AAST newsletter and AASM info

xxyzx wrote:Lately, the news has not been great for CPAP users and the sleep centers that care for them. The USPSTF recommended against screening of asymptomatic patients and, in doing so, threw some major shade on the use of CPAP.

They wrote: “There is uncertainty about the accuracy or clinical utility of all potential screening tools. Multiple treatments for OSA reduce AHI, ESS scores, and blood pressure. Trials of CPAP and other treatments have not established whether treatment reduces mortality or improves most other health outcomes, except for modest improvement in sleep-related quality of life.” (1, p. 415)

Sleep physicians believe they are helping patients reverse the consequences of OSA when they prescribe CPAP. But clear data in support of this has been lacking.

The AASM practice parameter recommends the use of CPAP for treatment of OSA because it reduces apnea. (2) The 2006 paper cites evidence of reduced sleepiness, improved quality of life, reduced blood pressure and minimal side effects as indications for use.

But, as the USPSTF points out, there is little evidence to support increased lifespan or reduced cardiovascular events. And, as data from the recent SAVE study showed, CPAP did not reduce cardiovascular events in patients with moderate-to-severe OSA. (3)

We don’t have much new to say about mortality or other health outcomes, but we have some new evidence to bolster the benefits of CPAP for health-related quality of life (HRQoL).

Let’s not underestimate the value of improved HRQoL. The AASM has included quality of life as one of the outcomes measures for OSA. (5) The improvement in the BestAIR study occurred even with the usual levels of adherence: an average of 3.8 hours of use per night and only 43.4% of patients meeting the arbitrary Medicare criterion of > 4 hours per night for 70% of nights. (4) The reduction in bodily pain was significant at p = .001.

Most of us would strongly consider a treatment even when the only benefit was feeling better, especially when the incidence of side effects is low.

It may be time for sleep professionals to move away from saying, “you have to use CPAP or you will die” to “try some CPAP; it will make you feel better.”

good evidence has established that persons with severe OSA die at twice the rate of controls

xxyzx wrote:

Goofproof wrote:

xxyzx wrote:Lately, the news has not been great for CPAP users and the sleep centers that care for them. The USPSTF recommended against screening of asymptomatic patients and, in doing so, threw some major shade on the use of CPAP.

They wrote: “There is uncertainty about the accuracy or clinical utility of all potential screening tools. Multiple treatments for OSA reduce AHI, ESS scores, and blood pressure. Trials of CPAP and other treatments have not established whether treatment reduces mortality or improves most other health outcomes, except for modest improvement in sleep-related quality of life.” (1, p. 415)

Sleep physicians believe they are helping patients reverse the consequences of OSA when they prescribe CPAP. But clear data in support of this has been lacking.

The AASM practice parameter recommends the use of CPAP for treatment of OSA because it reduces apnea. (2) The 2006 paper cites evidence of reduced sleepiness, improved quality of life, reduced blood pressure and minimal side effects as indications for use.

But, as the USPSTF points out, there is little evidence to support increased lifespan or reduced cardiovascular events. And, as data from the recent SAVE study showed, CPAP did not reduce cardiovascular events in patients with moderate-to-severe OSA. (3)

We don’t have much new to say about mortality or other health outcomes, but we have some new evidence to bolster the benefits of CPAP for health-related quality of life (HRQoL).

Let’s not underestimate the value of improved HRQoL. The AASM has included quality of life as one of the outcomes measures for OSA. (5) The improvement in the BestAIR study occurred even with the usual levels of adherence: an average of 3.8 hours of use per night and only 43.4% of patients meeting the arbitrary Medicare criterion of > 4 hours per night for 70% of nights. (4) The reduction in bodily pain was significant at p = .001.

Most of us would strongly consider a treatment even when the only benefit was feeling better, especially when the incidence of side effects is low.

It may be time for sleep professionals to move away from saying, “you have to use CPAP or you will die” to “try some CPAP; it will make you feel better.”

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More Junk writing, but they still got paid, that was the point, get (over) Paid.

As far as your post, it explains a lot, like your other posts, you are reading the print on the bottom the trash cans. Jim

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so you think AASM is a bunch of quacks and a double blind study with the results to back up their statement is trash

do you have any scientific evidence to dispute their conclusions

xxyzx wrote:Polly want a cracker

MaryLand wrote:Not only that, but using the criteria of ">4 hours per night, 70% of nights" tells us very little. 4 hours a night for 70% of nights, IMHO, will not yield nearly the benefits of 7 or 8 hours a night, 100% of nights. A truly well designed study would look at the outcomes for the latter group and compare it both to the 4 hours/70% group and an untreated group. It's like saying a daily dose of 400 IU of vitamin D gives only modest benefits, instead of recognizing that most people actually need at least 2000 IU per day up to 10,000 IU per day of vitamin D for optimal benefit.