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Sleep Apnea Syndromes HELP
Based on 19,581 articles published since 2010
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These are the 19581 published articles about Sleep Apnea Syndromes that originated from Worldwide during 2010-2020.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11 · 12 · 13 · 14 · 15 · 16 · 17 · 18 · 19 · 20
1 Guideline Italian Association of Sleep Medicine (AIMS) position statement and guideline on the treatment of menopausal sleep disorders. 2019

Silvestri, R / Aricò, I / Bonanni, E / Bonsignore, M / Caretto, M / Caruso, D / Di Perri, M C / Galletta, S / Lecca, R M / Lombardi, C / Maestri, M / Miccoli, M / Palagini, L / Provini, F / Puligheddu, M / Savarese, M / Spaggiari, M C / Simoncini, T. ·Center of Sleep Medicine, UOSD of Neurophysiopathology and Disorders of Movement, AOU G Martino, Department of Clinical and Experimental Medicine, University of Messina, Italy. Electronic address: rsilvestri@unime.it. · Center of Sleep Medicine, UOSD of Neurophysiopathology and Disorders of Movement, AOU G Martino, Department of Clinical and Experimental Medicine, University of Messina, Italy. · Division of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, Italy. · Division of Pneumology, University Hospital AOUP "Paolo Giaccone" PROMISE Department, University of Palermo, Italy. · Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, University of Pisa, Italy. · Department of Clinical and Experimental Medicine, Psychiatric Clinic, University of Pisa, Italy. · Sleep Disorder Centre, Department of Medical Sciences and Public Health, University of Cagliari, Italy. · Istituto Auxologico Italiano, IRCCS, Sleep Disorders Center & Department of Cardiovascular, Neural and Metabolic Sciences, San Luca Hospital, Milan, Italy; Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy. · Department of Clinical and Experimental Medicine, University of Pisa, Italy. · IRCCS, Institute of Neurological Sciences, Bologna, Italy; Department of BioMedical and NeuroMotor Sciences, University of Bologna, Italy. · "FM Puca" Neurology Unit, University Hospital Consortium Corporation Polyclinic of Bari, Italy. · Neurological Day Care Unit - Local Health Authority (AUSL 4), Parma, Italy. ·Maturitas · Pubmed #31547910.

ABSTRACT: Insomnia, vasomotor symptoms (VMS) and depression often co-occur after the menopause, with consequent health problems and reductions in quality of life. The aim of this position statement is to provide evidence-based advice on the management of postmenopausal sleep disorders derived from a systematic review of the literature. The latter yielded results on VMS, insomnia, circadian rhythm disorders, obstructive sleep apnea (OSA) and restless leg syndrome (RLS). Overall, the studies show that menopausal hormone therapy (MHT) improves VMS, insomnia, and mood. Several antidepressants can improve insomnia, either on their own or in association with MHT; these include selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), and mirtazapine. Long-term benefits for postmenopausal insomnia may also be achieved with non-drug strategies such as cognitive behavioral therapy (CBT) and aerobic exercise. Continuous positive airway pressure (CPAP) and mandibular advancement devices (MADs) both reduce blood pressure and cortisol levels in postmenopausal women suffering from OSA. However, the data regarding MHT on postmenopausal restless legs syndrome are conflicting.

2 Guideline Clinical Practice Guideline: Tonsillectomy in Children (Update). 2019

Mitchell, Ron B / Archer, Sanford M / Ishman, Stacey L / Rosenfeld, Richard M / Coles, Sarah / Finestone, Sandra A / Friedman, Norman R / Giordano, Terri / Hildrew, Douglas M / Kim, Tae W / Lloyd, Robin M / Parikh, Sanjay R / Shulman, Stanford T / Walner, David L / Walsh, Sandra A / Nnacheta, Lorraine C. ·1 UT Southwestern Medical Center, Dallas, Texas, USA. · 2 University of Kentucky, Lexington, Kentucky, USA. · 3 Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA. · 4 SUNY Downstate Medical Center, Brooklyn, New York, USA. · 5 University of Arizona College of Medicine, Phoenix, Arizona, USA. · 6 Consumers United for Evidence-based Healthcare, Fredericton, New Brunswick, Canada. · 7 Children's Hospital Colorado, Aurora, Colorado, USA. · 8 Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA. · 9 Yale School of Medicine, New Haven, Connecticut, USA. · 10 University of Minnesota School of Medicine, Minneapolis, Minnesota, USA. · 11 Mayo Clinic Center for Sleep Medicine, Rochester, Minnesota, USA. · 12 Seattle Children's Hospital, Seattle, Washington, USA. · 13 Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA. · 14 Advocate Children's Hospital, Park Ridge, Illinois, USA. · 15 Department of Research and Quality, American Academy of Otolaryngology-Head and Neck Surgery Foundation, Alexandria, Virginia, USA. ·Otolaryngol Head Neck Surg · Pubmed #30798778.

