Current treatment practices in obstructive sleep apnea and snoring.

PURPOSE: To determine current management strategies of otolaryngologists involved in the treatment of sleep-disordered breathing.

MATERIALS AND

METHODS

Survey of practitioners regarding their workup and treatment of patients suspected of obstructive sleep apnea.

RESULTS

Of 305 respondents, 280 actively treated patients with obstructive sleep apnea or snoring, form the basis for this study. Respondents were from assorted practice settings, from a diverse geographic background, and varied length of time in practice. Although 48% see more than 3 new outpatients a week for snoring or obstructive sleep apnea, only 46% routinely ask their patients about sleep problems, and 49 % fail to ask all of their patients with sleep apnea about sleep-related automobile accidents. Although most regularly use nasopharyngoscopy, a significant proportion seldom uses the Müller maneuver. Most tend to rely predominantly on whole-night polysomnography, rather than split night or home testing. Half of respondents offer their patients with simple snoring more than 1 method of treatment. Although many different surgical procedures are offered by most, only 28% of respondents offer patients any procedure aimed at airway obstruction at the base of tongue level.

CONCLUSIONS

Otolaryngologists, with their unique expertise in airway management, need to be more vigilant for patients with sleep-disordered breathing. The hypopharynx fails to be frequently addressed by the respondents and could lead to inadequate treatment of obstructive sleep apnea. Further research should seek to develop an evidence-based standard of care such that this disorder might be most effectively managed in the future.