Evidence-based Criteria for Sleep Testing for Obstructive Sleep Apnea (OSA)
| Sleep Testing | Ranking | Basis for Ranking |
|---|---|---|
| Full attended polysomnography indications: | ||
| a) The diagnosis of sleep-related breathing disorders | A | Standard of care32–34 |
| b) Positive airway pressure titration | A | Standard of care32–34 |
| c) Pre- and postoperative evaluation of patients having surgery for obstructive sleep apnea | A | Standard of care32–34 |
| d) Evaluation of patients being treated for OSA with persistent symptoms | A | High quality cohort studies32–34 |
| e) Patients with systolic or diastolic heart failure not responding to optimal medical management | A | Prospective diagnostic cohort studies8 |
| Split-night attended polysomnography for the diagnosis and treatment of sleep-related breathing disorders | A | Prospective diagnostic cohort studies32 |
| Treatment with PAP systems leads to reduced symptoms of sleepiness, increased quality of life, and lower blood pressure | A | Meta-analysis of retrospective cohort studies29 |
| Nonattended polysomnography (PSG) for the diagnosis of sleep-related breathing disorders | B | Retrospective cohort and case control studies with good follow up35,36 |
| Limited PSG for the diagnosis of sleep-related breathing disorders | — | Opinion and lower initial procedure cost35,36 |
| Auto-titrating PAP for treating obstructive sleep apnea | B | Case control studies with good follow up37 |
| Multiple sleep latency testing indications: | ||
| a) Assessing daytime sleepiness | B | Meta-analysis, usual practice, usual practice, disease oriented evidence38 |
| Maintenance of Wakefulness Testing to assess daytime sleepiness | C | Disease oriented evidence, usual practice38 |