Interventions for the Treatment of Obstructive Sleep Apnea in Adults: Recommendations
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As part of our collaboration with the Canadian Agency for Drugs and Technologies in Health (CADTH), I had the pleasure to interview Dr. Sachin Pendharkar, Associate Professor of Medicine and Community Health Sciences at the University of Calgary. CADTH conducted a comprehensive health technology assessment on Obstructive sleep apnea (OSA). The assessment was later used as the basis to develop a set of recommendations by CADTH expert committee. Dr. Pendharkar helped develop the recommendations for the CADTH report. I hope you find the interview informative. If you have questions related to OSA, email us at oasisdiscussions@cda-adc.ca Chiraz Guessaier, CDA Oasis Manager |
Highlights
Obstructive sleep apnea (OSA), a sleep disorder in which breathing stops and starts, can lead to serious health complications such as fatigue, hypertension, cardiovascular events, and diabetes. OSA occurs when the muscles of the throat intermittently relax during sleep, resulting in complete or partial blockage of the upper airway. Anyone can develop OSA, but some factors may increase the risk, such as obesity, male gender, older age, alcohol and drug use, smoking, having narrowed airways, and family history.
There are a variety of interventions for the management of OSA, and the use of positive airway pressure therapy is one option for OSA. Others include mandibular advancement devices to facilitate airflow, surgery, changes in diet and lifestyle to reduce risk factors for OSA, and pharmacotherapy. Public coverage of the costs of these treatments varies across Canada, leading to differences in access for Canadians. This is due, at least in part, to the challenge of selecting the most appropriate therapy for patients with differing clinical profiles.
Full interview (16.39″)
What is the association between parafunction (bruxism) and sleep apnea? Should bruxing patients be referred for sleep study before insertion of a bruxism appliance?
CDA Oasis Team On behalf of Dr. Sachin Pendharkar:
“I am not aware of strong evidence to link bruxism and sleep apnea, although there are a few studies demonstrating a possible epidemiologic connection. I would not recommend testing someone with bruxism for OSA unless they are otherwise at higher risk for OSA. From a treatment perspective, however, it would be important to identify those at higher risk for OSA if oral appliance therapy is being considered, as it would impact the selection of device.”