Summary of Evidence Based on Strength of Recommendation Taxonomy
| STRONG EVIDENCE (A) |
| The association of adult obstructive sleep apnea (OSA) with obesity, daytime sleepiness, hypertension, and motor vehicular accidents |
| Full-night or split-night attended polysomnography (PSG) indicated for the diagnosis and treatment of adult OSA and for patients with systolic or diastolic heart failure not responding to optimal medical management |
| GOOD EVIDENCE (B) |
| The association of adult OSA with congestive heart failure, myocardial infarction, cerebral vascular accidents, increased mortality, diabetes, and metabolic syndrome |
| Nonattended PSGs can diagnosis sleep breathing disorders |
| Auto-titration systems can be used to titrate continuous positive airway pressure (CPAP) therapy |
| Multiple sleep latency testing (MSLT) can be used in the assessment of daytime sleepiness |
| AREAS NEEDING MORE EVIDENCE |
| Treatment benefit |
| Pediatric sleep apnea |
| Long-term effects of CPAP, surgical, and dental treatment of adult OSA |
| Diagnostic correlates |
| Pediatric sleep apnea |
| Diagnostic testing |
| Pediatric sleep apnea |
| Maintenance of wakefulness test (MWT) for assessing daytime performance in sleepy patients |
| Alternatives to Epworth, MSLT, and MWT for assessing daytime sleepiness |
| Diagnostic and treatment alternatives to PSG in adult OSA |