valanju} and Isaac Shochat and Soose, {Ryan J.} and Steele, {Toby O.} and Erika Stephens and Carl Stepnowsky and Strohl, {Kingman P.} and Kate Sutherland and Suurna, {Maria V.} and Erica Thaler and Sritika Thapa and Vanderveken, {Olivier M.} and {de Vries}, Nico and Weaver, {Edward M.} and Weir, {Ian D.} and Wolfe, {Lisa F.} and Woodson, {B. Tucker} and Won, {Christine H.J.} and Josie Xu and Pratyusha Yalamanchi and Kathleen Yaremchuk and Yerem Yeghiazarians and Yu, {Jason L.} and Michelle Zeidler and Rosen, {Ilene M.}",

year = "2023",

doi = "10.1002/alr.23079",

language = "English",

journal = "International Forum of Allergy and Rhinology",

issn = "2042-6976",

}

Chang, JL, Goldberg, AN, Alt, JA, Ashbrook, L, Auckley, D, Ayappa, I, Bakhtiar, H, Barrera, JE, Bartley, BL, Billings, ME, Boon, MS, Bosschieter, P, Braverman, I, Brodie, K, Cabrera-Muffly, C, Caesar, R, Cahali, MB, Cai, Y, Cao, M, Capasso, R, Caples, SM, Chahine, LM, Chang, CP, Chang, KW, Chaudhary, N, Cheong, CSJ, Chowdhuri, S, Cistulli, PA, Claman, D, Collen, J, Coughlin, K, Creamer, J, Davis, EM, Dupuy-McCauley, KL, Durr, ML, Dutt, M, Ali, ME, Elkassabany, NM, Epstein, LJ, Fiala, JA, Freedman, N, Gill, K, Gillespie, MB, Golisch, L, Gooneratne, N, Gottlieb, DJ, Green, KK, Gulati, A, Gurubhagavatula, I, Hayward, N, Hoff, PT, Hoffmann, OMG, Holfinger, SJ, Hsia, J, Huntley, C, Huoh, KC, Huyett, P, Inala, S, Ishman, S, Jella, TK, Jobanputra, AM, Johnson, AP, Junna, MR, Kado, JT, Kaffenberger, TM, Kapur, VK, Kezirian, EJ, Khan, M, Kirsch, DB, Kominsky, A, Kryger, M, Krystal, AD, Kushida, CA, Kuzniar, TJ, Lam, DJ, Lettieri, CJ, Lim, DC, Lin, HC, Liu, SYC, MacKay, SG, Magalang, UJ, Malhotra, A, Maurer, JT, May, AM, Mitchell, RB, Mokhlesi, B, Mullins, AE, Nada, EM, Naik, S, Nokes, B, Olson, MD, Pack, AI, Pang, EB, Pang, KP, Patil, SP, de Perck, EV, Piccirillo, JF, Pien, GW, Piper, AJ, Plawecki, A, Quigg, M, Ravesloot, MJL, Redline, S, Rotenberg, BW, Ryden, A, Sarmiento, KF, Sbeih, F, Schell, AE, Schmickl, CN, Schotland, HM, Schwab, RJ, Seo, J, Shah, N, Shelgikar, AV, Shochat, I, Soose, RJ, Steele, TO, Stephens, E, Stepnowsky, C, Strohl, KP, Sutherland, K, Suurna, MV, Thaler, E, Thapa, S, Vanderveken, OM, de Vries, N, Weaver, EM, Weir, ID, Wolfe, LF, Woodson, BT, Won, CHJ, Xu, J, Yalamanchi, P, Yaremchuk, K, Yeghiazarians, Y, Yu, JL, Zeidler, M & Rosen, IM 2023, 'International consensus statement on obstructive sleep apnea', International Forum of Allergy and Rhinology. https://doi.org/10.1002/alr.23079

TY - JOUR

T1 - International consensus statement on obstructive sleep apnea

AU - Chang, Jolie L.

AU - Goldberg, Andrew N.

AU - Alt, Jeremiah A.

AU - Ashbrook, Lisa

AU - Auckley, Dennis

AU - Ayappa, Indu

AU - Bakhtiar, Hira

AU - Barrera, José E.

AU - Bartley, Bethany L.

AU - Billings, Martha E.

AU - Boon, Maurits S.

