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Obstructive Sleep Apnea (OSA) Medication: Antidiabetics, Glucagon-like Peptide-1 Agonists, Dopamine/Norepinephrine Reuptake Inhibitors, Sedative/Hypnotics, Stimulants

Lastra AC, Neborak JM, Mokhlesi B. Diagnosis and Treatment of Obstructive Sleep Apnea. JAMA Intern Med . 2025 Aug 18. [QxMD MEDLINE Link] . Young T, Evans L, Finn L, Palta M. Estimation of the clinically diagnosed proportion of sleep apnea syndrome in middle-a

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  • Lastra AC, Neborak JM, Mokhlesi B. Diagnosis and Treatment of Obstructive Sleep Apnea. JAMA Intern Med . 2025 Aug 18. [QxMD MEDLINE Link] .
  • Young T, Evans L, Finn L, Palta M. Estimation of the clinically diagnosed proportion of sleep apnea syndrome in middle-aged men and women. Sleep . 1997 Sep. 20 (9):705-6. [QxMD MEDLINE Link] .
  • [Guideline] Strohl KP, Brown DB, Collop N, George C, Grunstein R, Han F, et al. An official American Thoracic Society Clinical Practice Guideline: sleep apnea, sleepiness, and driving risk in noncommercial drivers. An update of a 1994 Statement. Am J Respir Crit Care Med . 2013 Jun 1. 187 (11):1259-66. [QxMD MEDLINE Link] .
  • Myers KA, Mrkobrada M, Simel DL. Does this patient have obstructive sleep apnea?: The Rational Clinical Examination systematic review. JAMA . 2013 Aug 21. 310 (7):731-41. [QxMD MEDLINE Link] .
  • [Guideline] Kapur VK, Auckley DH, Chowdhuri S, Kuhlmann DC, Mehra R, Ramar K, et al. Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline. J Clin Sleep Med . 2017 Mar 15. 13 (3):479-504. [QxMD MEDLINE Link] . [Full Text] .
  • AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications. Version 3. American Academy of Sleep Medicine. Available at https://aasm.org/clinical-resources/scoring-manual/ . February 2023; Accessed: July 17, 2026.
  • Malhotra A, Bednarik J, Chakladar S, Dunn JP, Weaver T, Grunstein R, et al. Tirzepatide for the treatment of obstructive sleep apnea: Rationale, design, and sample baseline characteristics of the SURMOUNT -OSA phase 3 trial. Contemp Clin Trials . 2024 Jun. 141:107516. [QxMD MEDLINE Link] .
  • Kanu C, Shinde S, Chakladar S, Dennehy EB, Weaver TE, Poon JL, et al. Effect of tirzepatide treatment on patient-reported outcomes among SURMOUNT-OSA participants with obstructive sleep apnea and obesity. Sleep Med . 2025 Oct. 134:106719. [QxMD MEDLINE Link] .
  • Wang D, Tang Y, Chen Y, Zhang S, Ma D, Luo Y, et al. The effect of non-benzodiazepine sedative hypnotics on CPAP adherence in patients with OSA: a systematic review and meta-analysis. Sleep . 2021 Aug 13. 44 (8): [QxMD MEDLINE Link] .
  • Pépin JL, Guillot M, Tamisier R, Lévy P. The upper airway resistance syndrome. Respiration . 2012. 83 (6):559-66. [QxMD MEDLINE Link] .
  • Veasey SC, Rosen IM. Obstructive Sleep Apnea in Adults. N Engl J Med . 2019 Apr 11. 380 (15):1442-1449. [QxMD MEDLINE Link] .
  • [Guideline] Mokhlesi B, Masa JF, Brozek JL, Gurubhagavatula I, Murphy PB, Piper AJ, et al. Evaluation and Management of Obesity Hypoventilation Syndrome. An Official American Thoracic Society Clinical Practice Guideline. Am J Respir Crit Care Med . 2019 Aug 1. 200 (3):e6-e24. [QxMD MEDLINE Link] .
  • Schwab RJ, Pasirstein M, Pierson R, Mackley A, Hachadoorian R, Arens R, et al. Identification of upper airway anatomic risk factors for obstructive sleep apnea with volumetric magnetic resonance imaging. Am J Respir Crit Care Med . 2003 Sep 1. 168 (5):522-30. [QxMD MEDLINE Link] .
  • White DP. Sleep apnea. Proc Am Thorac Soc . 2006. 3 (1):124-8. [QxMD MEDLINE Link] .
  • White DP. The pathogenesis of obstructive sleep apnea: advances in the past 100 years. Am J Respir Cell Mol Biol . 2006 Jan. 34 (1):1-6. [QxMD MEDLINE Link] .
  • Patil SP, Schneider H, Schwartz AR, Smith PL. Adult obstructive sleep apnea: pathophysiology and diagnosis. Chest . 2007 Jul. 132 (1):325-37. [QxMD MEDLINE Link] . [Full Text] .
  • Verbraecken J, Op de Beeck S, Schwartz AR, Vanderveken OM. The upper airway in obstructive sleep apnoea: state of the art. Eur Respir Rev . 2026 Apr. 35 (180): [QxMD MEDLINE Link] .
  • McGinley BM, Schwartz AR, Schneider H, Kirkness JP, Smith PL, Patil SP. Upper airway neuromuscular compensation during sleep is defective in obstructive sleep apnea. J Appl Physiol (1985) . 2008 Jul. 105 (1):197-205. [QxMD MEDLINE Link] . [Full Text] .
