This guideline establishes clinical practice recommendations for positive airway pressure (PAP) treatment of obstructive sleep apnea (OSA) in adults
Nightmare disorder affects approximately 4% of adults, occurring in isolation or as part of other disorders such as posttraumatic stress disorder (PTSD), and can significantly impair quality of life. This paper provides the American Academy of Sleep Medicine (AASM) position regarding various treatments of nightmare disorder in adults.
The diagnostic procedure for insomnia, and its co‐morbidities, should include a clinical interview, sleep history (sleep habits, sleep environment, work schedules, circadian factors), sleep questionnaires and diaries, questions about somatic and mental health, a physical examination and additional measures if indicated. Polysomnography can be used to evaluate other sleep disorders if suspected (i.e. periodic limb movement disorder, sleep‐related breathing disorders), in treatment‐resistant insomnia, for professional at‐risk populations and when substantial sleep state misperception is suspected. Cognitive behavioural therapy for insomnia is recommended as the first‐line treatment for chronic insomnia in adults of any age. A pharmacological intervention can be offered if this is not effective or not available. Benzodiazepines, benzodiazepine receptor agonists and some antidepressants are effective for short‐term treatment.
The complexity of central breathing disturbances during sleep has become increasingly obvious. They present as central sleep apnoeas (CSAs) and hypopnoeas, periodic breathing with apnoeas, or irregular breathing in patients with cardiovascular, other internal or neurological disorders, and can emerge under positive airway pressure treatment or opioid use, or at high altitude. As yet, there is insufficient knowledge on the clinical features, pathophysiological background and consecutive algorithms for stepped-care treatment. This guideline addresses the definition, discrimination, diagnosis and treatment of central breathing disturbances.
Current evidence on the safety and efficacy of hypoglossal nerve stimulation for moderate to severe obstructive sleep apnoea is limited in quantity and quality. Therefore, NICE recommends that this procedure should only be used with special arrangements for clinical governance, consent and audit or research.
An Official American Thoracic Society Research Statement: Impact of Mild Obstructive Sleep Apnea in Adults
A Canadian Thoracic Society position paper on driving and sleep apnoea
European Respiratory Society and European Society for hypertension recommendations and state-of-the-art review of epidemiology, pathophysiology, diagnostic procedures and treatment options for appropriate management of obstructive sleep apnoea (OSA) in cardiovascular (in particular hypertensive) patients, as well as for the management of cardiovascular diseases (in particular arterial hypertension) in OSA patients.
An Official American Thoracic Society Clinical Practice Guideline: Sleep Apnea, Sleepiness, and Driving Risk in Noncommercial Drivers
American Academy of Sleep Medicine (AASM) practice parameters of the treatment of Central Sleep Apnea Syndromes in Adults with an Evidence-Based Literature Review and Meta-Analyses
An American Academy of Sleep Medicine Clinical Practice Guideline on the Treatment of Restless Legs Syndrome and Periodic Limb Movement Disorder in Adults—An Update for 2012: Practice Parameters with an Evidence-
Based Systematic Review and Meta-Analyses
Canadian Thoracic Society 2011 guideline update: Diagnosis and treatment of sleep disordered breathing.
European Respiratory Society (ERS) task force report on non-CPAP therapies in obstructive sleep apnoea
An Official American Thoracic Society/AASM/ACCP/ERS Workshop Report addressing the research priorities for incorporating ambulatory management of adults with obstructive sleep apnoea into healthcare systems.
American Academy of Sleep Medicine (AASM) practice parameters for the Respiratory Indications for Polysomnography in Children
European Federation of Neurological Societies guidelines on the management of Narcolepsy in adults.
Canadian Thoracic Society/Canadian Sleep Society position paper on the use of portable monitoring for the diagnosis of obstructive sleep apnea/hypopnea in adults.
British Association for Psychopharmacology consensus statement on evidence-based treatment of insomnia, parasomnias and circadian rhythm disorders.
American Academy of Sleep Medicine (AASM) practice parameters for the Surgical Modifications of the Upper Airway for Obstructive Sleep Apnea in Adults
Adult Obstructive sleep Apnoea Task Force of the American Academy of sleep Medicine (AASM) clinical guideline.
UK National Institute for Health and Clinical Excellence (NICE) guideline on Continuous positive airway pressure for the treatment of obstructive sleep apnoea/hypopnoea syndrome