Am. J. Respir. Crit. Care Med., Vol 155, No. 1, 01 1997, 9-14.
Population and occupational screening for obstructive sleep apnea: are we there yet?
MJ Baumel, G Maislin and AI Pack
Department of Medicine, Center for Sleep and Respiratory Neurobiology, University of Pennsylvania Medical Center, Philadelphia 19104-4283, USA.
Several features of obstructive sleep apnea (OSA) suggest that it may be an
appropriate disease for screening programs for general populations and more
specific high-risk groups. Preliminary data suggest that OSA represents an
important health problem in terms of high prevalence, increased levels of
morbidity and mortality, and increased public safety risk. Furthermore, the
chronicity of the disease and the relatively low levels of recognition of
the disorder in the medical community suggest a potential for lead-time
gains for screening programs. Specific groups that might be considered for
screening programs include commercial vehicle operators, hazardous duty
personnel, and certain groups of medical patients. The purpose of this
clinical commentary is to consider the issues of population and specific
group screening for OSA by reviewing the general principles of screening
for chronic disease and then applying these principles specifically in the
case of OSA. More extensive outcomes data relating levels of severity of
the disorder to its potential adverse outcomes are needed and will assist
in tailoring appropriate screening programs and determining the
cost-effectiveness of screening various populations.
