PDF(Pubmed)
Abstract：
Evaluation and interpretation of the literature on obstructive sleep apnea (OSA) allows for consolidation and determination of the key factors important for clinical management of the adult OSA patient. Toward this goal, an international collaborative of multidisciplinary experts in sleep apnea evaluation and treatment have produced the International Consensus statement on Obstructive Sleep Apnea (ICS:OSA).
Using previously defined methodology, focal topics in OSA were assigned as literature review (LR), evidence-based review (EBR), or evidence-based review with recommendations (EBR-R) formats. Each topic incorporated the available and relevant evidence which was summarized and graded on study quality. Each topic and section underwent iterative review and the ICS:OSA was created and reviewed by all authors for consensus.
The ICS:OSA addresses OSA syndrome definitions, pathophysiology, epidemiology, risk factors for disease, screening methods, diagnostic testing types, multiple treatment modalities, and effects of OSA treatment on multiple OSA-associated comorbidities. Specific focus on outcomes with positive airway pressure (PAP) and surgical treatments were evaluated.
This review of the literature consolidates the available knowledge and identifies the limitations of the current evidence on OSA. This effort aims to create a resource for OSA evidence-based practice and identify future research needs. Knowledge gaps and research opportunities include improving the metrics of OSA disease, determining the optimal OSA screening paradigms, developing strategies for PAP adherence and longitudinal care, enhancing selection of PAP alternatives and surgery, understanding health risk outcomes, and translating evidence into individualized approaches to therapy.
Using previously defined methodology, focal topics in OSA were assigned as literature review (LR), evidence-based review (EBR), or evidence-based review with recommendations (EBR-R) formats. Each topic incorporated the available and relevant evidence which was summarized and graded on study quality. Each topic and section underwent iterative review and the ICS:OSA was created and reviewed by all authors for consensus.
The ICS:OSA addresses OSA syndrome definitions, pathophysiology, epidemiology, risk factors for disease, screening methods, diagnostic testing types, multiple treatment modalities, and effects of OSA treatment on multiple OSA-associated comorbidities. Specific focus on outcomes with positive airway pressure (PAP) and surgical treatments were evaluated.
This review of the literature consolidates the available knowledge and identifies the limitations of the current evidence on OSA. This effort aims to create a resource for OSA evidence-based practice and identify future research needs. Knowledge gaps and research opportunities include improving the metrics of OSA disease, determining the optimal OSA screening paradigms, developing strategies for PAP adherence and longitudinal care, enhancing selection of PAP alternatives and surgery, understanding health risk outcomes, and translating evidence into individualized approaches to therapy.
摘要：
背景：需要对阻塞性睡眠呼吸暂停的文献进行评估和解释，以巩固和总结对OSA成年患者临床管理重要的关键因素。为了这个目标,由睡眠呼吸暂停评估和治疗方面的多学科专家组成的国际合作组织发表了《阻塞性睡眠呼吸暂停国际共识声明》(ICS:OSA).
方法：使用先前定义的方法，OSA中的焦点主题被指定为文献综述(LR)，循证审查(EBR)，或基于建议的循证审查(EBR-R)格式。每个主题都包含了现有的相关证据，并对研究质量进行了总结和分级。每个主题和部分都进行了迭代审查，并创建了ICS：OSA，并由所有作者进行了审查，以达成共识。
结果：ICS：OSA解决了OSA综合征的定义，病理生理学,流行病学,疾病的危险因素，筛选方法,诊断测试类型,多种治疗方式，以及OSA和治疗对多种合并症的影响。评估了气道正压通气（PAP）和手术治疗的具体结果。
结论：这篇关于OSA文献的综述巩固了现有的知识，并确定了现有证据的局限性。这项工作旨在突出OSA循证实践的基础，并确定未来的研究需求。知识差距和改善机会包括改善OSA疾病的指标，确定最佳OSA筛选范例，制定PAP依从性和纵向护理的策略，加强PAP替代方案和手术的选择，了解健康风险结果，并将证据转化为个性化的治疗方法。本文受版权保护。保留所有权利。
方法：使用先前定义的方法，OSA中的焦点主题被指定为文献综述(LR)，循证审查(EBR)，或基于建议的循证审查(EBR-R)格式。每个主题都包含了现有的相关证据，并对研究质量进行了总结和分级。每个主题和部分都进行了迭代审查，并创建了ICS：OSA，并由所有作者进行了审查，以达成共识。
结果：ICS：OSA解决了OSA综合征的定义，病理生理学,流行病学,疾病的危险因素，筛选方法,诊断测试类型,多种治疗方式，以及OSA和治疗对多种合并症的影响。评估了气道正压通气（PAP）和手术治疗的具体结果。
结论：这篇关于OSA文献的综述巩固了现有的知识，并确定了现有证据的局限性。这项工作旨在突出OSA循证实践的基础，并确定未来的研究需求。知识差距和改善机会包括改善OSA疾病的指标，确定最佳OSA筛选范例，制定PAP依从性和纵向护理的策略，加强PAP替代方案和手术的选择，了解健康风险结果，并将证据转化为个性化的治疗方法。本文受版权保护。保留所有权利。