  • Patil SP, Schneider H, Marx JJ, Gladmon E, Schwartz AR, Smith PL. Neuromechanical control of upper airway patency during sleep. J Appl Physiol (1985) . 2007 Feb. 102 (2):547-56. [QxMD MEDLINE Link] .
  • Xie A, Skatrud JB, Puleo DS, Rahko PS, Dempsey JA. Apnea-hypopnea threshold for CO2 in patients with congestive heart failure. Am J Respir Crit Care Med . 2002 May 1. 165 (9):1245-50. [QxMD MEDLINE Link] .
  • Leung RS, Bradley TD. Sleep apnea and cardiovascular disease. Am J Respir Crit Care Med . 2001 Dec 15. 164 (12):2147-65. [QxMD MEDLINE Link] .
  • Xie A, Rutherford R, Rankin F, Wong B, Bradley TD. Hypocapnia and increased ventilatory responsiveness in patients with idiopathic central sleep apnea. Am J Respir Crit Care Med . 1995 Dec. 152 (6 Pt 1):1950-5. [QxMD MEDLINE Link] .
  • Badr MS, Toiber F, Skatrud JB, Dempsey J. Pharyngeal narrowing/occlusion during central sleep apnea. J Appl Physiol (1985) . 1995 May. 78 (5):1806-15. [QxMD MEDLINE Link] .
  • Onal E, Burrows DL, Hart RH, Lopata M. Induction of periodic breathing during sleep causes upper airway obstruction in humans. J Appl Physiol (1985) . 1986 Oct. 61 (4):1438-43. [QxMD MEDLINE Link] .
  • Hudgel DW, Chapman KR, Faulks C, Hendricks C. Changes in inspiratory muscle electrical activity and upper airway resistance during periodic breathing induced by hypoxia during sleep. Am Rev Respir Dis . 1987 Apr. 135 (4):899-906. [QxMD MEDLINE Link] .
  • Warner G, Skatrud JB, Dempsey JA. Effect of hypoxia-induced periodic breathing on upper airway obstruction during sleep. J Appl Physiol (1985) . 1987 Jun. 62 (6):2201-11. [QxMD MEDLINE Link] .
  • Badr MS, Kawak A, Skatrud JB, Morrell MJ, Zahn BR, Babcock MA. Effect of induced hypocapnic hypopnea on upper airway patency in humans during NREM sleep. Respir Physiol . 1997 Oct. 110 (1):33-45. [QxMD MEDLINE Link] .
  • Zhou XS, Shahabuddin S, Zahn BR, Babcock MA, Badr MS. Effect of gender on the development of hypocapnic apnea/hypopnea during NREM sleep. J Appl Physiol (1985) . 2000 Jul. 89 (1):192-9. [QxMD MEDLINE Link] .
  • Bonsignore MR, Suarez Giron MC, Marrone O, Castrogiovanni A, Montserrat JM. Personalised medicine in sleep respiratory disorders: focus on obstructive sleep apnoea diagnosis and treatment. Eur Respir Rev . 2017 Dec 31. 26 (146): [QxMD MEDLINE Link] .
  • Malhotra A, Mesarwi O, Pepin JL, Owens RL. Endotypes and phenotypes in obstructive sleep apnea. Curr Opin Pulm Med . 2020 Nov. 26 (6):609-614. [QxMD MEDLINE Link] .
  • Gozal D, Kheirandish-Gozal L. Cardiovascular morbidity in obstructive sleep apnea: oxidative stress, inflammation, and much more. Am J Respir Crit Care Med . 2008 Feb 15. 177 (4):369-75. [QxMD MEDLINE Link] . [Full Text] .
  • Larkin EK, Patel SR, Goodloe RJ, Li Y, Zhu X, Gray-McGuire C, et al. A candidate gene study of obstructive sleep apnea in European Americans and African Americans. Am J Respir Crit Care Med . 2010 Oct 1. 182 (7):947-53. [QxMD MEDLINE Link] . [Full Text] .
  • Cakirer B, Hans MG, Graham G, Aylor J, Tishler PV, Redline S. The relationship between craniofacial morphology and obstructive sleep apnea in whites and in African-Americans. Am J Respir Crit Care Med . 2001 Mar. 163 (4):947-50. [QxMD MEDLINE Link] .
  • Redline S, Tishler PV, Tosteson TD, Williamson J, Kump K, Browner I, et al. The familial aggregation of obstructive sleep apnea. Am J Respir Crit Care Med . 1995 Mar. 151 (3 Pt 1):682-7. [QxMD MEDLINE Link] .
  • Bassetti CLA, Randerath W, Vignatelli L, Ferini-Strambi L, Brill AK, Bonsignore MR, et al. EAN/ERS/ESO/ESRS statement on the impact of sleep disorders on risk and outcome of stroke. Eur J Neurol . 2020 Jul. 27 (7):1117-1136. [QxMD MEDLINE Link] .
  • Szily M, Tarnoki AD, Tarnoki DL, Kovacs DT, Forgo B, Lee J, et al. Genetic influences on the onset of obstructive sleep apnoea and daytime sleepiness: a twin study. Respir Res . 2019 Jun 17. 20 (1):125. [QxMD MEDLINE Link] .
  • Sofer T, Kurniansyah N, Murray M, Ho YL, Abner E, Esko T, et al. Genome-wide association study of obstructive sleep apnoea in the Million Veteran Program uncovers genetic heterogeneity by sex. EBioMedicine . 2023 Apr. 90:104536. [QxMD MEDLINE Link] .