AU - Bosschieter, Pien

AU - Braverman, Itzhak

AU - Brodie, Kara

AU - Cabrera-Muffly, Cristina

AU - Caesar, Ray

AU - Cahali, Michel B.

AU - Cai, Yi

AU - Cao, Michelle

AU - Capasso, Robson

AU - Caples, Sean M.

AU - Chahine, Lana M.

AU - Chang, Corissa P.

AU - Chang, Katherine W.

AU - Chaudhary, Nilika

AU - Cheong, Crystal S.J.

AU - Chowdhuri, Susmita

AU - Cistulli, Peter A.

AU - Claman, David

AU - Collen, Jacob

AU - Coughlin, Kevin

AU - Creamer, Jennifer

AU - Davis, Eric M.

AU - Dupuy-McCauley, Kara L.

AU - Durr, Megan L.

AU - Dutt, Mohan

AU - Ali, Mazen El

AU - Elkassabany, Nabil M.

AU - Epstein, Lawrence J.

AU - Fiala, Justin A.

AU - Freedman, Neil

AU - Gill, Kirat

AU - Gillespie, M. Boyd

AU - Golisch, Lea

AU - Gooneratne, Nalaka

AU - Gottlieb, Daniel J.

AU - Green, Katherine K.

AU - Gulati, Arushi

AU - Gurubhagavatula, Indira

AU - Hayward, Nathan

AU - Hoff, Paul T.

AU - Hoffmann, Oliver M.G.

AU - Holfinger, Steven J.

AU - Hsia, Jennifer

AU - Huntley, Colin

AU - Huoh, Kevin C.

AU - Huyett, Phillip

AU - Inala, Sanjana

AU - Ishman, Stacey

AU - Jella, Tarun K.

AU - Jobanputra, Aesha M.

AU - Johnson, Andrew P.

AU - Junna, Mithri R.

AU - Kado, Jenna T.

AU - Kaffenberger, Thomas M.

AU - Kapur, Vishesh K.

AU - Kezirian, Eric J.

AU - Khan, Meena

AU - Kirsch, Douglas B.

AU - Kominsky, Alan

AU - Kryger, Meir

AU - Krystal, Andrew D.

AU - Kushida, Clete A.

AU - Kuzniar, Thomasz J.

AU - Lam, Derek J.

AU - Lettieri, Christopher J.

AU - Lim, Diane C.

AU - Lin, Hsin Ching

AU - Liu, Stanley Y.C.

AU - MacKay, Stuart G.

AU - Magalang, Ulysses J.

AU - Malhotra, Atul

AU - Maurer, Joachim T.

AU - May, Anna M.

AU - Mitchell, Ron B.

AU - Mokhlesi, Babek

AU - Mullins, Anna E.

AU - Nada, Eman M.

AU - Naik, Sreelatha

AU - Nokes, Brandon

AU - Olson, Michael D.

AU - Pack, Allan I.

AU - Pang, Edward B.

AU - Pang, Kenny P.

AU - Patil, Susheel P.

AU - de Perck, Eli Van

AU - Piccirillo, Jay F.

AU - Pien, Grace W.

AU - Piper, Amanda J.

AU - Plawecki, Andrea

AU - Quigg, Mark

AU - Ravesloot, Madeline J.L.

AU - Redline, Susan

AU - Rotenberg, Brian W.

AU - Ryden, Armand

AU - Sarmiento, Kathleen F.

AU - Sbeih, Firas

AU - Schell, Amy E.

AU - Schmickl, Christopher N.

AU - Schotland, Helena M.

AU - Schwab, Richard J.

AU - Seo, Jiyeon

AU - Shah, Neomi

AU - Shelgikar, Anita Valanju

AU - Shochat, Isaac

AU - Soose, Ryan J.

AU - Steele, Toby O.

AU - Stephens, Erika

AU - Stepnowsky, Carl

AU - Strohl, Kingman P.

AU - Sutherland, Kate

AU - Suurna, Maria V.

AU - Thaler, Erica

AU - Thapa, Sritika

AU - Vanderveken, Olivier M.

AU - de Vries, Nico

AU - Weaver, Edward M.

AU - Weir, Ian D.

AU - Wolfe, Lisa F.

AU - Woodson, B. Tucker

AU - Won, Christine H.J.

AU - Xu, Josie

AU - Yalamanchi, Pratyusha

AU - Yaremchuk, Kathleen

AU - Yeghiazarians, Yerem

AU - Yu, Jason L.

