Advertisement

Current Pulmonology Reports

, Volume 8, Issue 1, pp 22–29 | Cite as

Screening for Obstructive Sleep Apnea: Should We Do It?

  • Sara PashaEmail author
Sleeping and Breathing (S Shafazand, Section Editor)
  • 50 Downloads
Part of the following topical collections:
  1. Topical Collection on Sleeping and Breathing

Abstract

Purpose of Review

Obstructive sleep apnea (OSA) is prevalent and underdiagnosed. It is associated with significant comorbidities and early detection and treatment might lead to improvement in important clinical outcomes. This paper will review current evidence on screening for OSA in the primary care setting and in certain high-risk groups.

Recent Findings

The 2017 United States Preventative Services Taskforce evidence review on OSA screening noted a lack of high-quality evidence linking OSA screening with important clinical outcomes and on the accuracy of proposed screening tools.

Summary

OSA symptoms are usually not discussed in the primary care setting. A screening tool such as a questionnaire is a simple approach that could be easily implemented in this setting. Further study into the long-term cardiovascular and mortality benefits of the treatment of OSA, randomized controlled trials linking the implementation of screening and improvement in important clinical outcomes, and the accuracy of available screening tools as well as their generalizability to the primary care population is needed to improve the strength of their recommendation and their adoption.

Keywords

Obstructive sleep apnea OSA Screening Primary care Berlin questionnaire STOP-BANG 