  • Peppard PE, Young T, Barnet JH, Palta M, Hagen EW, Hla KM. Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol . 2013 May 1. 177 (9):1006-14. [QxMD MEDLINE Link] .
  • Sönmez I, Vo Dupuy A, Yu KS, Cronin J, Yee J, Azarbarzin A. Unmasking obstructive sleep apnea: Estimated prevalence and impact in the United States. Respir Med . 2025 Nov. 248:108348. [QxMD MEDLINE Link] .
  • Boers E, Barrett MA, Benjafield AV, Barnet JH, Ravelo LA, Kaye L, et al. Projecting the 30-year burden of obstructive sleep apnoea in the USA: a prospective modelling study. Lancet Respir Med . 2025 Dec. 13 (12):1078-1086. [QxMD MEDLINE Link] .
  • Benjafield AV, Ayas NT, Eastwood PR, Heinzer R, Ip MSM, Morrell MJ, et al. Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis. Lancet Respir Med . 2019 Aug. 7 (8):687-698. [QxMD MEDLINE Link] .
  • Javaheri S, Javaheri S, Somers VK, Gozal D, Mokhlesi B, Mehra R, et al. Interactions of Obstructive Sleep Apnea With the Pathophysiology of Cardiovascular Disease, Part 1: JACC State-of-the-Art Review. J Am Coll Cardiol . 2024 Sep 24. 84 (13):1208-1223. [QxMD MEDLINE Link] .
  • Cowie MR, Linz D, Redline S, Somers VK, Simonds AK. Sleep Disordered Breathing and Cardiovascular Disease: JACC State-of-the-Art Review. J Am Coll Cardiol . 2021 Aug 10. 78 (6):608-624. [QxMD MEDLINE Link] .
  • Chen X, Wang R, Zee P, Lutsey PL, Javaheri S, Alcántara C, et al. Racial/Ethnic Differences in Sleep Disturbances: The Multi-Ethnic Study of Atherosclerosis (MESA). Sleep . 2015 Jun 1. 38 (6):877-88. [QxMD MEDLINE Link] .
  • Hnin K, Mukherjee S, Antic NA, Catcheside P, Chai-Coetzer CL, McEvoy D, et al. The impact of ethnicity on the prevalence and severity of obstructive sleep apnea. Sleep Med Rev . 2018 Oct. 41:78-86. [QxMD MEDLINE Link] .
  • Xu L, Keenan BT, Wiemken AS, Chi L, Staley B, Wang Z, et al. Differences in three-dimensional upper airway anatomy between Asian and European patients with obstructive sleep apnea. Sleep . 2020 May 12. 43 (5): [QxMD MEDLINE Link] .
  • Lee RW, Vasudavan S, Hui DS, Prvan T, Petocz P, Darendeliler MA, et al. Differences in craniofacial structures and obesity in Caucasian and Chinese patients with obstructive sleep apnea. Sleep . 2010 Aug. 33 (8):1075-80. [QxMD MEDLINE Link] .
  • Tan A, Cheung YY, Yin J, Lim WY, Tan LW, Lee CH. Prevalence of sleep-disordered breathing in a multiethnic Asian population in Singapore: A community-based study. Respirology . 2016 Jul. 21 (5):943-50. [QxMD MEDLINE Link] .
  • Redline S, Sotres-Alvarez D, Loredo J, Hall M, Patel SR, Ramos A, et al. Sleep-disordered breathing in Hispanic/Latino individuals of diverse backgrounds. The Hispanic Community Health Study/Study of Latinos. Am J Respir Crit Care Med . 2014 Feb 1. 189 (3):335-44. [QxMD MEDLINE Link] .
  • Locke BW, Sundar DJ, Ryujin D. Severity, comorbidities, and adherence to therapy in Native Hawaiians/Pacific Islanders with obstructive sleep apnea. J Clin Sleep Med . 2023 May 1. 19 (5):967-974. [QxMD MEDLINE Link] .
  • Lindberg E, Carter N, Gislason T, Janson C. Role of snoring and daytime sleepiness in occupational accidents. Am J Respir Crit Care Med . 2001 Dec 1. 164 (11):2031-5. [QxMD MEDLINE Link] .
  • Gottesman RF, Lutsey PL, Benveniste H, Brown DL, Full KM, Lee JM, et al. Impact of Sleep Disorders and Disturbed Sleep on Brain Health: A Scientific Statement From the American Heart Association. Stroke . 2024 Mar. 55 (3):e61-e76. [QxMD MEDLINE Link] .
  • Reutrakul S, Mokhlesi B. Obstructive Sleep Apnea and Diabetes: A State of the Art Review. Chest . 2017 Nov. 152 (5):1070-1086. [QxMD MEDLINE Link] .
  • Hong Y, Pei C, Hao L, Xu K, Liu F, Ding Z. The study of the relationship between moderate to severe sleep obstructive apnea and cognitive impairment, anxiety, and depression. Front Neurol . 2024. 15:1363005. [QxMD MEDLINE Link] .
  • Kosasih AM, Chong YF, Lee PL, Zhou JH, Lim DC, Lee CH. Sleep apnea and the ageing brain: bridging mechanisms and clinical outcomes. Am J Med . 2026 Jun 9. [QxMD MEDLINE Link] .
  • US Preventive Services Task Force, Bibbins-Domingo K, Grossman DC, Curry SJ, Davidson KW, Epling JW Jr, et al. Screening for Obstructive Sleep Apnea in Adults: US Preventive Services Task Force Recommendation Statement. JAMA . 2017 Jan 24. 317 (4):407-414. [QxMD MEDLINE Link] .