ABSTRACT: OBJECTIVE: This update of a 2011 guideline developed by the American Academy of Otolaryngology-Head and Neck Surgery Foundation provides evidence-based recommendations on the pre-, intra-, and postoperative care and management of children 1 to 18 years of age under consideration for tonsillectomy. Tonsillectomy is defined as a surgical procedure performed with or without adenoidectomy that completely removes the tonsil, including its capsule, by dissecting the peritonsillar space between the tonsil capsule and the muscular wall. Tonsillectomy is one of the most common surgical procedures in the United States, with 289,000 ambulatory procedures performed annually in children <15 years of age based on the most recent published data. This guideline is intended for all clinicians in any setting who interact with children who may be candidates for tonsillectomy. PURPOSE: The purpose of this multidisciplinary guideline is to identify quality improvement opportunities in managing children under consideration for tonsillectomy and to create explicit and actionable recommendations to implement these opportunities in clinical practice. Specifically, the goals are to educate clinicians, patients, and/or caregivers regarding the indications for tonsillectomy and the natural history of recurrent throat infections. Additional goals include the following: optimizing the perioperative management of children undergoing tonsillectomy, emphasizing the need for evaluation and intervention in special populations, improving the counseling and education of families who are considering tonsillectomy for their children, highlighting the management options for patients with modifying factors, and reducing inappropriate or unnecessary variations in care. Children aged 1 to 18 years under consideration for tonsillectomy are the target patient for the guideline. For this guideline update, the American Academy of Otolaryngology-Head and Neck Surgery Foundation selected a panel representing the fields of nursing, anesthesiology, consumers, family medicine, infectious disease, otolaryngology-head and neck surgery, pediatrics, and sleep medicine. KEY ACTION STATEMENTS: The guideline update group made strong recommendations for the following key action statements (KASs): (1) Clinicians should recommend watchful waiting for recurrent throat infection if there have been <7 episodes in the past year, <5 episodes per year in the past 2 years, or <3 episodes per year in the past 3 years. (2) Clinicians should administer a single intraoperative dose of intravenous dexamethasone to children undergoing tonsillectomy. (3) Clinicians should recommend ibuprofen, acetaminophen, or both for pain control after tonsillectomy. The guideline update group made recommendations for the following KASs: (1) Clinicians should assess the child with recurrent throat infection who does not meet criteria in KAS 2 for modifying factors that may nonetheless favor tonsillectomy, which may include but are not limited to multiple antibiotic allergies/intolerance, PFAPA (periodic fever, aphthous stomatitis, pharyngitis, and adenitis), or history of >1 peritonsillar abscess. (2) Clinicians should ask caregivers of children with obstructive sleep-disordered breathing and tonsillar hypertrophy about comorbid conditions that may improve after tonsillectomy, including growth retardation, poor school performance, enuresis, asthma, and behavioral problems. (3) Before performing tonsillectomy, the clinician should refer children with obstructive sleep-disordered breathing for polysomnography if they are <2 years of age or if they exhibit any of the following: obesity, Down syndrome, craniofacial abnormalities, neuromuscular disorders, sickle cell disease, or mucopolysaccharidoses. (4) The clinician should advocate for polysomnography prior to tonsillectomy for obstructive sleep-disordered breathing in children without any of the comorbidities listed in KAS 5 for whom the need for tonsillectomy is uncertain or when there is discordance between the physical examination and the reported severity of oSDB. (5) Clinicians should recommend tonsillectomy for children with obstructive sleep apnea documented by overnight polysomnography. (6) Clinicians should counsel patients and caregivers and explain that obstructive sleep-disordered breathing may persist or recur after tonsillectomy and may require further management. (7) The clinician should counsel patients and caregivers regarding the importance of managing posttonsillectomy pain as part of the perioperative education process and should reinforce this counseling at the time of surgery with reminders about the need to anticipate, reassess, and adequately treat pain after surgery. (8) Clinicians should arrange for overnight, inpatient monitoring of children after tonsillectomy if they are <3 years old or have severe obstructive sleep apnea (apnea-hypopnea index ≥10 obstructive events/hour, oxygen saturation nadir <80%, or both). (9) Clinicians should follow up with patients and/or caregivers after tonsillectomy and document in the medical record the presence or absence of bleeding within 24 hours of surgery (primary bleeding) and bleeding occurring later than 24 hours after surgery (secondary bleeding). (10) Clinicians should determine their rate of primary and secondary posttonsillectomy bleeding at least annually. The guideline update group made a strong recommendation against 2 actions: (1) Clinicians should not administer or prescribe perioperative antibiotics to children undergoing tonsillectomy. (2) Clinicians must not administer or prescribe codeine, or any medication containing codeine, after tonsillectomy in children younger than 12 years. The policy level for the recommendation about documenting recurrent throat infection was an option: (1) Clinicians may recommend tonsillectomy for recurrent throat infection with a frequency of at least 7 episodes in the past year, at least 5 episodes per year for 2 years, or at least 3 episodes per year for 3 years with documentation in the medical record for each episode of sore throat and ≥1 of the following: temperature >38.3°C (101°F), cervical adenopathy, tonsillar exudate, or positive test for group A beta-hemolytic streptococcus. DIFFERENCES FROM PRIOR GUIDELINE: (1) Incorporating new evidence profiles to include the role of patient preferences, confidence in the evidence, differences of opinion, quality improvement opportunities, and any exclusion to which the action statement does not apply. (2) There were 1 new clinical practice guideline, 26 new systematic reviews, and 13 new randomized controlled trials included in the current guideline update. (3) Inclusion of 2 consumer advocates on the guideline update group. (4) Changes to 5 KASs from the original guideline: KAS 1 (Watchful waiting for recurrent throat infection), KAS 3 (Tonsillectomy for recurrent infection with modifying factors), KAS 4 (Tonsillectomy for obstructive sleep-disordered breathing), KAS 9 (Perioperative pain counseling), and KAS 10 (Perioperative antibiotics). (5) Seven new KASs: KAS 5 (Indications for polysomnography), KAS 6 (Additional recommendations for polysomnography), KAS 7 (Tonsillectomy for obstructive sleep apnea), KAS 12 (Inpatient monitoring for children after tonsillectomy), KAS 13 (Postoperative ibuprofen and acetaminophen), KAS 14 (Postoperative codeine), and KAS 15a (Outcome assessment for bleeding). (6) Addition of an algorithm outlining KASs. (7) Enhanced emphasis on patient and/or caregiver education and shared decision making.

3 Guideline Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with awareness and attention to comorbidities. 2019

Elmets, Craig A / Leonardi, Craig L / Davis, Dawn M R / Gelfand, Joel M / Lichten, Jason / Mehta, Nehal N / Armstrong, April W / Connor, Cody / Cordoro, Kelly M / Elewski, Boni E / Gordon, Kenneth B / Gottlieb, Alice B / Kaplan, Daniel H / Kavanaugh, Arthur / Kivelevitch, Dario / Kiselica, Matthew / Korman, Neil J / Kroshinsky, Daniela / Lebwohl, Mark / Lim, Henry W / Paller, Amy S / Parra, Sylvia L / Pathy, Arun L / Prater, Elizabeth Farley / Rupani, Reena / Siegel, Michael / Stoff, Benjamin / Strober, Bruce E / Wong, Emily B / Wu, Jashin J / Hariharan, Vidhya / Menter, Alan. ·University of Alabama, Birmingham, Alabama. · Central Dermatology, St. Louis, Missouri. · Mayo Clinic, Rochester, Minnesota. · University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania. · National Psoriasis Foundation, Portland, Oregon. · National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland. · University of Southern California, Los Angeles, California. · Department of Dermatology, University of California San Francisco School of MedicineSan Francisco, California. · Medical College of Wisconsin, Milwaukee, Wisconsin. · Department of Dermatology, Icahn School of Medicine at Mt. Sinai, New York, New York. · University of Pittsburgh, Pennsylvania. · University of California San Diego, San Diego, California. · Baylor Scott and White, Dallas, Texas. · University Hospitals Cleveland Medical Center, Cleveland, Ohio. · Massachusetts General Hospital, Boston, Massachusetts. · Department of Dermatology, Henry Ford Hospital, Detroit, Michigan. · Northwestern University Feinberg School of Medicine, Chicago, Illinois. · Dermatology and Skin Surgery, Sumter, South Carolina. · Colorado Permanente Medical Group, Centennial, Colorado. · University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma. · Icahn School of Medicine at Mount Sinai, New York, New York. · Emory University School of Medicine, Atlanta, Georgia. · University of Connecticut, Farmington, Connecticut; Probity Medical Research, Waterloo, Canada. · San Antonio Uniformed Services Health Education Consortium, Joint-Base San Antonio, Texas. · Dermatology Research and Education Foundation, Irvine, California. · American Academy of Dermatology, Rosemont, Illinois. Electronic address: vhariharan@aad.org. ·J Am Acad Dermatol · Pubmed #30772097.

ABSTRACT: Psoriasis is a chronic, inflammatory, multisystem disease that affects up to 3.2% of the US population. This guideline addresses important clinical questions that arise in psoriasis management and care, providing recommendations on the basis of available evidence.

4 Guideline French Society of Otorhinolaryngology and Head and Neck Surgery (SFORL) guidelines concerning the role of otorhinolaryngologists in the management of paediatric obstructive sleep apnoea syndrome: Follow-up protocol for treated children. 2018

Akkari, M / Marianowski, R / Chalumeau, F / Fayoux, P / Leboulanger, N / Monteyrol, P J / Mondain, M / Anonymous1150965. ·Département d'ORL et chirurgie cervico faciale, UAM d'ORL pédiatrique, hôpital Gui de Chauliac, CHU de Montpellier, 80, avenue Augustin Fliche, 34295 Montpellier cedex 5, France. Electronic address: mohamed.akkari.orl@gmail.com. · Département d'ORL et chirurgie cervico faciale, hôpital Morvan, CHU de Brest, 29000 Brest, France. · Centre d'étude du sommeil, Antony, 94260 Fresnes, France. · Département d'ORL et chirurgie cervico faciale pédiatrique, hôpital Jeanne de Flandre, CHU de Lille, 59037 Lille, France. · Département d'ORL et chirurgie cervico faciale pédiatrique, hôpital Necker-Enfants-Malades, Assistance Publique des Hôpitaux de Paris, 75015 Paris, France. · Département d'ORL et chirurgie cervico faciale, polyclinique du Tondu et clinique du sommeil, hôpital Pellegrin, 33000 Bordeaux, France. · Département d'ORL et chirurgie cervico faciale, UAM d'ORL pédiatrique, hôpital Gui de Chauliac, CHU de Montpellier, 80, avenue Augustin Fliche, 34295 Montpellier cedex 5, France. ·Eur Ann Otorhinolaryngol Head Neck Dis · Pubmed #30318322.