Notes

Compliance with Ethical Standards

Conflict of Interest

Sara Pasha declares no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    Young T, Palta M, Dempsey J, Peppard PE, Nieto FJ, Hla KM. Burden of sleep apnea: rationale, design, and major findings of the Wisconsin Sleep Cohort study. WMJ. 2009;108(5):246–9.PubMedPubMedCentralGoogle Scholar
  2. 2.
    Peppard PE, Young T, Barnet JH, Palta M, Hagen EW, Hla KM. Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol. 2013;177(9):1006. Epub 2013 Apr 14–14.CrossRefGoogle Scholar
  3. 3.
    Bixler EO, Vgontzas AN, Ten Have T, Tyson K, Kales A. Effects of age on sleep apnea in men: I. Prevalence and severity. Am J Respir Crit Care Med. 1998;157:144–8.CrossRefGoogle Scholar
  4. 4.
    Young T, Peppard PE, Gottlieb DJ. Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med. 2002;165:1217–39.CrossRefGoogle Scholar
  5. 5.
    Duran J, Esnaola S, Rubio R, Iztueta A. Obstructive sleep apnea-hypopnea and related clinical features in a population-based sample of subjects aged 30 to 70 yr. Am J Respir Crit Care Med. 2001;163(3 Pt 1):685–9.CrossRefGoogle Scholar
  6. 6.
    Redline S, Tishler PV, Hans MG, Tosteson TD, Strohl KP, Spry K. Racial differences in sleep-disordered breathing in African-Americans and Caucasians. Am J Respir Crit Care Med. 1997;155(1):186–92.CrossRefGoogle Scholar
  7. 7.
    Ancoli-Israel S, Klauber MR, Stepnowsky C, Estline E, Chinn A, Fell R. Sleep-disordered breathing in African-American elderly. Am J Respir Crit Care Med. 1995;152(6 Pt 1):1946–9.CrossRefGoogle Scholar
  8. 8.
    Redline S, Sotres-Alvarez D, Loredo J, Hall M, Patel SR, Ramos A, et al. Sleep-disordered breathing in Hispanic/Latino individuals of diverse backgrounds: the Hispanic Community Health Study/Study of Latinos. Am J Respir Crit Care Med. 2014;189(3):335–44.CrossRefGoogle Scholar
  9. 9.
    Johnson DA, Guo N, Rueschman M, Wang R, Wilson JG, Redline S. Prevalence and correlates of obstructive sleep apnea among African Americans: the Jackson Heart Sleep Study. Sleep. 2018;1:41(10).  https://doi.org/10.1093/sleep/zsy154.CrossRefGoogle Scholar
  10. 10.
    Chen X, Wang R, Zee P, et al. Racial/ethnic differences in sleep disturbances: the multi-ethnic study of atherosclerosis (MESA). Sleep. 2015;38(6):877–88.PubMedPubMedCentralGoogle Scholar
  11. 11.
    Netzer NC, Hoegel JJ, Loube D. Et al; Sleep in primary care international study group. Prevalence of symptoms and risk of sleep apnea in primary care. Chest. 2003;124(4):1406–14.CrossRefGoogle Scholar
  12. 12.
    Mold JW, Quattlebaum C, Schinnerer E, Boeckman L, Orr W, Hollabaugh K. Identification by primary care clinicians of patients with obstructive sleep apnea: a practice-based research network (PBRN) study. J Am Board Fam Med. 2011;24(2):138–45.  https://doi.org/10.3122/jabfm.2011.02.100095.CrossRefPubMedGoogle Scholar
  13. 13.
    Dempsey JA, Veasey SC, Morgan BJ, O’Donnell CP. Pathophysiology of sleep apnea. Physiol Rev. 2010;90(1):47–112.CrossRefGoogle Scholar
  14. 14.
    Peppard PE, Young T, Palta M, Skatrud J. Prospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med. 2000;342(19):1378–84.CrossRefGoogle Scholar
  15. 15.
    Mehra R, Benjamin EJ, Shahar E, Gottlieb DJ, Nawabit R, Kirchner HL, et al. Association of nocturnal arrhythmias with sleep-disordered breathing: The Sleep Heart Health Study. Am J Respir Crit Care Med. 2006;173(8):910–6.CrossRefGoogle Scholar
  16. 16.
    Marin JM, Carrizo SJ, Vincente E, Agusti AG. Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet. 2005;365:1046–53.CrossRefGoogle Scholar
  17. 17.
    Gottlieb DJ, Yenokyan G, Newman AB, O'Connor GT, Punjabi NM, Quan SF, et al. Prospective study of obstructive sleep apnea and incident coronary heart disease and heart failure: the sleep heart health study. Circulation. 2010;122(4):352–60.  https://doi.org/10.1161/CIRCULATIONAHA.109.901801.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Yaggi HK, Concato J, Kernan WN, Lichtman JH, Brass LM, Mohsenin V. Obstructive sleep apnea as a risk factor for stroke and death. N Engl J Med. 2005;353(19):2034–41.CrossRefGoogle Scholar
