In November, the U.S. Preventive Services Task Force (USPSTF) released its final recommendation statement on screening for obstructive sleep apnea in asymptomatic patients 18 years or older. Consistent with its statement in 2017, USPSTF concluded that the current evidence is insufficient to assess the balance of benefits and harms of screening for obstructive sleep apnea in adults.
What the task force found
When determining new guidance for screening, the task force looked at the evidence because it can negatively affect people’s health. The negative health consequences has been tied to heart disease and stroke, among other health conditions.
But, unfortunately, there is not enough evidence to determine if screening all adults for sleep apnea actually will improve health and quality of life.
From March 29 through April 25, the USPSTF had an open comment time frame. During this time, there were comments that expressed concern that the recommendation statement does not properly differentiate between people who are asymptomatic from those with unrecognized symptoms.
In response, the USPSTF added clarifying language to describe common symptoms of sleep apnea. They also defined what is meant by having unrecognized symptoms. The comments also proposed that the USPSTF call for screening in patients who are considered to be at higher risk for sleep apnea. While the USPSTF recognizes that certain groups are at more of an increased risk for obstructive sleep apnea, they did not find any studies that directly evaluated the effect of screening on health outcomes.
Neither a recommendation for or against screening
One thing that the USPSTF wanted to clarify with this statement is that they are not taking a firm stance one way or another. They are not for or against screening and clinicians should continue to use their own clinical judgment to determine if screening is appropriate for their individual patients.
This will continue to be a topic of conversation for some time, so don’t get discouraged and continue to use your professional experience to determine the best course of action for your patients. It is also important to note that this recommendation does not apply to individuals who present with symptoms or concerns about obstructive sleep apnea or for those who have been referred for evaluation or treatment and for those who have acute conditions that could trigger the onset of sleep apnea.