Scottish Intercollegiate Guidelines Network

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Scottish Intercollegiate Guidelines NetworkManagement of Obstructive SleepApnoea/Hypopnoea Syndrome in AdultsA national clinical guideline1Introduction12Definitions and clinical background33Diagnosis64Treatment of OSAHS125Surgical interventions186Effects of treatment on driving and quality of life 217Information for discussion withpatients and carers248Development of the guideline269Implementation and audit29Annexes30Abbreviations32Reference s33June 200373This guideline is endorsed by the British Thoracic Society Scottish Intercollegiate Guidelines NetworkISBN 1 899893 33 4First published 2003SIGN consents to the photocopying of this guideline for thepurpose of implementation in NHSScotlandScottish Intercollegiate Guidelines NetworkRoyal College of Physicians9 Queen StreetEdinburgh EH2 TO EVIDENCE STATEMENTS AND GRADES OF RECOMMENDATIONSLEVELS OF EVIDENCE1++High quality meta-analyses, systematic reviews of randomised controlled trials (RCTs),or RCTs with a very low risk of bias1+Well conducted meta-analyses, systematic reviews of RCTs, or RCTs with a lowrisk of bias1 -Meta-analyses, systematic reviews of RCTs, or RCTs with a high risk of bias2++High quality systematic reviews

3 2 DEFINITIONS AND BACKGROUND 2 Definitions and clinical background 2.1 CLINICAL FEATURES There are many causes of excessive sleepiness but the commonest treatable medical cause is the

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