  19. 19.
    Coughlin SR, Mawdsley L, Mugarza JA, Calverley PM, Wilding JP. Obstructive sleep apnoea is independently associated with an increased prevalence of metabolic syndrome. Eur Heart J. 2004;25(9):735–41.CrossRefGoogle Scholar
  20. 20.
    Tregear S, Reston J, Schoelles K, Phillips B. Obstructive sleep apnea and risk of motor vehicle crash: systematic review and meta-analysis. J Clin Sleep Med. 2009;5(6):573–81.PubMedPubMedCentralGoogle Scholar
  21. 21.
    Rajaratnam SMW, Barger LK, Lockley SW, Shea SA, Wang W, Landrigan CP, et al. Harvard work hours, health and safety group. Sleep disorders, health, and safety in police officers. JAMA. 2011;306(23):2567–78.CrossRefGoogle Scholar
  22. 22.
    Terán-Santos J, Jiménez-Gómez A, Cordero-Guevara J. The association between sleep apnea and the risk of traffic accidents. Cooperative Group Burgos-Santander. N Engl J Med. 1999;340(11):847–51.CrossRefGoogle Scholar
  23. 23.
    Horstmann S, Hess CW, Bassetti C, Gugger M, Mathis J. Sleepiness-related accidents in sleep apnea patients. Sleep. 2000;23(3):383–9.CrossRefGoogle Scholar
  24. 24.
    Giles TL, Lasserson TJ, Smith BJ, White J, Wright J, Cates CJ. Continuous positive airways pressure for obstructive sleep apnoea in adults. Cochrane Database Syst Rev. 2006.Google Scholar
  25. 25.
    Fava C, Dorigoni S, Dalle Vedove F, Danese E, Montagnana M, Guidi GC, et al. Effect of CPAP on blood pressure in patients with OSA/hypopnea a systematic review and meta-analysis. Chest. 2014;145(4):762–71.CrossRefGoogle Scholar
  26. 26.
    Redline S, Baker-Goodwin S, Bakker JP, Epstein M, Hanes S, Hanson M, et al. Sleep apnea patient-centered outcomes network. Patient partnerships transforming sleep medicine research and clinical care: perspectives from the sleep apnea patient-centered outcomes network. J Clin Sleep Med. 2016;12(7):1053–8.CrossRefGoogle Scholar
  27. 27.
    Rahaghi F, Basner RC. Delayed diagnosis of obstructive sleep apnea: don’t ask, don’t tell. Sleep Breath. 1999;3(4):119–24.CrossRefGoogle Scholar
  28. 28.
    Bartlett DJ, Marshall NS, Williams A, Grunstein RR. Predictors of primary medical care consultation for sleep disorders. Sleep Med. 2008;9(8):857e64.CrossRefGoogle Scholar
  29. 29.
    Bailes S, Baltzan M, Rizzo D, Fichten CS, Grad R, Wolkove N, et al. Sleep disorder symptoms are common and unspoken in Canadian general practice. Fam Pract. 2009;26(4):294e300.CrossRefGoogle Scholar
  30. 30.
    Grover M, Mookadam M, Armas D, Bozarth C, Castleberry T, Gannon M, et al. Identifying patients at risk for obstructive sleep apnea in a primary care practice. J Am Board Fam Med. 2011;24(2):152e60.CrossRefGoogle Scholar
  31. 31.
    Burgess KR, Havryk A, Newton S, Tsai WH, Whitelaw WA. Targeted case finding for OSA within the primary care setting. J Clin Sleep Med. 2013;9(7):681e6.Google Scholar
  32. 32.
    Epstein LJ, Kristo D, Strollo PJ Jr, Friedman N, Malhotra A, Patil SP, et al. Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. J Clin Sleep Med. 2009;5(3):263e76.Google Scholar
  33. 33.
    Knauert M, Naik S, Gillespie MB, Kryger M. Clinical consequences and economic costs of untreated obstructive sleep apnea syndrome. Otolaryngol Head Neck Surg. 2015;1:17–27.Google Scholar
  34. 34.
    Aurora RN, Quan SF. Quality measure for screening for adult obstructive sleep apnea by primary care physicians. J Clin Sleep Med. 2016;12(8):1185–7.  https://doi.org/10.5664/jcsm.6064.CrossRefPubMedPubMedCentralGoogle Scholar
  35. 35.
    Netzer NC, Stoohs RA, Netzer CM, Clark K, Strohl KP. Using the Berlin questionnaire to identify patients at risk for the sleep apnea syndrome. Ann Intern Med. 1999;131(7):485e91.CrossRefGoogle Scholar