ABSTRACT: OBJECTIVES: The authors present the French Society of Oto-Rhino-Laryngology and Head and Neck Surgery (SFORL) clinical practice guidelines concerning the role of otorhinolaryngologists in the management of paediatric obstructive sleep apnoea syndrome (OSAS). This chapter is devoted to the follow-up protocol for children treated for OSAS. METHODS: A multidisciplinary task force was commissioned to carry out a review of the scientific literature on this topic. On the basis of the articles selected and the personal experience of each member of the task force, guidelines were drafted and graded as A, B or C or expert opinion according to a decreasing level of scientific evidence, and were then reviewed by a reading committee, independently of the task force. The final guidelines were established at a consensus meeting. RESULTS: Short-term, medium-term and long-term clinical follow-up and complementary investigations are necessary in view of the risk of residual OSAS, and the risk of recurrence of OSAS related to adenoid and tonsillar regrowth following adenotonsillectomy, the treatment most commonly performed. The modalities of follow-up after surgery, continuous positive airway pressure (CPAP) ventilation, orthodontic treatment, myofascial rehabilitation, and drug therapy are described. The indications for nasal endoscopy and sleep studies as part of follow-up are specified.

5 Guideline The Role of Weight Management in the Treatment of Adult Obstructive Sleep Apnea. An Official American Thoracic Society Clinical Practice Guideline. 2018

Hudgel, David W / Patel, Sanjay R / Ahasic, Amy M / Bartlett, Susan J / Bessesen, Daniel H / Coaker, Melisa A / Fiander, P Michelle / Grunstein, Ronald R / Gurubhagavatula, Indira / Kapur, Vishesh K / Lettieri, Christopher J / Naughton, Matthew T / Owens, Robert L / Pepin, Jean-Louis / Tuomilehto, Henri / Wilson, Kevin C / Anonymous7481022. · ·Am J Respir Crit Care Med · Pubmed #30215551.

ABSTRACT: BACKGROUND: Overweight/obesity is a common, reversible risk factor for obstructive sleep apnea severity (OSA). The purpose of this guideline is to provide evidence-based recommendations for the management of overweight/obesity in patients with OSA. METHODS: The Grading of Recommendations, Assessment, Development and Evaluation approach was used to evaluate the literature. Clinical recommendations were formulated by a panel of pulmonary, sleep medicine, weight management, and behavioral science specialists. RESULTS: Behavioral, pharmacological, and surgical treatments promote weight loss and can reduce OSA severity, reverse common comorbidities, and improve quality of life, although published studies have methodological limitations. After considering the quality of evidence, feasibility, and acceptability of these interventions, the panel made a strong recommendation that patients with OSA who are overweight or obese be treated with comprehensive lifestyle intervention consisting of 1) a reduced-calorie diet, 2) exercise or increased physical activity, and 3) behavioral guidance. Conditional recommendations were made regarding reduced-calorie diet and exercise/increased physical activity as separate management tools. Pharmacological therapy and bariatric surgery are appropriate for selected patients who require further assistance with weight loss. CONCLUSIONS: Weight-loss interventions, especially comprehensive lifestyle interventions, are associated with improvements in OSA severity, cardiometabolic comorbidities, and quality of life. The American Thoracic Society recommends that clinicians regularly assess weight and incorporate weight management strategies that are tailored to individual patient preferences into the routine treatment of adult patients with OSA who are overweight or obese.

6 Guideline Polysomnography for Obstructive Sleep Apnea Should Include Arousal-Based Scoring: An American Academy of Sleep Medicine Position Statement. 2018

Malhotra, Raman K / Kirsch, Douglas B / Kristo, David A / Olson, Eric J / Aurora, Rashmi N / Carden, Kelly A / Chervin, Ronald D / Martin, Jennifer L / Ramar, Kannan / Rosen, Carol L / Rowley, James A / Rosen, Ilene M / Anonymous3870954. ·Washington University Sleep Center, St. Louis, Missouri. · Carolinas Healthcare Medical Group Sleep Services, Charlotte, North Carolina. · University of Pittsburgh, Pittsburgh, Pennsylvania. · Division of Pulmonary and Critical Care Medicine, Center for Sleep Medicine, Mayo Clinic, Rochester, Minnesota. · Johns Hopkins School of Medicine, Baltimore, Maryland. · Saint Thomas Medical Partners - Sleep Specialists, Nashville, Tennessee. · University of Michigan Sleep Disorders Center, Ann Arbor, Michigan. · Veterans Affairs Greater Los Angeles Healthcare System, North Hills, California. · David Geffen School of Medicine at the University of California, Los Angeles, California. · Department of Pediatrics, Case Western Reserve University, University Hospitals - Cleveland Medical Center, Cleveland, Ohio. · Wayne State University, Detroit, Michigan. · Division of Sleep Medicine, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania. ·J Clin Sleep Med · Pubmed #29991439.

ABSTRACT: ABSTRACT: The diagnostic criteria for obstructive sleep apnea (OSA) in adults, as defined in the International Classification of Sleep Disorders, Third Edition, requires an increased frequency of obstructive respiratory events demonstrated by in-laboratory, attended polysomnography (PSG) or a home sleep apnea test (HSAT). However, there are currently two hypopnea scoring criteria in The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications (AASM Scoring Manual). This dichotomy results in differences among laboratory reports, patient treatments and payer policies. Confusion occurs regarding recognizing and scoring "arousal-based respiratory events" during OSA testing. "Arousal-based scoring" recognizes hypopneas associated with electroencephalography-based arousals, with or without significant oxygen desaturation, when calculating an apnea-hypopnea index (AHI), or it includes respiratory effort-related arousals (RERAs), in addition to hypopneas and apneas, when calculating a respiratory disturbance index (RDI). Respiratory events associated with arousals, even without oxygen desaturation, cause significant, and potentially dangerous, sleep apnea symptoms. During PSG, arousal-based respiratory scoring should be performed in the clinical evaluation of patients with suspected OSA, especially in those patients with symptoms of excessive daytime sleepiness, fatigue, insomnia, or other neurocognitive symptoms. Therefore, it is the position of the AASM that the

7 Guideline Society of Anesthesia and Sleep Medicine Guideline on Intraoperative Management of Adult Patients With Obstructive Sleep Apnea. 2018

Memtsoudis, Stavros G / Cozowicz, Crispiana / Nagappa, Mahesh / Wong, Jean / Joshi, Girish P / Wong, David T / Doufas, Anthony G / Yilmaz, Meltem / Stein, Mark H / Krajewski, Megan L / Singh, Mandeep / Pichler, Lukas / Ramachandran, Satya Krishna / Chung, Frances. ·From the Department of Anesthesiology, Critical Care & Pain Management, Weill Cornell Medical College and Hospital for Special Surgery, New York, New York. · Department of Anesthesiology, Perioperative Medicine and Intensive Care Medicine, Paracelsus Medical University, Salzburg, Austria. · Department of Anesthesia and Perioperative Medicine, London Health Sciences Centre and St Joseph's Health Care, Western University, London, Ontario, Canada. · Department of Anesthesia and Pain Medicine, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada. · Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical School, Dallas, Texas. · Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University Medical Center, Palo Alto, California. · Department of Anesthesiology, Northwestern University, Chicago, Illinois. · Department of Anesthesiology, Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey. · Department of Anesthesia, Critical Care, and Pain Management, Beth Israel Deaconess Medical Center, Boston, Massachusetts. · Department of Anesthesia, University of Toronto, Toronto, Ontario, Canada. · Toronto Sleep and Pulmonary Centre, Toronto, Canada. · Department of Anesthesia and Pain Management, Women's College Hospital, Toronto, Canada. · Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada. · Department of Anesthesiology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts. ·Anesth Analg · Pubmed #29944522.