  • Ge X, Han F, Huang Y, Zhang Y, Yang T, Bai C, et al. Is obstructive sleep apnea associated with cardiovascular and all-cause mortality?. PLoS One . 2013. 8 (7):e69432. [QxMD MEDLINE Link] .
  • Yeghiazarians Y, Jneid H, Tietjens JR, Redline S, Brown DL, El-Sherif N, et al. Obstructive Sleep Apnea and Cardiovascular Disease: A Scientific Statement From the American Heart Association. Circulation . 2021 Jul 20. 144 (3):e56-e67. [QxMD MEDLINE Link] . [Full Text] .
  • Zhao YY, Wang R, Gleason KJ, Lewis EF, Quan SF, Toth CM, et al. Effect of Continuous Positive Airway Pressure Treatment on Health-Related Quality of Life and Sleepiness in High Cardiovascular Risk Individuals With Sleep Apnea: Best Apnea Interventions for Research (BestAIR) Trial. Sleep . 2017 Apr 1. 40 (4): [QxMD MEDLINE Link] .
  • Azarbarzin A, Vena D, Esmaeili N, Wellman A, Pinilla L, Messineo L, et al. Cardiovascular benefit of continuous positive airway pressure according to high-risk obstructive sleep apnoea: a multi-trial analysis. Eur Heart J . 2026 May 5. 47 (17):2077-2089. [QxMD MEDLINE Link] .
  • Benjafield AV, Pepin JL, Cistulli PA, Wimms A, Lavergne F, Sert Kuniyoshi FH, et al. Positive airway pressure therapy and all-cause and cardiovascular mortality in people with obstructive sleep apnoea: a systematic review and meta-analysis of randomised controlled trials and confounder-adjusted, non-randomised controlled studies. Lancet Respir Med . 2025 May. 13 (5):403-413. [QxMD MEDLINE Link] .
  • Pépin JL, Bailly S, Rinder P, Adler D, Benjafield AV, Lavergne F, et al. Relationship Between CPAP Termination and All-Cause Mortality: A French Nationwide Database Analysis. Chest . 2022 Jun. 161 (6):1657-1665. [QxMD MEDLINE Link] .
  • Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep . 1991 Dec. 14 (6):540-5. [QxMD MEDLINE Link] .
  • Chervin RD, Aldrich MS. The Epworth Sleepiness Scale may not reflect objective measures of sleepiness or sleep apnea. Neurology . 1999 Jan 1. 52 (1):125-31. [QxMD MEDLINE Link] .
  • Chervin RD. Sleepiness, fatigue, tiredness, and lack of energy in obstructive sleep apnea. Chest . 2000 Aug. 118 (2):372-9. [QxMD MEDLINE Link] .
  • Morin CM, Belleville G, Bélanger L, Ivers H. The Insomnia Severity Index: psychometric indicators to detect insomnia cases and evaluate treatment response. Sleep . 2011 May 1. 34 (5):601-8. [QxMD MEDLINE Link] .
  • Young T, Peppard PE, Gottlieb DJ. Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med . 2002 May 1. 165 (9):1217-39. [QxMD MEDLINE Link] .
  • Nuckton TJ, Glidden DV, Browner WS, Claman DM. Physical examination: Mallampati score as an independent predictor of obstructive sleep apnea. Sleep . 2006 Jul. 29 (7):903-8. [QxMD MEDLINE Link] .
  • Punjabi N, Qu RW, Vacaru A, Pandey B, Tamares S, Inman JC. The Obstructive Sleep Apnea Physical Exam: A Systematic Review and Meta-Analysis. Laryngoscope Investig Otolaryngol . 2025 Jun. 10 (3):e70154. [QxMD MEDLINE Link] .
  • Chung F, Yegneswaran B, Liao P, Chung SA, Vairavanathan S, Islam S, et al. STOP questionnaire: a tool to screen patients for obstructive sleep apnea. Anesthesiology . 2008 May. 108 (5):812-21. [QxMD MEDLINE Link] .
  • Chung F, Subramanyam R, Liao P, Sasaki E, Shapiro C, Sun Y. High STOP-Bang score indicates a high probability of obstructive sleep apnoea. Br J Anaesth . 2012 May. 108 (5):768-75. [QxMD MEDLINE Link] . [Full Text] .
  • Netzer NC, Stoohs RA, Netzer CM, Clark K, Strohl KP. Using the Berlin Questionnaire to identify patients at risk for the sleep apnea syndrome. Ann Intern Med . 1999 Oct 5. 131 (7):485-91. [QxMD MEDLINE Link] .
  • Dunietz GL, Chervin RD, Tauman R, Shaklai S, Sankari A. OSA in Women: Associations With Reproductive Aging and Screening Challenges. Chest . 2026 Mar. 169 (3):803-812. [QxMD MEDLINE Link] .
  • Fabozzi A, Pasqualotto F, Laguardia M, Natuzzi PF, Capone R, Steffanina A, et al. Gender differences in obstructive sleep apnea syndrome: a pilot study. Sleep Breath . 2024 Aug. 28 (4):1645-1650. [QxMD MEDLINE Link] .
  • Won CHJ, Reid M, Sofer T, Azarbarzin A, Purcell S, White D, et al. Sex differences in obstructive sleep apnea phenotypes, the multi-ethnic study of atherosclerosis. Sleep . 2020 May 12. 43 (5): [QxMD MEDLINE Link] .