  36. 36.
    Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991;14(6):540e5.CrossRefGoogle Scholar
  37. 37.
    Chung F, Yegneswaran B, Liao P, Chung SA, Vairavanathan S, Islam S, et al. STOP questionnaire: a tool to screen patients for obstructive sleep apnea. Anesthesiology. 2008;108(5):812e21.Google Scholar
  38. 38.
    Chung F, Subramanyam R, Liao P, Sasaki E, Shapiro C, Sun Y. High STOP-Bang score indicates a high probability of obstructive sleep apnoea. Br J Anaesth. 2012;108(5):768e75.CrossRefGoogle Scholar
  39. 39.
    • Miller JN, Berger AM. Screening and assessment for obstructive sleep apnea in primary care. Sleep Med Rev. 2016;29:41–51.  https://doi.org/10.1016/j.smrv.2015.09.005. Epub 2015. This article is a comprehensive review of the sensitivity, specificity, and diagnostic accuracy of several commonly used screening questionnaires. The study reported inconsistent psychometric findings for OSA screening measures with a lack of validation research in primary care.
  40. 40.
    • Qaseem A, Dallas P, Owens DK, Starkey M, Holty JC, Shekelle P. Diagnosis of obstructive sleep apnea in adults: a clinical practice guideline from the American College of Physicians. A review of studies aimed at determining the accuracy of level II, III, and IV portable devices as well as screening questionnaires when compared to polysomnography for the diagnosis of OSA. The conclusions of the authors were limited by the absence of high-quality evidence. Google Scholar
  41. 41.
    Chiu HY, Chen PY, Chuang LP, Chen NH, Tu YK, Hsieh YJ, et al. Diagnostic accuracy of the Berlin questionnaire, STOP-BANG, STOP, and Epworth sleepiness scale in detecting obstructive sleep apnea: a bivariate meta-analysis. Sleep Med Rev. 2017;36:57–70.  https://doi.org/10.1016/j.smrv.2016.10.004.CrossRefPubMedGoogle Scholar
  42. 42.
    •• Jonas DE, Amick HR, Feltner C, Weber RP, Arvanitis M, Stine A, et al. Screening for obstructive sleep apnea in adults: evidence report and systematic review for the US Preventive Services Task Force. JAMA. 2017;317(4):415–33.  https://doi.org/10.1001/jama.2016.19635 This is a comprehensive USPSTF commissioned systematic review of the current evidence on screening for obstructive sleep apnea. It includes literature on the accuracy of various screening tools and diagnostic tests and on OSA treatment outcomes.CrossRefPubMedGoogle Scholar
  43. 43.
    Shah N, Hanna DB, Teng Y, Sotres-Alvarez D, Hall M, Loredo JS, et al. Sex-specific prediction models for sleep apnea from the Hispanic community health study/study of Latinos. Chest. 2016;149(6):1409–18.  https://doi.org/10.1016/j.chest.2016.01.013.CrossRefPubMedPubMedCentralGoogle Scholar
  44. 44.
    Chai-Coetzer CL, Antic NA, Rowland LS, Catcheside PG, Esterman A, Reed RL, et al. A simplified model of screening questionnaire and home monitoring for obstructive sleep apnoea in primary care. Thorax. 2011;66(3):213–9.  https://doi.org/10.1136/thx.2010.152801.CrossRefPubMedGoogle Scholar
  45. 45.
    Foster GD, Sanders MH, Millman R, Zammit G, Borradaile KE, Newman AB, et al. Obstructive sleep apnea among obese patients with type 2 diabetes. Diabetes Care. 2009;32(6):1017–9.  https://doi.org/10.2337/dc08-1776.CrossRefPubMedPubMedCentralGoogle Scholar
  46. 46.
    Resnick HE, Redline S, Shahar E, Gilpin A, Newman A, Walter R, et al. Diabetes and sleep disturbances: findings from the Sleep Heart Health Study. Diabetes Care. 2003;26(3):702–9.CrossRefGoogle Scholar
  47. 47.
    Heffner JE, Rozenfeld Y, Kai M, Stephens EA, Brown LK. Prevalence of diagnosed sleep apnea among patients with type 2 diabetes in primary care. Chest. 2012;141(6):1414–21.  https://doi.org/10.1378/chest.11-1945.CrossRefPubMedGoogle Scholar
  48. 48.
    Punjabi NM, Sorkin JD, Katzel LI, Goldberg AP, Schwartz AR, Smith PL. Sleep-disordered breathing and insulin resistance in middle-aged and overweight men. Am J Respir Crit Care Med. 2002;165(5):677–82.CrossRefGoogle Scholar