ABSTRACT: The purpose of the Society of Anesthesia and Sleep Medicine Guideline on Intraoperative Management of Adult Patients With Obstructive Sleep Apnea (OSA) is to present recommendations based on current scientific evidence. This guideline seeks to address questions regarding the intraoperative care of patients with OSA, including airway management, anesthetic drug and agent effects, and choice of anesthesia type. Given the paucity of high-quality studies with regard to study design and execution in this perioperative field, recommendations were to a large part developed by subject-matter experts through consensus processes, taking into account the current scientific knowledge base and quality of evidence. This guideline may not be suitable for all clinical settings and patients and is not intended to define standards of care or absolute requirements for patient care; thus, assessment of appropriateness should be made on an individualized basis. Adherence to this guideline cannot guarantee successful outcomes, but recommendations should rather aid health care professionals and institutions to formulate plans and develop protocols for the improvement of the perioperative care of patients with OSA, considering patient-related factors, interventions, and resource availability. Given the groundwork of a comprehensive systematic literature review, these recommendations reflect the current state of knowledge and its interpretation by a group of experts at the time of publication. While periodic reevaluations of literature are needed, novel scientific evidence between updates should be taken into account. Deviations in practice from the guideline may be justifiable and should not be interpreted as a basis for claims of negligence.

8 Guideline French Society of ENT (SFORL) guidelines (short version) on the roles of the various treatment options in childhood obstructive sleep apnea-hypopnea syndrome. 2018

Pateron, B / Marianowski, R / Monteyrol, P-J / Couloigner, V / Akkari, M / Chalumeau, F / Fayoux, P / Leboulanger, N / Franco, P / Mondain, M. ·Service de chirurgie ORL et cervico-faciale, hôpital universitaire Necker-Enfants-Malades, 149, rue de Sèvres, 75015 Paris, France. Electronic address: benedicte.pateron@aphp.fr. · Service de chirurgie ORL et cervico-faciale, CHU de Brest, 29000 Brest, France. · Cabinet ORL, 33000 Bordeaux, France. · Service de chirurgie ORL et cervico-faciale, hôpital universitaire Necker-Enfants-Malades, 149, rue de Sèvres, 75015 Paris, France. · Service de chirurgie ORL et cervico-faciale, 34000 Montpellier, France. · Cabinet ORL, 94260 Fresnes, France. · Service de chirurgie ORL et cervico-faciale, CHRU de Lille, 59037 Lille cedex, France. · Cabinet de pédiatrie, 69500 Lyon, France. ·Eur Ann Otorhinolaryngol Head Neck Dis · Pubmed #29731297.

ABSTRACT: OBJECTIVE: The authors present the guidelines of the French Society of ENT and Head & Neck Surgery (SFORL) on the role of the ENT physician in childhood obstructive sleep apnea-hypopnea syndrome (OSAHS). This section of the guidelines concerns the roles of the various medical and surgical treatment options. METHOD: A multidisciplinary work-group was entrusted with a review of the scientific literature on the topic. Based on the retrieved articles and the group members' own experience, guidelines were drawn up, then read over by a reading group independent of the work-group. An editorial meeting then produced the final text. RESULTS: Adenotonsillectomy is the reference treatment for childhood OSAHS with adenotonsillar hypertrophy. Respiratory assistance is recommended in children with severe OSAHS without nasal and/or oropharyngeal obstacle, after surgery in case of persistent OSAHS, in case of contraindications to surgery, in complex obstruction related to pharyngolaryngeal or laryngeal pathology or comorbidity, or as an alternative to tracheotomy. Nasal route corticosteroids may be used in childhood OSAHS in with associated nasal obstruction.

9 Guideline Obesity Management Task Force of the European Association for the Study of Obesity Released "Practical Recommendations for the Post-Bariatric Surgery Medical Management". 2018

Busetto, Luca / Dicker, Dror / Azran, Carmil / Batterham, Rachel L / Farpour-Lambert, Nathalie / Fried, Martin / Hjelmesæth, Jøran / Kinzl, Johann / Leitner, Deborah R / Makaronidis, Janine M / Schindler, Karin / Toplak, Hermann / Yumuk, Volkan. ·Department of Internal Medicine, University of Padova, Padova, Italy. luca.busetto@unipd.it. · Clinica Medica 3, Azienda Ospedaliera di Padova, Via Giustiniani 2, 35128, Padova, Italy. luca.busetto@unipd.it. · Department of Internal Medicine D and Obesity Clinic, Hasharon Hospital, Rabin Medical Center, Petah Tikva, Israel. · Sackler School of Medicine Tel Aviv University, Tel Aviv, Israel. · Clinical Pharmacy, Herzliya Medical Center, Herzliya, Israel. · University College London Hospital Bariatric Centre for Weight Management and Metabolic Surgery, University College London Hospital, London, UK. · National Institute of Health Research, University College London Hospital Biomedical Research Centre, London, UK. · Centre for Obesity Research, Rayne Institute, Department of Medicine, University College London, London, UK. · Obesity Prevention and Care Program Contrepoids, Service of Therapeutic Education for Chronic Diseases, Department of Community Medicine, Primary Care and Emergency, University Hospitals of Geneva and University of Geneva, Geneva, Switzerland. · OB Klinika, Centre for Treatment of Obesity and Metabolic Disorders, 1st Faculty of Medicine, Charles University, Prague, Czech Republic. · Morbid Obesity Centre, Vestfold Hospital Trust and Department of Endocrinology, Morbid Obesity and Preventive Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway. · Department of Psychiatry and Psychotherapy II, Medical University Innsbruck, Innsbruck, Austria. · Department of Medicine, Medical University Graz, Graz, Austria. · Department of Medicine III, Medical University of Vienna, Vienna, Austria. · Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey. ·Obes Surg · Pubmed #29725979.

ABSTRACT: Bariatric patients may face specific clinical problems after surgery, and multidisciplinary long-term follow-up is usually provided in specialized centers. However, physicians, obstetricians, dieticians, nurses, clinical pharmacists, midwives, and physical therapists not specifically trained in bariatric medicine may encounter post-bariatric patients with specific problems in their professional activity. This creates a growing need for dissemination of first level knowledge in the management of bariatric patients. Therefore, the Obesity Management Task Force (OMTF) of the European Association for the Study of Obesity (EASO) decided to produce and disseminate a document containing practical recommendations for the management of post-bariatric patients. The list of practical recommendations included in the EASO/OMTF document is reported in this brief communication.

10 Guideline [Guidelines in Practice: The New S3 Guideline "Sleeping Disorders - Sleep-Related Abnormal Breathing"]. 2017

Gerlach, Martin / Sanner, Bernd. · ·Laryngorhinootologie · Pubmed #29017230.