AU - Zeidler, Michelle

AU - Rosen, Ilene M.

PY - 2023

Y1 - 2023

N2 - Background: Evaluation and interpretation of the literature on obstructive sleep apnea is needed to consolidate and summarize key factors important for clinical management of the OSA adult patient. Toward this goal, an international collaborative of multidisciplinary experts in sleep apnea evaluation and treatment have produced the International Consensus statement on Obstructive Sleep Apnea (ICS:OSA). Methods: Using previously defined methodology, focal topics in OSA were assigned as literature review (LR), evidence-based review (EBR), or evidence-based review with recommendations (EBR-R) formats. Each topic incorporated the available and relevant evidence which was summarized and graded on study quality. Each topic and section underwent iterative review and the ICS:OSA was created and reviewed by all authors for consensus. Results: The ICS:OSA addresses OSA syndrome definitions, pathophysiology, epidemiology, risk factors for disease, screening methods, diagnostic testing types, multiple treatment modalities, and effects of OSA and treatment on the multiple comorbidities. Specific focus on outcomes with positive airway pressure (PAP) and surgical treatments were evaluated. Conclusion: This review of the literature in OSA consolidates the available knowledge and identifies the limitations of the current evidence. This effort aims to highlight the basis of OSA evidence-based practice and identify future research needs. Knowledge gaps and opportunities for improvement include improving the metrics of OSA disease, determining the optimal OSA screening paradigms, developing strategies for PAP adherence and longitudinal care, enhancing selection of PAP alternatives and surgery, understanding health risk outcomes, and translating evidence into individualized approaches to therapy. This article is protected by copyright. All rights reserved.

AB - Background: Evaluation and interpretation of the literature on obstructive sleep apnea is needed to consolidate and summarize key factors important for clinical management of the OSA adult patient. Toward this goal, an international collaborative of multidisciplinary experts in sleep apnea evaluation and treatment have produced the International Consensus statement on Obstructive Sleep Apnea (ICS:OSA). Methods: Using previously defined methodology, focal topics in OSA were assigned as literature review (LR), evidence-based review (EBR), or evidence-based review with recommendations (EBR-R) formats. Each topic incorporated the available and relevant evidence which was summarized and graded on study quality. Each topic and section underwent iterative review and the ICS:OSA was created and reviewed by all authors for consensus. Results: The ICS:OSA addresses OSA syndrome definitions, pathophysiology, epidemiology, risk factors for disease, screening methods, diagnostic testing types, multiple treatment modalities, and effects of OSA and treatment on the multiple comorbidities. Specific focus on outcomes with positive airway pressure (PAP) and surgical treatments were evaluated. Conclusion: This review of the literature in OSA consolidates the available knowledge and identifies the limitations of the current evidence. This effort aims to highlight the basis of OSA evidence-based practice and identify future research needs. Knowledge gaps and opportunities for improvement include improving the metrics of OSA disease, determining the optimal OSA screening paradigms, developing strategies for PAP adherence and longitudinal care, enhancing selection of PAP alternatives and surgery, understanding health risk outcomes, and translating evidence into individualized approaches to therapy. This article is protected by copyright. All rights reserved.

KW - Obstructive sleep apnea

KW - PAP adherence

KW - atrial fibrillation

KW - cardiovascular event

KW - cerebrovascular disease

KW - consensus

KW - dementia

KW - evidence-based medicine

KW - home sleep apnea testing

KW - hypertension

KW - hypoglossal nerve stimulation

KW - mortality

KW - motor vehicle accidents

KW - neurocognitive function

KW - perioperative management

KW - polysomnography

KW - positive airway pressure

KW - screening

KW - sleep

KW - sleep disordered breathing

KW - sleep surgery

KW - sleepiness

KW - surgical outcomes

KW - systematic review

KW - treatment outcomes

KW - uvulopalatopharyngoplasty

UR - http://www.scopus.com/inward/record.url?scp=85144703544&partnerID=8YFLogxK

U2 - 10.1002/alr.23079

DO - 10.1002/alr.23079

M3 - Review article

C2 - 36068685

AN - SCOPUS:85144703544

SN - 2042-6976

JO - International Forum of Allergy and Rhinology

JF - International Forum of Allergy and Rhinology

ER -

International consensus statement on obstructive sleep apnea

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