  49. 49.
    Meslier N, Gagnadoux F, Giraud P, Person C, Ouksel H, Urban T, et al. Impaired glucose-insulin metabolism in males with obstructive sleep apnoea syndrome. Eur Respir J. 2003;22(1):156–60.CrossRefGoogle Scholar
  50. 50.
    Punjabi NM, Shahar E, Redline S, Gottlieb DJ, Givelber R, Resnick HE, et al. Sleep-disordered breathing, glucose intolerance, and insulin resistance: the Sleep Heart Health Study. Am J Epidemiol. 2004;160(6):521–30.CrossRefGoogle Scholar
  51. 51.
    Aronsohn RS, Whitmore H, Van Cauter E, Tasali E. Impact of untreated obstructive sleep apnea on glucose control in type 2 diabetes. Am J Respir Crit Care Med. 2010;181(5):507–13.CrossRefGoogle Scholar
  52. 52.
    Pillai A, Warren G, Gunathilake W, Idris I. Effects of sleep apnea severity on glycemic control in patients with type 2 diabetes prior to continuous positive airway pressure treatment. Diabetes Technol Ther. 2011;13(9):945–9.CrossRefGoogle Scholar
  53. 53.
    Fendri S, Rose D, Myambu S, Jeanne S, Lalau JD. Nocturnal hyperglycaemia in type 2 diabetes with sleep apnoea syndrome. Diabetes Res Clin Pract. 2011;91(1):e21–3.CrossRefGoogle Scholar
  54. 54.
    Smurra M, Philip P, Taillard J, Guilleminault C, Bioulac B, Gin H. CPAP treatment does not affect glucose-insulin metabolism in sleep apneic patients. Sleep Med. 2001;2(3):207–13.CrossRefGoogle Scholar
  55. 55.
    Tasali E, Chapotot F, Leproult R, Whitmore H, Ehrmann DA. Treatment of obstructive sleep apnea improves cardiometabolic function in young obese women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2011;96(2):365–74.CrossRefGoogle Scholar
  56. 56.
    Harsch IA, Schahin SP, Brückner K, Radespiel-Tröger M, Fuchs FS, Hahn EG, et al. The effect of continuous positive airway pressure treatment on insulin sensitivity in patients with obstructive sleep apnoea syndrome and type 2 diabetes. Respiration. 2004;71(3):252–9.CrossRefGoogle Scholar
  57. 57.
    Federation ID. The IDF Consensus statement on sleep apnoea and type 2 diabetes. Brussels: International Diabetes Federation; (2008).Google Scholar
  58. 58.
    Donovan LM, Rueschman M, Weng J, Basu N, Dudley KA, Bakker JP, et al. The effectiveness of an obstructive sleep apnea screening and treatment program in patients with type 2 diabetes. Diabetes Res Clin Pract. 2017;134:145–52.  https://doi.org/10.1016/j.diabres.2017.10.013.CrossRefPubMedPubMedCentralGoogle Scholar
  59. 59.
    Antony KM, Agrawal A, Arndt ME, Murphy AM, Alapat PM, Guntupalli KK, et al. Obstructive sleep apnea in pregnancy: reliability of prevalence and prediction estimates. J Perinatol. 2014;34:587–93.CrossRefGoogle Scholar
  60. 60.
    Pien GW, Pack AI, Jackson N, Maislin G, Macones GA, Schwab RJ. Risk factors for sleep-disordered breathing in pregnancy. Thorax. 2014;69:371–7.CrossRefGoogle Scholar
  61. 61.
    Lockhart EM, Ben Abdallah A, Tuuli MG, Leighton BL. Obstructive sleep apnea in pregnancy: assessment of current screening tools. Obstet Gynecol. 2015;126:93–102.CrossRefGoogle Scholar
  62. 62.
    Louis J, Auckley D, Miladinovic B, Shepherd A, Mencin P, Kumar D, et al. Perinatal outcomes associated with obstructive sleep apnea in obese pregnant women. Obstet Gynecol. 2012;120:1085–92.PubMedGoogle Scholar
  63. 63.
    Chen Y-H, Kang J-H, Lin C-C, Wang I-T, Keller JJ, Lin H-C. Obstructive sleep apnea and the risk of adverse pregnancy outcomes. Am J Obstet Gynecol. 2012;206:136.e1–5.CrossRefGoogle Scholar
  64. 64.
    Facco FL, Parker CB, Reddy UM, Silver RM, Koch MA, Louis JM, et al. Association between sleep-disordered breathing and hypertensive disorders of pregnancy and gestational diabetes mellitus. Obstet Gynecol. 2017;129:31–41.CrossRefGoogle Scholar
  65. 65.
    Louis JM, Mogos MF, Salemi JL, Redline S, Salihu HM. Obstructive sleep apnea and severe maternal-infant morbidity/mortality in the United States, 1998–2009. Sleep. 2014;37:843–9.CrossRefGoogle Scholar