ABSTRACT: Sleep related breathing disorders include central sleep apnea (CSA), obstructive sleep apnea (OSA), sleep-related hypoventilation, and sleep-related hypoxia. These disorders are frequent and growing in clinical relevance. The related chapter of the S3 guideline "Non-restorative sleep/Sleep disorders", published by the German Sleep Society (DGSM), has recently been updated in November 2016. Epidemiology, diagnostics, therapeutic procedures, and classification of sleep related disorders have been revised. Concerning epidemiology, a considerably higher mortality rate among pregnant women with OSA has been emphasized. With regards to diagnostics, the authors point out that respiratory polygraphy may be sufficient in diagnosing OSA, if a typical clinical condition is given. For CSA, recommendations were changed to diagnose CSA with low apnea rates present. Significant changes for treating CSA in patients with left ventricular dysfunction have been introduced. In addition, there is now to be differentiated between sleep-related hypoventilation and sleep-related hypoxaemia. Obesity hypoventilation syndrome is discussed in more detail. This article sums up and comments on the published changes.

11 Guideline Clinical Use of a Home Sleep Apnea Test: An American Academy of Sleep Medicine Position Statement. 2017

Rosen, Ilene M / Kirsch, Douglas B / Chervin, Ronald D / Carden, Kelly A / Ramar, Kannan / Aurora, R Nisha / Kristo, David A / Malhotra, Raman K / Martin, Jennifer L / Olson, Eric J / Rosen, Carol L / Rowley, James A / Anonymous3890920. ·Division of Sleep Medicine, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania. · Carolinas Healthcare Medical Group Sleep Services, Charlotte, North Carolina. · University of Michigan Sleep Disorders Center, University of Michigan, Ann Arbor, Michigan. · Saint Thomas Medical Partners -Sleep Specialists, Nashville, Tennessee. · Division of Pulmonary/Sleep/Critical Care, Mayo Clinic, Rochester, Minnesota. · Johns Hopkins University, School of Medicine, Baltimore, Maryland. · University of Pittsburgh, Pittsburgh, Pennsylvania. · SLUCare Sleep Disorders Center. · Department of Neurology, Saint Louis University, St. Louis, Missouri. · Veteran Affairs Greater Los Angeles Health System, North Hills, California and David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, California. · Department of Pediatrics, Case Western Reserve University, University Hospitals - Cleveland Medical Center, Cleveland, Ohio. · Wayne State University, Detroit, Michigan. ·J Clin Sleep Med · Pubmed #28942762.

ABSTRACT: ABSTRACT: The diagnosis and effective treatment of obstructive sleep apnea (OSA) in adults is an urgent health priority. It is the position of the American Academy of Sleep Medicine (AASM) that only a physician can diagnose medical conditions such as OSA and primary snoring. Throughout this statement, the term "physician" refers to a medical provider who is licensed to practice medicine. A home sleep apnea test (HSAT) is an alternative to polysomnography for the diagnosis of OSA in uncomplicated adults presenting with signs and symptoms that indicate an increased risk of moderate to severe OSA. It is also the position of the AASM that: the need for, and appropriateness of, an HSAT must be based on the patient's medical history and a face-to-face examination by a physician, either in person or via telemedicine; an HSAT is a medical assessment that must be ordered by a physician to diagnose OSA or evaluate treatment efficacy; an HSAT should not be used for general screening of asymptomatic populations; diagnosis, assessment of treatment efficacy, and treatment decisions must not be based solely on automatically scored HSAT data, which could lead to sub-optimal care that jeopardizes patient health and safety; and the raw data from the HSAT device must be reviewed and interpreted by a physician who is either board-certified in sleep medicine or overseen by a board-certified sleep medicine physician.

12 Guideline American Academy of Sleep Medicine Position Paper for the Use of a Home Sleep Apnea Test for the Diagnosis of OSA in Children. 2017

Kirk, Valerie / Baughn, Julie / D'Andrea, Lynn / Friedman, Norman / Galion, Anjalee / Garetz, Susan / Hassan, Fauziya / Wrede, Joanna / Harrod, Christopher G / Malhotra, Raman K. ·University of Calgary, Calgary, Alberta, Canada. · Mayo Clinic, Rochester, Minnesota. · Children's Hospital of Wisconsin, Milwaukee, Wisconsin. · Rocky Mountain Pediatric Sleep Disorders, Aurora, Colorado. · Children's Hospital of Orange County, Orange, California. · University of Michigan Medical Center, Ann Arbor, Michigan. · University of Michigan, Ann Arbor, Michigan. · Seattle Children's Hospital, Seattle, Washington. · American Academy of Sleep Medicine, Darien, Illinois. · Saint Louis University, St. Louis, Missouri. ·J Clin Sleep Med · Pubmed #28877820.

ABSTRACT: INTRODUCTION: The purpose of this position paper is to establish the American Academy of Sleep Medicine's (AASM) position on the use of a home sleep apnea test (HSAT) for the diagnosis of obstructive sleep apnea (OSA) in children (birth to 18 years of age). METHODS: The AASM commissioned a task force of 8 experts in sleep medicine to review the available literature on the use of an HSAT to diagnose OSA in children. The task force developed the position statement based on a thorough review of these studies and their clinical expertise. The AASM Board of Directors approved the final position statement. POSITION STATEMENT: Use of a home sleep apnea test is not recommended for the diagnosis of obstructive sleep apnea in children. The ultimate judgment regarding propriety of any specific care must be made by the clinician, in light of the individual circumstances presented by the patient, available diagnostic tools, accessible treatment options, and resources.

13 Guideline Screening for Obstructive Sleep Apnea in Adults: Recommendation Statement. 2017

Anonymous4810914. · ·Am Fam Physician · Pubmed #28762711.

ABSTRACT: -- No abstract --

14 Guideline Perioperative management of obstructive sleep apnea in bariatric surgery: a consensus guideline. 2017

de Raaff, Christel A L / Gorter-Stam, Marguerite A W / de Vries, Nico / Sinha, Ashish C / Jaap Bonjer, H / Chung, Frances / Coblijn, Usha K / Dahan, Albert / van den Helder, Rick S / Hilgevoord, Antonius A J / Hillman, David R / Margarson, Michael P / Mattar, Samer G / Mulier, Jan P / Ravesloot, Madeline J L / Reiber, Beata M M / van Rijswijk, Anne-Sophie / Singh, Preet Mohinder / Steenhuis, Roos / Tenhagen, Mark / Vanderveken, Olivier M / Verbraecken, Johan / White, David P / van der Wielen, Nicole / van Wagensveld, Bart A. ·Department of Surgery, OLVG West, Amsterdam, the Netherlands. Electronic address: c.deraaff@olvg.nl. · Department of Surgery, VU Medical Center, Amsterdam, the Netherlands. · Department of Oral Kinesiology, ACTA, Amsterdam, the Netherlands; Department of Otorhinolaryngology and Head and Neck Surgery, Translational Neurosciences Research Group, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Department of Otorhinolaryngology, OLVG West, Amsterdam, the Netherlands. · Department of Anesthesiology and Perioperative Medicine, Temple University, Philadelphia, PA, USA. · Department of Anesthesiology, University Health Network, University of Toronto, Toronto, Canada. · Department of Anesthesiology, LUMC, Leiden, the Netherlands. · Department of Surgery, Noordwest Ziekenhuisgroep, Alkmaar, the Netherlands. · Department of Clinical Neurophysiology, OLVG West, Amsterdam, the Netherlands. · Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Perth, Australia. · Department of Anaesthesia, Saint Richard's Hospital, Chichester, United Kingdom. · Department of Surgery, Oregon Health & Science University, Portland, Oregon, USA. · Department of Anesthesiology, AZ Sint Jan, Brugge, Belgium. · Department of Otorhinolaryngology, OLVG West, Amsterdam, the Netherlands. · Department of Surgery, Rode Kruis Ziekenhuis, Beverwijk, the Netherlands. · Department of Surgery, MC Slotervaart, Amsterdam, the Netherlands. · Department of Anesthesiology, All India Institute of Medical Sciences, New Delhi, India. · Medical Library, OLVG West, Amsterdam, the Netherlands. · Department of Otorhinolaryngology and Head and Neck Surgery, Translational Neurosciences Research Group, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium. · Department of Pulmonary Medicine and Multidisciplinary Sleep Disorders Centre, Antwerp University Hospital and University of Antwerp, Edegem, Belgium. · Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA. · Department of Surgery, OLVG West, Amsterdam, the Netherlands. ·Surg Obes Relat Dis · Pubmed #28666588.

