Screening for Obstructive Sleep Apnea in Adults: Updated Evidence Report and Systematic Review for the US Preventive...

Area of Science:

• Sleep Medicine
• Preventive Health
• Clinical Diagnostics

Background:

• Obstructive sleep apnea (OSA) is linked to serious adverse health outcomes.
• Effective screening strategies are needed for early detection and intervention.

Purpose of the Study:

• To evaluate the evidence on screening test accuracy for OSA in asymptomatic or undiagnosed adults.
• To inform the US Preventive Services Task Force recommendations.

Main Methods:

• Systematic review of screening test accuracy studies, randomized clinical trials (RCTs), and meta-analyses.
• Searched major databases (PubMed, Embase, Cochrane) and trial registries.
• Included studies reporting on test accuracy, quality of life, and health outcomes.

Main Results:

• Screening accuracy varied; Multivariable Apnea Prediction score showed good accuracy (AUC 0.80-0.83) for severe OSA.
• Positive airway pressure (PAP) and mandibular advancement devices improved excessive daytime sleepiness (ESS) and quality of life (QOL).
• No significant reduction in mortality, cardiovascular events, or crashes was found with PAP treatment; modest blood pressure reduction observed.

Conclusions:

• The clinical utility and accuracy of primary care OSA screening tools remain uncertain.
• While PAP and mandibular advancement devices improve symptoms and QOL, their long-term impact on major health outcomes requires further investigation.
• Evidence does not support screening for reducing mortality or major adverse health events.