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April/May 2017 (vol. 13/6)
While treatments for obstructive sleep apnoea are effective in improving some health outcomes, there is insufficient evidence to justify screening for, or treatment of, the condition in asymptomatic adults (including adults with unrecognised symptoms) a systematic review of screening tools, diagnostic tests and treatments by the US Preventive Services Task Force concludes. The review and meta-analysis included 110 studies, with a combined population of 46,188 participants. There were no randomised trials on the effect of screening on clinical outcomes, and insufficient evidence to assess the balance between the benefits and harms of screening. For those referred for treatment, continuous positive airway pressure (CPAP) improved intermediate health outcomes – reduced apnoea-hypopnea index (AHI) and Epworth Sleepiness Scale (ESS) scores, and lower blood pressure – and sleeprelated quality of life. Mandibular advancement devices (MADs) and weight-loss programmes were also associated with lower AHI and ESS scores. However, there was inadequate evidence on whether or not CPAP or MADs improved longer-term health outcomes, such as mortality, cognitive impairment, motor vehicle crashes and cardiovascular or cerebrovascular events.
Occupational Health at Work April/May 2017 (vol. 13/6) pp39-40