ABSTRACT: BACKGROUND: The frequency of metabolic and bariatric surgery (MBS) is increasing worldwide, with over 500,000 cases performed every year. Obstructive sleep apnea (OSA) is present in 35%-94% of MBS patients. Nevertheless, consensus regarding the perioperative management of OSA in MBS patients is not established. OBJECTIVES: To provide consensus based guidelines utilizing current literature and, when in the absence of supporting clinical data, expert opinion by organizing a consensus meeting of experts from relevant specialties. SETTING: The meeting was held in Amsterdam, the Netherlands. METHODS: A panel of 15 international experts identified 75 questions covering preoperative screening, treatment, postoperative monitoring, anesthetic care and follow-up. Six researchers reviewed the literature systematically. During this meeting, the "Amsterdam Delphi Method" was utilized including controlled acquisition of feedback, aggregation of responses and iteration. RESULTS: Recommendations or statements were provided for 58 questions. In the judgment of the experts, 17 questions provided no additional useful information and it was agreed to exclude them. With the exception of 3 recommendations (64%, 66%, and 66% respectively), consensus (>70%) was reached for 55 statements and recommendations. Several highlights: polysomnography is the gold standard for diagnosing OSA; continuous positive airway pressure is recommended for all patients with moderate and severe OSA; OSA patients should be continuously monitored with pulse oximetry in the early postoperative period; perioperative usage of sedatives and opioids should be minimized. CONCLUSION: This first international expert meeting provided 58 statements and recommendations for a clinical consensus guideline regarding the perioperative management of OSA patients undergoing MBS.

15 Guideline Australasian Sleep Association clinical practice guidelines for performing sleep studies in children. 2017

Pamula, Yvonne / Nixon, Gillian M / Edwards, Elizabeth / Teng, Arthur / Verginis, Nicole / Davey, Margot J / Waters, Karen / Suresh, Sadasivam / Twiss, Jacob / Tai, Andrew. ·Department of Respiratory and Sleep Medicine, Women's and Children's Hospital, North Adelaide, South Australia, Australia. Electronic address: yvonne.pamula@sa.gov.au. · The Ritchie Centre, Hudson Institute of Medical Research, Clayton, Victoria, Australia; Department of Paediatrics, Monash University, Clayton, Victoria, Australia; Melbourne Children's Sleep Centre, Monash Children's Hospital, Clayton, Victoria, Australia. · Paediatric Respiratory Department, Starship Children's Hospital, Auckland, New Zealand. · Department of Sleep Medicine, Sydney Children's Hospital, Randwick, New South Wales, Australia; School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Kensington, New South Wales, Australia. · Melbourne Children's Sleep Centre, Monash Children's Hospital, Clayton, Victoria, Australia. · Department of Respiratory Medicine, The Children's Hospital at Westmead, Westmead, New South Wales, Australia; Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia. · Department of Respiratory and Sleep Medicine, Lady Cilento Children's Hospital, South Brisbane, Queensland, Australia. · Department of Respiratory and Sleep Medicine, Women's and Children's Hospital, North Adelaide, South Australia, Australia; Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia. ·Sleep Med · Pubmed #28648225.

ABSTRACT: -- No abstract --

16 Guideline Guidelines for sleep studies in adults - a position statement of the Australasian Sleep Association. 2017

Douglas, James A / Chai-Coetzer, Ching Li / McEvoy, David / Naughton, Matthew T / Neill, Alister M / Rochford, Peter / Wheatley, John / Worsnop, Christopher. ·The Prince Charles Hospital, Brisbane, Queensland, Australia. Electronic address: n.shillabeer@elsevier.com. · Adelaide Institute for Sleep Health, Flinders Centre of Research Excellence, Flinders University, Adelaide, South Australia, Australia; Sleep Health Service, Repatriation General Hospital, Southern Adelaide Local Health Network, Adelaide, South Australia, Australia. · Mater Medical Centre, Brisbane, Queensland, Australia. · The Alfred Hospital, Melbourne, Victoria, Australia; Monash University, Melbourne, Victoria, Australia. · WellSleep Sleep Investigation Centre, University of Otago, New Zealand. · Institute of Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia. · Ludwig Engel Centre for Respiratory Research, The Westmead Institute for Medical Research, Sydney, NSW, Australia; University of Sydney at Westmead Hospital, Sydney, NSW, Australia. ·Sleep Med · Pubmed #28648224.

ABSTRACT: -- No abstract --

17 Guideline [Guidelines in Practice: The New S3 Guideline "Sleeping Disorders - Sleep-Related Abnormal Breathing"]. 2017

Gerlach, M / Sanner, B. ·Medizinische Klinik, Agaplesion Bethesda Krankenhaus Wuppertal. ·Pneumologie · Pubmed #28558398.

ABSTRACT: Sleep related breathing disorders include central sleep apnea (CSA), obstructive sleep apnea (OSA), sleep-related hypoventilation, and sleep-related hypoxia. These disorders are frequent and growing in clinical relevance. The related chapter of the S3 guideline "Non-restorative sleep/Sleep disorders", published by the German Sleep Society (DGSM), has recently been updated in November 2016. Epidemiology, diagnostics, therapeutic procedures, and classification of sleep related disorders have been revised. Concerning epidemiology, a considerably higher mortality rate among pregnant women with OSA has been emphasized. With regards to diagnostics, the authors point out that respiratory polygraphy may be sufficient in diagnosing OSA, if a typical clinical condition is given. For CSA, recommendations were changed to diagnose CSA with low apnea rates present. Significant changes for treating CSA in patients with left ventricular dysfunction have been introduced. In addition, there is now to be differentiated between sleep-related hypoventilation and sleep-related hypoxaemia. Obesity hypoventilation syndrome is discussed in more detail. This article sums up and comments on the published changes.

18 Guideline 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. 2017

Yancy, Clyde W / Jessup, Mariell / Bozkurt, Biykem / Butler, Javed / Casey, Donald E / Colvin, Monica M / Drazner, Mark H / Filippatos, Gerasimos S / Fonarow, Gregg C / Givertz, Michael M / Hollenberg, Steven M / Lindenfeld, JoAnn / Masoudi, Frederick A / McBride, Patrick E / Peterson, Pamela N / Stevenson, Lynne Warner / Westlake, Cheryl. · ·J Am Coll Cardiol · Pubmed #28461007.

ABSTRACT: -- No abstract --

19 Guideline 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. 2017

Yancy, Clyde W / Jessup, Mariell / Bozkurt, Biykem / Butler, Javed / Casey, Donald E / Colvin, Monica M / Drazner, Mark H / Filippatos, Gerasimos S / Fonarow, Gregg C / Givertz, Michael M / Hollenberg, Steven M / Lindenfeld, JoAnn / Masoudi, Frederick A / McBride, Patrick E / Peterson, Pamela N / Stevenson, Lynne Warner / Westlake, Cheryl. ·Writing group members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information. ACC/AHA Task Force on Clinical Practice Guidelines Liaison. ACC/AHA Representative. ACP Representative. ISHLT Representative. HFSA Representative. CHEST Representative. ACC/AHA Task Force on Performance Measures Representative. AAFP Representative. ·Circulation · Pubmed #28455343.