  66. 66.
    Fung AM, Wilson DL, Lappas M, Howard M, Barnes M, O'Donoghue F, et al. Effects of maternal obstructive sleep apnoea on fetal growth: a prospective cohort study. PLoS One. 2013;8:e68057.CrossRefGoogle Scholar
  67. 67.
    Pamidi S, Marc I, Simoneau G, Lavigne L, Olha A, Benedetti A, et al. Maternal sleep-disordered breathing and the risk of delivering small for gestational age infants: a prospective cohort study. Thorax. 2016;71:719–25.CrossRefGoogle Scholar
  68. 68.
    Lockhart EM, Ben Abdallah A, Tuuli MG, Leighton BL. Obstructive sleep apnea in pregnancy: assessment of current screening tools. Obstet Gynecol. 2015;126:93–102.CrossRefGoogle Scholar
  69. 69.
    Tantrakul V, Numthavaj P, Guilleminault C, McEvoy M, Panburana P, Khaing W, et al. Performance of screening questionnaires for obstructive sleep apnea during pregnancy: a systematic review and meta-analysis. Sleep Med Rev. 2017;36:96–106.  https://doi.org/10.1016/j.smrv.2016.11.003.CrossRefPubMedGoogle Scholar
  70. 70.
    Louis JM, Koch MA, Reddy UM, Silver RM, Parker CB, Facco FL, et al. Predictors of sleep-disordered breathing in pregnancy. Am J Obstet Gynecol. 2018;218(5):521.e1–521.e12.  https://doi.org/10.1016/j.ajog.2018.01.031.CrossRefGoogle Scholar
  71. 71.
    Facco FL, Ouyang DW, Zee PC, Grobman WA. Development of a pregnancy-specific screening tool for sleep apnea. J Clin Sleep Med. 2012;8(4):389–94.  https://doi.org/10.5664/jcsm.2030.CrossRefPubMedPubMedCentralGoogle Scholar
  72. 72.
    Continuous positive airway pressure (CPAP) for sleep apnea in pregnancy (SLEEP). ClinicalTrials.gov Identifier: NCT03487185.
  73. 73.
    Finkel KJ, Searleman AC, Tymkew H, Tanaka CY, Saager L, Safer-Zadeh E, et al. Prevalence of undiagnosed obstructive sleep apnea among adult surgical patients in an academic medical center. Sleep Med. 2009;10:753–8.CrossRefGoogle Scholar
  74. 74.
    Chung F, Ward B, Ho J, Yuan H, Kayumov L, Shapiro C. Preoperative identification of sleep apnea risk in elective surgical patients, using the Berlin questionnaire. J Clin Anesth. 2007;19:130–4.CrossRefGoogle Scholar
  75. 75.
    Vasu TS, Doghramji K, Cavallazzi R, Grewal R, Hirani A, Leiby B, et al. Obstructive sleep apnea syndrome and postoperative complications: clinical use of the STOP-BANG questionnaire. Arch Otolaryngol Head Neck Surg. 2010;136:1020–4.CrossRefGoogle Scholar
  76. 76.
    Frey WC, Pilcher J. Obstructive sleep-related breathing disorders in patients evaluated for bariatric surgery. Obes Surg. 2003;13:676–83.CrossRefGoogle Scholar
  77. 77.
    O’Keeffe T, Patterson EJ. Evidence supporting routine polysomnography before bariatric surgery. Obes Surg. 2004;14:23–6.CrossRefGoogle Scholar
  78. 78.
    Singh M, Liao P, Kobah S, Wijeysundera DN, Shapiro C, Chung F. Proportion of surgical patients with undiagnosed obstructive sleep apnoea. Br J Anaesth. 2013;110:629–36.CrossRefGoogle Scholar
  79. 79.
    Kaw R, Chung F, Pasupluleti V, et al. Meta-analysis of the association between obstructive sleep apnoea and postoperative outcome. Brit J Anesth. 2012;6:897–906.CrossRefGoogle Scholar
  80. 80.
    Vasu TS, Grewal R, Doghramji K. Obstructive sleep apnea syndrome and perioperative complications: a systematic review of the literature. J Clin Sleep Med. 2012;8(2):199–207.  https://doi.org/10.5664/jcsm.1784.CrossRefPubMedPubMedCentralGoogle Scholar
  81. 81.
    Dimitrov L, Macavei V. Can screening tools for obstructive sleep apnea predict postoperative complications? A systematic review of the literature. J Clin Sleep Med. 2016;12(9):1293–300.  https://doi.org/10.5664/jcsm.6136.CrossRefPubMedPubMedCentralGoogle Scholar
  82. 82.
    Gupta RM, Parvizi J, Hanssen AD, et al. Postoperative complications in patients with obstructive sleep apnea syndrome undergoing hip or knee replacement: a case-control study. Mayo Clin Proc. 2001;76:897–905.CrossRefGoogle Scholar