  • Bouloukaki I, Tsiligianni I, Schiza S. Evaluation of Obstructive Sleep Apnea in Female Patients in Primary Care: Time for Improvement?. Med Princ Pract . 2021. 30 (6):508-514. [QxMD MEDLINE Link] .
  • [Guideline] Dominguez JE, Cantrell S, Habib AS, Izci-Balserak B, Lockhart E, Louis JM, et al. Society of Anesthesia and Sleep Medicine and the Society for Obstetric Anesthesia and Perinatology Consensus Guideline on the Screening, Diagnosis, and Treatment of Obstructive Sleep Apnea in Pregnancy. Obstet Gynecol . 2023 Aug 1. 142 (2):403-423. [QxMD MEDLINE Link] .
  • Pamidi S, Kimoff RJ. Maternal Sleep-Disordered Breathing. Chest . 2018 Apr. 153 (4):1052-1066. [QxMD MEDLINE Link] .
  • Young T, Finn L, Austin D, Peterson A. Menopausal status and sleep-disordered breathing in the Wisconsin Sleep Cohort Study. Am J Respir Crit Care Med . 2003 May 1. 167 (9):1181-5. [QxMD MEDLINE Link] .
  • Huang T, Lin BM, Redline S, Curhan GC, Hu FB, Tworoger SS. Type of Menopause, Age at Menopause, and Risk of Developing Obstructive Sleep Apnea in Postmenopausal Women. Am J Epidemiol . 2018 Jul 1. 187 (7):1370-1379. [QxMD MEDLINE Link] .
  • Dunietz GL, Chervin RD, Tauman R, Shaklai S, Sankari A. OSA in Women: Associations With Reproductive Aging and Screening Challenges. Chest . 2026 Mar. 169 (3):803-812. [QxMD MEDLINE Link] .
  • Young T, Shahar E, Nieto FJ, Redline S, Newman AB, Gottlieb DJ, et al. Predictors of sleep-disordered breathing in community-dwelling adults: the Sleep Heart Health Study. Arch Intern Med . 2002 Apr 22. 162 (8):893-900. [QxMD MEDLINE Link] .
  • Brennan M, McDonnell MJ, Walsh SM, Gargoum F, Rutherford R. Review of the prevalence, pathogenesis and management of OSA-COPD overlap. Sleep Breath . 2022 Dec. 26 (4):1551-1560. [QxMD MEDLINE Link] .
  • Javaheri S, Brown LK, Abraham WT, Khayat R. Apneas of Heart Failure and Phenotype-Guided Treatments: Part One: OSA. Chest . 2020 Feb. 157 (2):394-402. [QxMD MEDLINE Link] .
  • Lévy P, Naughton MT, Tamisier R, Cowie MR, Bradley TD. Sleep apnoea and heart failure. Eur Respir J . 2022 May. 59 (5): [QxMD MEDLINE Link] .
  • Forbus L, Kelly UA. Screening for Obstructive Sleep Apnea in Veterans Seeking Treatment of Posttraumatic Stress Disorder. ANS Adv Nurs Sci . 2015 Oct-Dec. 38 (4):298-305. [QxMD MEDLINE Link] .
  • McCall CA, Watson NF. A Narrative Review of the Association between Post-Traumatic Stress Disorder and Obstructive Sleep Apnea. J Clin Med . 2022 Jan 14. 11 (2): [QxMD MEDLINE Link] .
  • Sweetman A, Lack L, McEvoy RD, Catcheside PG, Antic NA, Chai-Coetzer CL, et al. Effect of depression, anxiety, and stress symptoms on response to cognitive behavioral therapy for insomnia in patients with comorbid insomnia and sleep apnea: a randomized controlled trial. J Clin Sleep Med . 2021 Mar 1. 17 (3):545-554. [QxMD MEDLINE Link] . [Full Text] .
  • Hartenbaum N, Collop N, Rosen IM, Phillips B, George CF, Rowley JA, et al. Sleep apnea and commercial motor vehicle operators: statement from the joint Task Force of the American College of Chest Physicians, American College of Occupational and Environmental Medicine, and the National Sleep Foundation. J Occup Environ Med . 2006 Sep. 48 (9 Suppl):S4-37. [QxMD MEDLINE Link] .
  • Miller CM, Khanna A, Strohl KP. Assessment and policy for commercial driver license referrals. J Clin Sleep Med . 2007 Jun 15. 3 (4):417-23. [QxMD MEDLINE Link] . [Full Text] .
  • Xie C, Zhu R, Tian Y, Wang K. Association of obstructive sleep apnoea with the risk of vascular outcomes and all-cause mortality: a meta-analysis. BMJ Open . 2017 Dec 22. 7 (12):e013983. [QxMD MEDLINE Link] . [Full Text] .
  • Punjabi NM, Caffo BS, Goodwin JL, Gottlieb DJ, Newman AB, O'Connor GT, et al. Sleep-disordered breathing and mortality: a prospective cohort study. PLoS Med . 2009 Aug. 6 (8):e1000132. [QxMD MEDLINE Link] . [Full Text] .
  • Marin JM, Carrizo SJ, Vicente E, Agusti AG. Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet . 2005 Mar 19-25. 365 (9464):1046-53. [QxMD MEDLINE Link] .
  • Peppard PE, Young T, Palta M, Skatrud J. Prospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med . 2000 May 11. 342 (19):1378-84. [QxMD MEDLINE Link] .
  • Kario K, Hettrick DA, Prejbisz A, Januszewicz A. Obstructive Sleep Apnea-Induced Neurogenic Nocturnal Hypertension: A Potential Role of Renal Denervation?. Hypertension . 2021 Apr. 77 (4):1047-1060. [QxMD MEDLINE Link] .
