title: Practice parameters for the medical therapy of obstructive sleep apnea.
abstract: Therapies for obstructive sleep apnea other than positive airway pressure, oral appliances, and surgical modifications of the upper airway are reviewed in this practice parameter. Several of these therapies such as weight loss and positional therapy hold some promise. Others, such as serotonergic agents, may gain credibility in the future but lack well-designed clinical trials. No practice parameters could be developed for a number of possible therapeutic modalities that had little or no evidence-based data on which to form a conclusion. The role of an organized, targeted weight-loss program either as a single therapy or as a supplement to PAP needs to be clarified. Although bariatric surgery is increasingly performed for refractory medically complicated obesity, its long-term effectiveness in treatment of obstructive sleep apnea in morbidly obese patients is not yet demonstrated. Positional therapy, or methods for preventing sleep in the supine position, has probably been underutilized due to lack of easily measured predictive factors and randomized controlled trials.
authors.affiliation: Sleep Disorders Center, Pulm Crit Care Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. morgenthaler.timothy@mayo.edu
authors.forename: Timothy I
authors.initials: TI
authors.lastname: Morgenthaler
authors.forename: Sheldon
authors.initials: S
authors.lastname: Kapen
authors.forename: Teofilo
authors.initials: T
authors.lastname: Lee-Chiong
authors.forename: Cathy
authors.initials: C
authors.lastname: Alessi
authors.forename: Brian
authors.initials: B
authors.lastname: Boehlecke
authors.forename: Terry
authors.initials: T
authors.lastname: Brown
authors.forename: Jack
authors.initials: J
authors.lastname: Coleman
authors.forename: Leah
authors.initials: L
authors.lastname: Friedman
authors.forename: Vishesh
authors.initials: V
authors.lastname: Kapur
authors.forename: Judith
authors.initials: J
authors.lastname: Owens
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Pancer
authors.forename: Todd
authors.initials: T
authors.lastname: Swick
mesh_terms: D003131:Combined Modality Therapy; D045422:Continuous Positive Airway Pressure; D019317:Evidence-Based Medicine; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D020181:Sleep Apnea, Obstructive / Q000628:therapy*; D016896:Treatment Outcome; D015431:Weight Loss