  83. 83.
    Practice guidelines for the perioperative management of patients with obstructive sleep apnea: an updated report by the American Society of Anesthesiologists Task Force on Perioperative Management of patients with obstructive sleep apnea. Anesthesiology. 2014;120:268–86.Google Scholar
  84. 84.
    Gurubhagavatula I, Sullivan S, Meoli A, Patil S, Olson R, Berneking M, et al. Management of obstructive sleep apnea in commercial motor vehicle operators: recommendations of the AASM Sleep and Transportation Safety Awareness Task Force. J Clin Sleep Med. 2017;13(5):745–58.  https://doi.org/10.5664/jcsm.6598.CrossRefPubMedPubMedCentralGoogle Scholar
  85. 85.
    Howard ME, Desai AV, Grunstein RR, Hukins C, Armstrong JG, Joffe D, et al. Sleepiness, sleep-disordered breathing, and accident risk factors in commercial vehicle drivers. Am J Respir Crit Care Med. 2004;170(9):1014–21.CrossRefGoogle Scholar
  86. 86.
    Pack A, Dinges D, Maislin G (2002) A study of prevalence of Sleep Apnea among commercial truck drivers. Publication no. DOT-RT-02–030. Federal Motor Carrier Safety Administration, Washington, DC.Google Scholar
  87. 87.
    Berger M, Varvarigou V, Rielly A, Czeisler CA, Malhotra A, Kales SN. Employer-mandated sleep apnea screening and diagnosis in commercial drivers. J Occup Environ Med. 2012;54(8):1017–25.CrossRefGoogle Scholar
  88. 88.
    Stoohs RA, Bingham LA, Itoi A, Guilleminault C, Dement WC. Sleep and sleep-disordered breathing in commercial long-haul truck drivers. Chest. 1995;107(5):1275–82.CrossRefGoogle Scholar
  89. 89.
    Seneviratne U, Puvanendran K. Excessive daytime sleepiness in obstructive sleep apnea: prevalence, severity, and predictors. Sleep Med. 2004;5:339–43.CrossRefGoogle Scholar
  90. 90.
    Tregear S, Reston J, Schoelles K, Phillips B. Obstructive sleep apnea and risk of motor vehicle crash: systematic review and meta-analysis. J Clin Sleep Med. 2009;5(10):573–81.PubMedPubMedCentralGoogle Scholar
  91. 91.
    Tregear S, Reston J, Schoelles K, Phillips B. Continuous positive airway pressure reduces risk of motor vehicle crash among drivers with obstructive sleep apnea: systematic review and meta-analysis. Sleep. 2010;33(10):1373–80.CrossRefGoogle Scholar
  92. 92.
    Hartenbaum N, Collop N, Rosen IM, et al. Sleep apnea and commercial motor vehicle operators: statement from the joint Task Force of the American College of Chest Physicians, American College of Occupational and Environmental Medicine, and the National Sleep Foundation. J Occup Environ Med. 2006;48(9Suppl):S4–S37.CrossRefGoogle Scholar
  93. 93.
    Ancoli-Israel S, Czeisler CA, George CF, Guilleminault C, Pack AI. Expert panel recommendations: obstructive sleep apnea and commercial motor vehicle driver safety. Federal Motor Carrier Safety Administration website. https://cms.fmcsa.dot.gov/regulations/medical/expert-panel-recommendationsobstructive-sleep-apnea-and-commercial-motor. Published 2008.
  94. 94.
    January 28, 2008 MRB Meeting Summary. Federal Motor Carrier Safety Administration website. https://www.fmcsa.dot.gov/january-28-2008-mrbmeeting-summary. Published April 7, 2008. Updated November 24, 2009.
  95. 95.
    Proposed recommendations on obstructive sleep apnea. Federal Motor Carrier Safety Administration website. https://www.fmcsa.dot.gov/regulations/ notices/2012–9555. Published April 20, 2012.
  96. 96.
    Final Report: OSA (MCSAC/MRB February 2012 meeting) (Task 11–05). Federal Motor Carrier Safety Administration website. https://www.fmcsa.dot. gov/advisory-committees/mcsac/final-report-osa-mcsacmrb-february-2012- meeting-task-11-05-0. Published February 21,2012.

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Section on Pulmonary Critical Care and Sleep Medicine, Good Samaritan HospitalUniversity of KentuckyLexingtonUSA

Personalised recommendations