  • Weiss JW, Tamisier R, Liu Y. Sympathoexcitation and arterial hypertension associated with obstructive sleep apnea and cyclic intermittent hypoxia. J Appl Physiol (1985) . 2015 Dec 15. 119 (12):1449-54. [QxMD MEDLINE Link] .
  • Drager LF, Bortolotto LA, Lorenzi MC, Figueiredo AC, Krieger EM, Lorenzi-Filho G. Early signs of atherosclerosis in obstructive sleep apnea. Am J Respir Crit Care Med . 2005 Sep 1. 172 (5):613-8. [QxMD MEDLINE Link] .
  • Lu M, Fang F, Wang Z, Xu L, Sanderson JE, Zhan X, et al. Association Between OSA and Quantitative Atherosclerotic Plaque Burden: A Coronary CT Angiography Study. Chest . 2021 Nov. 160 (5):1864-1874. [QxMD MEDLINE Link] .
  • Peixoto de Miranda ÉJF, Mazzotti DR, Santos RB, Souza SP, Parise BK, Giatti S, et al. Incident Coronary Calcium Score in Patients With OSA With and Without Excessive Sleepiness: Brazilian Longitudinal Study of Adult Health. Chest . 2024 Jan. 165 (1):202-212. [QxMD MEDLINE Link] .
  • Shah NA, Yaggi HK, Concato J, Mohsenin V. Obstructive sleep apnea as a risk factor for coronary events or cardiovascular death. Sleep Breath . 2010 Jun. 14 (2):131-6. [QxMD MEDLINE Link] .
  • Mooe T, Franklin KA, Wiklund U, Rabben T, Holmström K. Sleep-disordered breathing and myocardial ischemia in patients with coronary artery disease. Chest . 2000 Jun. 117 (6):1597-602. [QxMD MEDLINE Link] .
  • Kuniyoshi FH, Garcia-Touchard A, Gami AS, Romero-Corral A, van der Walt C, Pusalavidyasagar S, et al. Day-night variation of acute myocardial infarction in obstructive sleep apnea. J Am Coll Cardiol . 2008 Jul 29. 52 (5):343-6. [QxMD MEDLINE Link] .
  • Wang Y, Buayiximu K, Zhu T, Yan R, Zhu Z, Ni J, et al. Day-night pattern of acute ST-segment elevation myocardial infarction onset in patients with obstructive sleep apnea. J Clin Sleep Med . 2024 May 1. 20 (5):765-775. [QxMD MEDLINE Link] .
  • Liu X, Wang B, Hao W, Qiu Y, Guo Q, Guo Y, et al. Association of Obstructive Sleep Apnea and Nocturnal Hypoxemia With the Circadian Rhythm of Myocardial Infarction. J Am Heart Assoc . 2025 Feb 4. 14 (3):e036729. [QxMD MEDLINE Link] .
  • Javaheri S, Caref EB, Chen E, Tong KB, Abraham WT. Sleep apnea testing and outcomes in a large cohort of Medicare beneficiaries with newly diagnosed heart failure. Am J Respir Crit Care Med . 2011 Feb 15. 183 (4):539-46. [QxMD MEDLINE Link] .
  • Wang H, Parker JD, Newton GE, Floras JS, Mak S, Chiu KL, et al. Influence of obstructive sleep apnea on mortality in patients with heart failure. J Am Coll Cardiol . 2007 Apr 17. 49 (15):1625-1631. [QxMD MEDLINE Link] .
  • Taranto Montemurro L, Floras JS, Millar PJ, Kasai T, Gabriel JM, Spaak J, et al. Inverse relationship of subjective daytime sleepiness to sympathetic activity in patients with heart failure and obstructive sleep apnea. Chest . 2012 Nov. 142 (5):1222-1228. [QxMD MEDLINE Link] .
  • Mehra R, Benjamin EJ, Shahar E, Gottlieb DJ, Nawabit R, Kirchner HL, et al. Association of nocturnal arrhythmias with sleep-disordered breathing: The Sleep Heart Health Study. Am J Respir Crit Care Med . 2006 Apr 15. 173 (8):910-6. [QxMD MEDLINE Link] . [Full Text] .
  • Garrigue S, Pépin JL, Defaye P, Murgatroyd F, Poezevara Y, Clémenty J, et al. High prevalence of sleep apnea syndrome in patients with long-term pacing: the European Multicenter Polysomnographic Study. Circulation . 2007 Apr 3. 115 (13):1703-9. [QxMD MEDLINE Link] . [Full Text] .
  • Dong JY, Zhang YH, Qin LQ. Obstructive sleep apnea and cardiovascular risk: meta-analysis of prospective cohort studies. Atherosclerosis . 2013 Aug. 229 (2):489-95. [QxMD MEDLINE Link] .
  • Yaggi HK, Concato J, Kernan WN, Lichtman JH, Brass LM, Mohsenin V. Obstructive sleep apnea as a risk factor for stroke and death. N Engl J Med . 2005 Nov 10. 353 (19):2034-41. [QxMD MEDLINE Link] .
  • Shahar E, Whitney CW, Redline S, Lee ET, Newman AB, Nieto FJ, et al. Sleep-disordered breathing and cardiovascular disease: cross-sectional results of the Sleep Heart Health Study. Am J Respir Crit Care Med . 2001 Jan. 163 (1):19-25. [QxMD MEDLINE Link] .
