Research Priorities in Ambulatory Management of Obstructive Sleep Apnea Workshop

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The application seeks partial financial support for a workshop on research priorities in the ambulatory management of obstructive sleep apnea (OSA) to be held on October 15-16, 2007 in Washington, DC. Moderate to severe OSA is estimated to affect 4% of adult females and 9% of adult males in the US and a large majority of these individuals are undiagnosed. A large body of data now supports that OSA is an independent risk factor for motor vehicle accidents, neurocognitive deficits, and cardiovascular morbidity and mortality. Substantial evidence also supports that appropriate treatment of OSA reduces the risk of these consequences. However there is a major problem with patient access to diagnosis and treatment of OSA based on the need to perform costly and labor-intensive polysomnography in a sleep laboratory. Technological improvements may allow for the use of simplified portable monitor testing for OSA in diverse settings, including unattended home recordings. Such an approach might reduce cost and increase patient access to testing, leading to earlier recognition of disease and faster initiation of treatment, thereby reducing the health care burden associated with OSA. Interest in the clinical application of portable monitor devices is growing rapidly, and in some contexts, portable monitoring has become a mainstay approach to the management of OSA. Despite the intuitive appeal of portable monitor testing, validation data remain limited. A recent report from the Institute of Medicine and evidence based reviews from AHRQ and professional societies find major deficiencies particularly with regard to unattended home portable monitor testing. The planned workshop on research priorities in ambulatory management of OSA is a direct response to these reports. The workshop will bring together diverse stakeholders with interest in portable monitor testing to establish the research priorities regarding portable monitor testing and develop specific recommendations regarding methodological issues in this critical area. We submit that this workshop is an essential ?next step? to ensuring that there is substantive advancement of scientific knowledge in this important field.