2018ATS临床实践指南_体重管理在治疗成人阻塞性睡眠呼吸暂停中的作用.pdf

AMERICAN THORACIC SOCIETY DOCUMENTS The Role of Weight Management in the Treatment of Adult Obstructive Sleep Apnea An Official American Thoracic Society Clinical Practice Guideline David W. Hudgel, Sanjay R. Patel, Amy M. Ahasic, Susan J. Bartlett, Daniel H. Bessesen, Melisa A. Coaker, P. Michelle Fiander, Ronald R. Grunstein, Indira Gurubhagavatula, Vishesh K. Kapur, Christopher J. Lettieri, Matthew T. Naughton, Robert L. Owens, Jean-Louis D. Pepin, Henri Tuomilehto, and Kevin C. Wilson; on behalf of the American Thoracic Society Assembly on Sleep and Respiratory Neurobiology THIS OFFICIAL CLINICAL PRACTICE GUIDELINE OF THE AMERICAN THORACIC SOCIETY WILL BE APPROVED OCTOBER 2018 Background: Overweight/obesity is a common, reversible risk intervention consisting of 1) a reduced-calorie diet, 2) exercise or factor for obstructive sleep apnea severity (OSA). The purpose of this increased physical activity, and 3) behavioral guidance. Conditional guideline is to provide evidence-based recommendations for the recommendations were made regarding reduced-calorie diet and management of overweight/obesity in patients with OSA. exercise/increased physical activity as separate management tools. Pharmacological therapy and bariatric surgery are appropriate for Methods: The Grading of Recommendations, Assessment, selected patients who require further assistance with weight loss. Development and Evaluation approach was used to evaluate the literature. Clinical recommendations were formulated by a panel of pulmonary, Conclusions: Weight-loss interventions, especially comprehensive sleep medicine, weight management, and behavioral science specialists. lifestyle interventions, are associated with improvements in OSA