ABSTRACT: -- No abstract --

20 Guideline AASM Scoring Manual Updates for 2017 (Version 2.4). 2017

Berry, Richard B / Brooks, Rita / Gamaldo, Charlene / Harding, Susan M / Lloyd, Robin M / Quan, Stuart F / Troester, Matthew T / Vaughn, Bradley V. ·University of Florida, Gainesville, Florida. · Capital Health, Hamilton, New Jersey. · Johns Hopkins University, Baltimore, Maryland. · University of Alabama at Birmingham, Birmingham, Alabama. · Mayo Clinic, Rochester, Minnesota. · Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. · University of Arizona College of Medicine, Tucson, Arizona. · Phoenix Children's Hospital, Phoenix, Arizona. · University of North Carolina, Chapel Hill, North Carolina. ·J Clin Sleep Med · Pubmed #28416048.

ABSTRACT: -- No abstract --

21 Guideline Management of Obstructive Sleep Apnea in Commercial Motor Vehicle Operators: Recommendations of the AASM Sleep and Transportation Safety Awareness Task Force. 2017

Gurubhagavatula, Indira / Sullivan, Shannon / Meoli, Amy / Patil, Susheel / Olson, Ryan / Berneking, Michael / Watson, Nathaniel F. ·Division of Sleep Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania. · Corporal Michael Crescenz VA Medical Center, Philadelphia, Pennsylvania. · Department of Psychiatry, Stanford University, Palo Alto, California. · Penn State Sleep Research and Treatment Center, Hummelstown, Pennsylvania. · Johns Hopkins School of Medicine, Baltimore, Maryland. · Oregon Institute of Occupational Health Sciences, Oregon Health and Science University, Portland, Oregon. · Concentra, Inc., Grand Rapids, Michigan. · University of Washington Medicine Sleep Disorders Center and Department of Neurology, University of Washington, Seattle, Washington. ·J Clin Sleep Med · Pubmed #28356173.

ABSTRACT: ABSTRACT: The American Academy of Sleep Medicine Sleep and Transportation Safety Awareness Task Force responded to the Federal Motor Carrier Safety Administration and Federal Railroad Administration Advance Notice of Proposed Rulemaking and request for public comments regarding the evaluation of safety-sensitive personnel for moderate-to-severe obstructive sleep apnea (OSA). The following document represents this response. The most salient points provided in our comments are that (1) moderate-to-severe OSA is common among commercial motor vehicle operators (CMVOs) and contributes to an increased risk of crashes; (2) objective screening methods are available and preferred for identifying at-risk drivers, with the most commonly used indicator being body mass index; (3) treatment in the form of continuous positive airway pressure (CPAP) is effective and reduces crashes; (4) CPAP is economically viable; (5) guidelines are available to assist medical examiners in determining whether CMVOs with moderate-to-severe OSA should continue to work without restrictions, with conditional certification, or be disqualified from operating commercial motor vehicles.

22 Guideline Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline. 2017

Kapur, Vishesh K / Auckley, Dennis H / Chowdhuri, Susmita / Kuhlmann, David C / Mehra, Reena / Ramar, Kannan / Harrod, Christopher G. ·University of Washington, Seattle, WA. · MetroHealth Medical Center and Case Western Reserve University, Cleveland, OH. · John D. Dingell VA Medical Center and Wayne State University, Detroit, MI. · Bothwell Regional Health Center, Sedalia, MO. · Cleveland Clinic, Cleveland, OH. · Mayo Clinic, Rochester, MN. · American Academy of Sleep Medicine, Darien, IL. ·J Clin Sleep Med · Pubmed #28162150.

ABSTRACT: INTRODUCTION: This guideline establishes clinical practice recommendations for the diagnosis of obstructive sleep apnea (OSA) in adults and is intended for use in conjunction with other American Academy of Sleep Medicine (AASM) guidelines on the evaluation and treatment of sleep-disordered breathing in adults. METHODS: The AASM commissioned a task force of experts in sleep medicine. A systematic review was conducted to identify studies, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) process was used to assess the evidence. The task force developed recommendations and assigned strengths based on the quality of evidence, the balance of benefits and harms, patient values and preferences, and resource use. In addition, the task force adopted foundational recommendations from prior guidelines as "good practice statements", that establish the basis for appropriate and effective diagnosis of OSA. The AASM Board of Directors approved the final recommendations. RECOMMENDATIONS: The following recommendations are intended as a guide for clinicians diagnosing OSA in adults. Under GRADE, a STRONG recommendation is one that clinicians should follow under most circumstances. A WEAK recommendation reflects a lower degree of certainty regarding the outcome and appropriateness of the patient-care strategy for all patients. The ultimate judgment regarding propriety of any specific care must be made by the clinician in light of the individual circumstances presented by the patient, available diagnostic tools, accessible treatment options, and resources. Good Practice Statements: Diagnostic testing for OSA should be performed in conjunction with a comprehensive sleep evaluation and adequate follow-up. Polysomnography is the standard diagnostic test for the diagnosis of OSA in adult patients in whom there is a concern for OSA based on a comprehensive sleep evaluation.Recommendations: We recommend that clinical tools, questionnaires and prediction algorithms not be used to diagnose OSA in adults, in the absence of polysomnography or home sleep apnea testing. (STRONG). We recommend that polysomnography, or home sleep apnea testing with a technically adequate device, be used for the diagnosis of OSA in uncomplicated adult patients presenting with signs and symptoms that indicate an increased risk of moderate to severe OSA. (STRONG). We recommend that if a single home sleep apnea test is negative, inconclusive, or technically inadequate, polysomnography be performed for the diagnosis of OSA. (STRONG). We recommend that polysomnography, rather than home sleep apnea testing, be used for the diagnosis of OSA in patients with significant cardiorespiratory disease, potential respiratory muscle weakness due to neuromuscular condition, awake hypoventilation or suspicion of sleep related hypoventilation, chronic opioid medication use, history of stroke or severe insomnia. (STRONG). We suggest that, if clinically appropriate, a split-night diagnostic protocol, rather than a full-night diagnostic protocol for polysomnography be used for the diagnosis of OSA. (WEAK). We suggest that when the initial polysomnogram is negative and clinical suspicion for OSA remains, a second polysomnogram be considered for the diagnosis of OSA. (WEAK).

