Sleep apnea screenings lack evidence: U.S. panel

(Reuters Health) - It’s unclear whether everyone should be screened for a common sleep-related breathing problem, a government-backed U.S. panel says.

There is insufficient evidence to say whether doctors should be routinely screening for obstructive sleep apnea in people who don’t have any symptoms, said Dr. Alexander Krist, a member of the U.S. Preventive Services Task Force (USPSTF).

Obstructive sleep apnea occurs when the airway collapses and keeps air out for seconds to minutes at a time. The condition is linked with increased blood pressure, cardiovascular disease and other health conditions.

Data from the 1990s suggests about one in 10 people in the U.S. have mild obstructive sleep apnea while about 4 to 7 percent of people have more severe forms of the disease, according to the USPSTF. The disorder may be more common now due to higher rates of obesity.

To see whether the existing research on obstructive sleep apnea supports screening everyone for the disorder, the USPSTF commissioned a systematic review of the scientific literature.

No studies have examined whether using questionnaires to screen people for the disorder led to changes in their health, according to the USPSTF’s statement published in JAMA.

People who were treated for obstructive sleep apnea with continuous positive airway pressure - known as CPAP - and mandibular advancement devices did have some improvement in their blood pressure, daytime sleepiness and the severity of their disorder. Whether those benefits would apply to people screened without symptoms of the disorder is unknown.

As for harms, there was some evidence that CPAP and mandibular advancement devices may cause nasal dryness, nose bleeds, mucus, eye or skin irritations and discomfort.

While the USPSTF can’t recommend that everyone be screened for obstructive sleep apnea, Krist said it shouldn’t stop people with symptoms from being tested.

Loud and chronic snoring, choking during the night, morning headaches, cognition problems, mood changes, frequent nighttime bathroom use and dry mouth or sore throats in the morning are all symptoms of the disorder, according to the National Institutes of Health.

“If someone is suffering from that, they should talk to their doctor about whether sleep apnea is something they should be concerned about,” said Krist, who is also a family physician affiliated with Virginia Commonwealth University in Richmond.

The new statement from the USPSTF is a call for more research into the disorder, he told Reuters Health.

SOURCE: and JAMA, online January 24, 2017.