  • Xu PH, Hui CKM, Lui MMS, Lam DCL, Fong DYT, Ip MSM. Incident Type 2 Diabetes in OSA and Effect of CPAP Treatment: A Retrospective Clinic Cohort Study. Chest . 2019 Oct. 156 (4):743-753. [QxMD MEDLINE Link] .
  • Aronsohn RS, Whitmore H, Van Cauter E, Tasali E. Impact of untreated obstructive sleep apnea on glucose control in type 2 diabetes. Am J Respir Crit Care Med . 2010 Mar 1. 181 (5):507-13. [QxMD MEDLINE Link] .
  • Lettieri CJ, Williams SG, Collen JF. OSA Syndrome and Posttraumatic Stress Disorder: Clinical Outcomes and Impact of Positive Airway Pressure Therapy. Chest . 2016 Feb. 149 (2):483-490. [QxMD MEDLINE Link] .
  • Krakow B, Melendrez D, Johnston L, Warner TD, Clark JO, Pacheco M, et al. Sleep-disordered breathing, psychiatric distress, and quality of life impairment in sexual assault survivors. J Nerv Ment Dis . 2002 Jul. 190 (7):442-52. [QxMD MEDLINE Link] .
  • Yaffe K, Laffan AM, Harrison SL, Redline S, Spira AP, Ensrud KE, et al. Sleep-disordered breathing, hypoxia, and risk of mild cognitive impairment and dementia in older women. JAMA . 2011 Aug 10. 306 (6):613-9. [QxMD MEDLINE Link] . [Full Text] .
  • Chang WP, Liu ME, Chang WC, Yang AC, Ku YC, Pai JT, et al. Sleep apnea and the risk of dementia: a population-based 5-year follow-up study in Taiwan. PLoS One . 2013. 8 (10):e78655. [QxMD MEDLINE Link] . [Full Text] .
  • Kao CY, Huang TH, Kao CH, Huang JY, Kao CT, Hsieh YH. The Population Based Risk of Obstructive Sleep Apnea and Psychiatric Conditions. Depress Anxiety . 2025. 2025:4329208. [QxMD MEDLINE Link] . [Full Text] .
  • Kim JY, Ko I, Kim DK. Association of Obstructive Sleep Apnea With the Risk of Affective Disorders. JAMA Otolaryngol Head Neck Surg . 2019 Nov 1. 145 (11):1020-1026. [QxMD MEDLINE Link] .
  • Mesarwi OA, Loomba R, Malhotra A. Obstructive Sleep Apnea, Hypoxia, and Nonalcoholic Fatty Liver Disease. Am J Respir Crit Care Med . 2019 Apr 1. 199 (7):830-841. [QxMD MEDLINE Link] .
  • Sansa G, Iranzo A, Santamaria J. Obstructive sleep apnea in narcolepsy. Sleep Med . 2010 Jan. 11 (1):93-5. [QxMD MEDLINE Link] .
  • Buchanan A, Cohen R, Looney S, Kalathingal S, De Rossi S. Cone-beam CT analysis of patients with obstructive sleep apnea compared to normal controls. Imaging Sci Dent . 2016 Mar. 46 (1):9-16. [QxMD MEDLINE Link] .
  • Mansukhani MP, Kolla BP, Wang Z, Morgenthaler TI. Effect of Varying Definitions of Hypopnea on the Diagnosis and Clinical Outcomes of Sleep-Disordered Breathing: A Systematic Review and Meta-Analysis. J Clin Sleep Med . 2019 May 15. 15 (5):687-696. [QxMD MEDLINE Link] .
  • Campos-Rodriguez F, Martínez-García MA, Reyes-Nuñez N, Selma-Ferrer MJ, Punjabi NM, Farre R. Impact of different hypopnea definitions on obstructive sleep apnea severity and cardiovascular mortality risk in women and elderly individuals. Sleep Med . 2016 Nov-Dec. 27-28:54-58. [QxMD MEDLINE Link] .
  • Won CHJ, Qin L, Selim B, Yaggi HK. Varying Hypopnea Definitions Affect Obstructive Sleep Apnea Severity Classification and Association With Cardiovascular Disease. J Clin Sleep Med . 2018 Dec 15. 14 (12):1987-1994. [QxMD MEDLINE Link] .
  • Redline S, Budhiraja R, Kapur V, Marcus CL, Mateika JH, Mehra R, et al. The scoring of respiratory events in sleep: reliability and validity. J Clin Sleep Med . 2007 Mar 15. 3 (2):169-200. [QxMD MEDLINE Link] .
  • Skolnik C, Attarian H. The ethics of hypopnea scoring. J Clin Sleep Med . 2024 Apr 1. 20 (4):615-617. [QxMD MEDLINE Link] .
  • Ichikawa M, Akiyama T, Tsujimoto Y, Anan K, Yamakawa T, Terauchi Y. Diagnostic accuracy of home sleep apnea testing using peripheral arterial tonometry for sleep apnea: A systematic review and meta-analysis. J Sleep Res . 2022 Dec. 31 (6):e13682. [QxMD MEDLINE Link] .
  • El Shayeb M, Topfer LA, Stafinski T, Pawluk L, Menon D. Diagnostic accuracy of level 3 portable sleep tests versus level 1 polysomnography for sleep-disordered breathing: a systematic review and meta-analysis. CMAJ . 2014 Jan 7. 186 (1):E25-51. [QxMD MEDLINE Link] .
  • Schnall RP, Sheffy JK, Penzel T. Peripheral arterial tonometry-PAT technology. Sleep Med Rev . 2022 Feb. 61:101566. [QxMD MEDLINE Link] .