23 Guideline Prevention, diagnosis, and treatment of obesity. 2016 position statement of the Spanish Society for the Study of Obesity. 2017

Lecube, Albert / Monereo, Susana / Rubio, Miguel Ángel / Martínez-de-Icaya, Purificación / Martí, Amelia / Salvador, Javier / Masmiquel, Lluís / Goday, Alberto / Bellido, Diego / Lurbe, Empar / García-Almeida, José Manuel / Tinahones, Francisco José / García-Luna, Pedro Pablo / Palacio, Enrique / Gargallo, Manuel / Bretón, Irene / Morales-Conde, Salvador / Caixàs, Assumpta / Menéndez, Edelmiro / Puig-Domingo, Manel / Casanueva, Felipe F. ·Servicio de Endocrinología y Nutrición, Unidad de Obesidad, Hospital Universitari Arnau de Vilanova de Lleida, Institut de Recerca Biomèdica de Lleida, CIBERDEM (CIBER de Diabetes y Enfermedades Metabólicas Asociadas, ISCIII), Universitat de Lleida, Lleida, España. Electronic address: alecube@gmail.com. · Servicio de Endocrinología y Nutrición, Hospital General Universitario Gregorio Marañón, Madrid, España. · Servicio de Endocrinología y Nutrición, Hospital Clínico San Carlos, Madrid, España. · Sección de Endocrinología y Nurición, Hospital Universitario Severo Ochoa de Leganés, Madrid, España. · Departamento de Ciencias de la Alimentación y Fisiología, Universidad de Navarra, CIBERobn (CIBER de Fisiopatología de la Obesidad y Nutrición, ISCIII), Instituto de Investigación Sanitaria de Navarra (Idisna), Pamplona, España. · Departamento de Endocrinología y Nutrición, Clínica Universidad de Navarra, CIBERobn (CIBER de Fisiopatología de la Obesidad y Nutrición, ISCIII), Instituto de Investigación Sanitaria de Navarra (Idisna), Pamplona, España. · Servicio de Endocrinología y Nutrición, Unidad de Obesidad, Hospital de Son Llàtzer, Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IdISPa), Universitat de les Illes Balears, Palma de Mallorca, España. · Hospital del Mar, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), CIBERobn (CIBER de Fisiopatología de la Obesidad y Nutrición, ISCIII), Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, España. · Servicio Endocrinología y Nutrición, Complejo Hospitalario Universitario de Ferrol (CHUF), SERGAS, Ferrol, A Coruña, España. · Departamento de Pediatría, Consorcio Hospital General. CIBERobn (CIBER de Fisiopatología de la Obesidad y Nutrición, ISCIII), Universidad de Valencia, Valencia, España. · Complejo Hospitalario de Málaga (Virgen de la Victoria), Hospital Quirón-Salud Málaga, Universidad de Málaga, Málaga, España. · Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Clínico Virgen de la Victoria, CIBERobn (CIBER de Fisiopatología de la Obesidad y Nutrición, ISCIII), Universidad de Málaga, Málaga, España. · Unidad de Nutrición Clínica y Dietética, Servicio de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Sevilla, España. · Servicio de Endocrinología y Nutrición, Hospital Universitario Nuestra Señora de Candelaria (HUNSC), Santa Cruz de Tenerife, España. · Servicio de Endocrinología y Nutrición, Hospital Virgen de la Torre, Madrid, España. · Unidad de Innovación Cirugía Mínima Invasiva, Servicio de Cirugía General y Digestiva, Hospital Universitario Virgen del Rocío, Sevilla, España. · Servicio de Endocrinología y Nutrición, Hospital Universitari Parc Taulí de Sabadell, Corporació Sanitària Parc Taulí, Institut de Recerca I3PT, Universitat Autònoma de Barcelona, Sabadell, España. · Servicio de Endocrinología y Nutrición, Hospital Universitario Central de Asturias (HUCA). Departamento de Medicina, Universidad de Oviedo, Oviedo, España. · Servicio de Endocrinología y Nutrición, Hospital Germans Trias i Pujol, Badalona. Departamento de Medicina, Universidad Autónoma de Barcelona, Barcelona, España. · Departamento de Medicina, Universidad de Santiago, Compejo Hospitalario Universitario de Santiago (CHUS), CIBERobn (CIBER de Fisiopatología de la Obesidad y Nutrición, ISCIII), Santiago de Compostela, España. ·Endocrinol Diabetes Nutr · Pubmed #27543006.

ABSTRACT: -- No abstract --

24 Guideline 7th Brazilian Guideline of Arterial Hypertension: Chapter 12 - Secondary Arterial Hypertension 2016

Malachias, M V B / Bortolotto, L A / Drager, L F / Borelli, F A O / Lotaif, L A D / Martins, L C. · ·Arq Bras Cardiol · Pubmed #27819391.

ABSTRACT: -- No abstract --

25 Guideline Society of Anesthesia and Sleep Medicine Guidelines on Preoperative Screening and Assessment of Adult Patients With Obstructive Sleep Apnea. 2016

Chung, Frances / Memtsoudis, Stavros G / Ramachandran, Satya Krishna / Nagappa, Mahesh / Opperer, Mathias / Cozowicz, Crispiana / Patrawala, Sara / Lam, David / Kumar, Anjana / Joshi, Girish P / Fleetham, John / Ayas, Najib / Collop, Nancy / Doufas, Anthony G / Eikermann, Matthias / Englesakis, Marina / Gali, Bhargavi / Gay, Peter / Hernandez, Adrian V / Kaw, Roop / Kezirian, Eric J / Malhotra, Atul / Mokhlesi, Babak / Parthasarathy, Sairam / Stierer, Tracey / Wappler, Frank / Hillman, David R / Auckley, Dennis. ·From the *Department of Anesthesiology, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada; †Department of Anesthesiology, Weill Cornell Medical College and Hospital for Special Surgery, New York, New York; ‡Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan; §Department of Anesthesiology and Perioperative Medicine, University Hospital, St. Joseph's Hospital and Victoria Hospital, London Health Sciences Centre and St. Joseph's Health care, Western University, London, Ontario, Canada; ‖Paracelsus Medical University, Department of Anesthesiology, Perioperative Medicine and Intensive Care, Salzburg, Austria; ¶Department of Anesthesiology, Hospital for Special Surgery, Weill Cornell Medical College New York, New York; #Department of Anesthesia, Perioperative Medicine and Intensive Care, Paracelsus Medical University, Salzburg, Austria; **Department of Medicine, University of California San Diego, San Diego, California; ††Sparrow Hospital, Lansing, Michigan; ‡‡Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical School, Texas; §§Department of Medicine, Division of Respiratory Medicine, The University of British Columbia, Vancouver, BC, Canada; ‖‖University of British Columbia, Vancouver, BC, Canada; ¶¶Department of Medicine, Emory University, Atlanta, Georgia; ##Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University Medical Center, Palo Alto, California; ***Department of Anesthesia, Critical Care and Pain Medicine, Harvard University, Cambridge, Massachusetts; †††Library and Information Services, University Health Network, University of Toronto, Toronto, Ontario, Canada; ‡‡‡Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota; §§§Department of Pulmonary, Critical Care and Sleep Medicine, Mayo Clinic, Rochester, Minnesota; ‖‖‖School of Medicine, Universidad Peruana de Ciencias Apl ·Anesth Analg · Pubmed #27442772.

ABSTRACT: The purpose of the Society of Anesthesia and Sleep Medicine guideline on preoperative screening and assessment of adult patients with obstructive sleep apnea (OSA) is to present recommendations based on the available clinical evidence on the topic where possible. As very few well-performed randomized studies in this field of perioperative care are available, most of the recommendations were developed by experts in the field through consensus processes involving utilization of evidence grading to indicate the level of evidence upon which recommendations were based. This guideline may not be appropriate for all clinical situations and all patients. The decision whether to follow these recommendations must be made by a responsible physician on an individual basis. Protocols should be developed by individual institutions taking into account the patients' conditions, extent of interventions and available resources. This practice guideline is not intended to define standards of care or represent absolute requirements for patient care. The adherence to these guidelines cannot in any way guarantee successful outcomes and is rather meant to help individuals and institutions formulate plans to better deal with the challenges posed by perioperative patients with OSA. These recommendations reflect the current state of knowledge and its interpretation by a group of experts in the field at the time of publication. While these guidelines will be periodically updated, new information that becomes available between updates should be taken into account. Deviations in practice from guidelines may be justifiable and such deviations should not be interpreted as a basis for claims of negligence.

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