Identify the disease condition and give a brief statement of incidence and prevalence in the U.S. Discuss the pathophysiology of the disease and typical clinical presentation seen in patients with the condition. 

Powerpoint presentation with notes on Cpg, the Clinical Practice Guidelines

The Clinical Practice Guidelines for Adult Obstructive sleep Apnea

Disease & Background:

Obstructive sleep apnea is a sleep disorder that results in interrupted sleep and intermittent hypoxia. OSA affects around 3% of American women and 10% of US men. OSA occurs more frequently in people over 50, those who are obese, and individuals with specific craniofacial disorders. OSA is often characterized by loud snoring or apneas that are witnessed, as well as excessive sleepiness and headaches in the morning.

Publication & Applicability in Primary Care:

American Academy of Sleep Medicine has developed a Clinical Practice Guideline in 2017 for the Diagnosis of Adult Obstructive Sleep Apnea. In 2019, the guideline was updated, and it is best to refer to this most recent revision. The CPG can be used in primary care settings, as primary care providers often are the first to contact patients who have symptoms of OSA.

Key Action Statements & Body of Evidence:

1. According to the AASM, polysomnography should be performed as a standard test in adult patients suspected of having OSA. (Strong recommendation, high-quality evidence)
2. The AASM recommends that home sleep apnea tests (HSAT), which are performed without a physician present, can be used to diagnose OSA for patients who have a moderate-to-severe OSA pre-test probability. (Conditional recommendation, moderate-quality evidence)
3. The AASM suggests that PSG be used to diagnose patients who have OSA, and comorbidities like chronic obstructive pulmonary (COPD), congestive cardiac failure (CHF), neuromuscular diseases. (Strong recommendation, moderate-quality evidence)
4. (Conditional recommendation, low-quality evidence) The AASM recommends that PSG be used to diagnose patients who have OSA with comorbidities like chronic insomnia and restless legs syndrome. (Conditional recommendation, low-quality evidence)
5. (Strong recommendation, moderate-quality evidence) The AASM advises against routinely using sleep questionnaires or Clinical Prediction Rules to diagnose OSA among adults. (Strong recommendation, moderate-quality evidence)

In summary, the AASM’s CPG for the Diagnostic Testing for Adult Obstructive Sleep Apnea provides evidence-based recommendations for the diagnosis of OSA. PSG can be recommended as an adult diagnostic standard test. Home sleep apnea test can be performed by patients who have a higher pre-test likelihood of having moderate or severe OSA. PSG may be recommended in patients who have comorbidities, such as COPD or CHF. Sleep questionnaires or rules of clinical prediction are not recommended for adults to diagnose OSA. These recommendations should be known by primary care providers when they evaluate and manage patients who have symptoms of OSA.