Practice Parameters for the Medical Therapy of Obstructive Sleep Apnea Standards of Practice Committee of the American Academy of Sleep Medicine

Summary: Therapies for obstructive sleep apnea other than positive air- way pressure, oral appliances, and surgical modifications of the upper airway are reviewed in this practice parameter. Several of these therapies such as weight loss and positional therapy hold some promise. Others, such as serotonergic agents, may gain credibility in the future but lack well-designed clinical trials. No practice parameters could be developed for a number of possible therapeutic modalities that had little or no evi- dence-based data on which to form a conclusion. The role of an orga- nized, targeted weight-loss program either as a single therapy or as a supplement to PAP needs to be clarified. Although bariatric surgery is in- creasingly performed for refractory medically complicated obesity, its long- term effectiveness in treatment of obstructive sleep apnea in morbidly obese patients is not yet demonstrated. Positional therapy, or methods for preventing sleep in the supine position, has probably been underuti- lized due to lack of easily measured predictive factors and randomized controlled trials. Keywords: Obstructive sleep apnea, medical therapy, weight reduction, bariatric surgery, positional therapy, supplementary oxygen, selective se- rotonergic uptake inhibitors. Citation: Morgenthaler TI; Kapen S; Lee-Chiong T et al. Practice pa- rameters for the medical therapy of obstructive sleep apnea. SLEEP 2006;29(8):1031-1035. (21 Hours) Specifically designed for the needs of the sleep physician, this course is geared toward developing the pattern recognition skills necessary for accurate and efficient record interpretation. Topics include: sleep stage scoring and arousal recognition, sleep disordered breathing, disorders associated with COPD and neuromuscular disease, CPAP and bi-level pressure titration, narcolepsy, parasomnias and other conditions diagnosed and treated by sleep disorders centers.