Guidelines in Development

AASM clinical practice guidelines provide physicians with recommendations for the evaluation, diagnosis, treatment and follow-up of patients with sleep disorders.

The AASM Guidelines Advisory Panel reviews and prioritizes suggested topics for clinical practice guidelines to identify those most suited for further pursuit. The AASM Board of Directors approves topics for development, then invites experts in sleep and circadian science research and sleep medicine to develop the guideline.

The task force performs a systematic review of all published evidence on the topic, and then it assesses the evidence using GRADE (Grading of Recommendations Assessment, Development and Evaluation). Evidence-based clinical practice recommendations are developed to provide overall diagnostic or treatment strategies for patients, taking into account the quality of evidence, balance of benefits versus harms, patient values and preferences and resource use.

A draft of the guideline will be made available for a 4-week public comment period before it is approved by the AASM Board of Directors for publication.

Clinical Practice Guideline for Medications for Residual Sleepiness in Adults Treated for Obstructive Sleep Apnea

This clinical practice guideline will provide practice recommendations for the treatment of residual sleepiness in effectively treated adults with obstructive sleep apnea.

Task Force Chair: Chitra Lal, MD

Task Force Members:

  • Lucas Donovan, MD, MS (Vice Chair)
  • Mark Boulos, MD, MSc
  • Sogol Javaheri, MD, MPH, MA
  • Gonzalo Labarca Trucios, MD
  • Chad Ruoff, MD

BOD Liaison: Alexandre Rocha Abreu, MD
GAP Liaison: James Rowley, MD
Staff: Gerard Carandang, MS

Patient Populations: Adults with OSA (age greater than or equal to 18 years, AHI ≥ 5/hr) who are adequately treated for OSA with any primary therapy for OSA and still have residual sleepiness

Interventions:

  1. Modafinil
  2. Armodafinil
  3. Solriamfetol
  4. Pitolisant
  5. Methylphenidate hydrochloride
  6. Lisdexamphetamine
  7. Dexmethylphenidate
  8. Amphetamine/Dextroamphetamine
  9. Caffeine

Outcomes:

  1. Excessive daytime sleepiness (ESS, MWT, etc.)
  2. Quality of life
  3. Functional status
  4. Cognition
  5. Vigilance
  6. Driving safety
  7. Work productivity/academic performance
  8. Adverse events

The final recommendations will be based upon the available evidence, and must be approved by the AASM Board of Directors.

Clinical Practice Guideline for the Diagnostic Testing for Adult OSA

This guideline project will prioritize doing a focused update of the existing clinical practice guideline for the diagnostic testing for adult OSA. An updated literature search will capture evidence for newer devices that can be included in the evidence base for the guideline.

Task Force Chair: Indu Ayappa, PhD

Task Force Members:

  • Dennis Auckley, MD (Vice Chair)
  • Lee Brown, MD
  • Ambrose Chiang, MD
  • Joyce Lee-Iannotti, MD

BOD and GAP Liaison: Vishesh Kapur, MD, MPH

Staff: Gerard Carandang, MS

Patient Populations:

Uncomplicated adult patients presenting with signs and symptoms that indicate an increased risk of OSA

Interventions:

  1. Updated data in previously accepted types of home sleep apnea tests
  2. Data in new/novel types of home sleep apnea tests

Outcomes:

  1. Diagnostic accuracy
  2. Quality of life
  3. Sleepiness
  4. OSA severity (AHI, REI, ODI, hypoxemic burden, time below 90%)
  5. Cardiovascular endpoints
  6. Mental health
  7. Cognitive function
  8. Treatment adherence

The final recommendations will be based upon the available evidence, and must be approved by the AASM Board of Directors.

Clinical Practice Guideline for the Use of a Home Sleep Apnea Test (HSAT) for the Diagnosis of OSA in Children

This clinical practice guideline will provide practice recommendations for the use of HSAT for the diagnosis of OSA in children. This guideline will update and replace the existing position paper for the Use of HSAT for the diagnosis of OSA in Children (2017).

Task Force Chair: Lynn D’Andrea, MD

Task Force Members: 

  • Christopher Cielo, DO (Vice Chair)
  • Anne-Marie Adams, PhD
  • Dominic Gault, MD
  • Christine Heubi, MD

BOD Liaison: Anuja Bandyopadhyay, MD

GAP Liaison: Carol Rosen, MD

Staff: Taylor Shaffer, MS

Patient Populations:

Children with suspected OSA (< 18 years old)

Interventions:

  1. HSAT (types 2, 3, 4 devices)
  2. HSAT with ≥ 6 hrs recording time
  3. HSAT multiple nights
  4. HSAT with caregiver setup

Outcomes:

  1. Diagnosis of OSA (presence and severity)
  2. Sufficient data for clinical decision making
  3. Harms

The final recommendations will be based upon the available evidence, and must be approved by the AASM Board of Directors.

Clinical Practice Guideline for the Treatment of Extrinsic Circadian Rhythm Sleep-Wake Disorders

This clinical practice guideline will provide recommendations for the treatment of extrinsic circadian rhythm sleep-wake disorders in adults and children. This guideline will update and replace the existing practice parameters.

Task Force Chair: Kenneth Wright, PhD

Task Force Members: 

  • Sabra Abbott, MD, PhD (Vice Chair)
  • Liza H Ashbrook, MD
  • Christopher Drake, PhD
  • Erin Flynn-Evans, PhD
  • Catherine McCall, MD

BOD and GAP Liaison: Lynn Marie Trotti, MD, Msc

Staff: Taylor Shaffer, MS

Patient Populations:

Adults with shift work disorder or jet lag disorder

Interventions:

  1. Planned sleep schedules/naps
  2. Timed light and or dark exposure
  3. Timed melatonin/melatonin agonist administration or other chronobiotic administration
  4. Sleep promoting medications (e.g., benzodiazepines, benzodiazepine receptor agonists) or substances
  5. Stimulant medications/ wake promoting medications or substances
  6. Caffeine
  7. Timed physical activity/exercise
  8. Diet and meal timing
  9. Combination treatments, CBT-I or sleep hygiene
  10. Planned work schedule

Outcomes:

  • Excessive sleepiness/alertness
  • Total sleep time
  • Sleep quality
  • Circadian alignment
  • Quality of life
  • Mental health
  • Cognitive performance/ work performance
  • Accident risk
  • Sleep efficiency
  • GI symptoms

The final recommendations will be based upon the available evidence, and must be approved by the AASM Board of Directors.