  • Kezirian EJ, Hohenhorst W, de Vries N. Drug-induced sleep endoscopy: the VOTE classification. Eur Arch Otorhinolaryngol . 2011 Aug. 268 (8):1233-1236. [QxMD MEDLINE Link] .
  • Chang CP, Kushida C, Panchal N, Liu SY. Consumer Sleep Technology and Wearables: Screening is Not Diagnosis. J Oral Maxillofac Surg . 2026 Apr. 84 (4):440-441. [QxMD MEDLINE Link] .
  • Khosla S, Deak MC, Gault D, Goldstein CA, Hwang D, Kwon Y, et al. Consumer Sleep Technology: An American Academy of Sleep Medicine Position Statement. J Clin Sleep Med . 2018 May 15. 14 (5):877-880. [QxMD MEDLINE Link] .
  • Morgenthaler TI, Kapen S, Lee-Chiong T, Alessi C, Boehlecke B, Brown T, et al. Practice parameters for the medical therapy of obstructive sleep apnea. Sleep . 2006 Aug 1. 29(8):1031-5. [QxMD MEDLINE Link] .
  • Peppard PE, Young T, Palta M, Dempsey J, Skatrud J. Longitudinal study of moderate weight change and sleep-disordered breathing. JAMA . 2000 Dec 20. 284 (23):3015-21. [QxMD MEDLINE Link] .
  • Zepbound (tirzepatide) injection [package insert]. Indianapolis, IN: Eli Lilly and Co. December 2024. Available at [Full Text] .
  • McNicholas WT, Op de Beeck S, Tondo P, Verbraecken J, Bonsignore MR. OSA Endotyping as Targets for Treatment. How Far Have We Come?. Respirology . 2026 Apr. 31 (4):339-351. [QxMD MEDLINE Link] .
  • Chang JL, Goldberg AN, Alt JA, Mohammed A, et al. International Consensus Statement on Obstructive Sleep Apnea. Int Forum Allergy Rhinol . 2023 Jul. 13 (7):1061-1482. [QxMD MEDLINE Link] .
  • [Guideline] Patil SP, Ayappa IA, Caples SM, Kimoff RJ, Patel SR, Harrod CG. Treatment of Adult Obstructive Sleep Apnea with Positive Airway Pressure: An American Academy of Sleep Medicine Clinical Practice Guideline. J Clin Sleep Med . 2019 Feb 15. 15 (2):335-343. [QxMD MEDLINE Link] .
  • Patil SP, Ayappa IA, Caples SM, Kimoff RJ, Patel SR, Harrod CG. Treatment of Adult Obstructive Sleep Apnea With Positive Airway Pressure: An American Academy of Sleep Medicine Systematic Review, Meta-Analysis, and GRADE Assessment. J Clin Sleep Med . 2019 Feb 15. 15 (2):301-334. [QxMD MEDLINE Link] .
  • Almendros I, Acerbi I, Vilaseca I, Montserrat JM, Navajas D, Farré R. Continuous positive airway pressure (CPAP) induces early nasal inflammation. Sleep . 2008 Jan. 31 (1):127-31. [QxMD MEDLINE Link] .
  • Mulgrew AT, Fox N, Ayas NT, Ryan CF. Diagnosis and initial management of obstructive sleep apnea without polysomnography: a randomized validation study. Ann Intern Med . 2007 Feb 6. 146 (3):157-66. [QxMD MEDLINE Link] .
  • Berry RB, Hill G, Thompson L, McLaurin V. Portable monitoring and autotitration versus polysomnography for the diagnosis and treatment of sleep apnea. Sleep . 2008 Oct. 31 (10):1423-31. [QxMD MEDLINE Link] . [Full Text] .
  • Kuna ST, Gurubhagavatula I, Maislin G, Hin S, Hartwig KC, McCloskey S, et al. Noninferiority of functional outcome in ambulatory management of obstructive sleep apnea. Am J Respir Crit Care Med . 2011 May 1. 183 (9):1238-44. [QxMD MEDLINE Link] .
  • Engleman HM, Martin SE, Deary IJ, Douglas NJ. Effect of continuous positive airway pressure treatment on daytime function in sleep apnoea/hypopnoea syndrome. Lancet . 1994 Mar 5. 343 (8897):572-5. [QxMD MEDLINE Link] .
  • Bonsignore MR, Pepin JL, Cibella F, Barbera CD, Marrone O, Verbraecken J, et al. Excessive Daytime Sleepiness in Obstructive Sleep Apnea Patients Treated With Continuous Positive Airway Pressure: Data From the European Sleep Apnea Database. Front Neurol . 2021. 12:690008. [QxMD MEDLINE Link] .
  • Crawford MR, Bartlett DJ, Coughlin SR, Phillips CL, Neill AM, Espie CA, et al. The effect of continuous positive airway pressure usage on sleepiness in obstructive sleep apnoea: real effects or expectation of benefit?. Thorax . 2012 Oct. 67 (10):920-4. [QxMD MEDLINE Link] .
  • Fava C, Dorigoni S, Dalle Vedove F, Danese E, Montagnana M, Guidi GC, et al. Effect of CPAP on blood pressure in patients with OSA/hypopnea a systematic review and meta-analysis. Chest . 2014 Apr. 145 (4):762-771. [QxMD MEDLINE Link] .
  • Benning L, Herzig JJ, Mollet MS, Bradicich M, Pengo MF, Ulrich S, et al. Effects of CPAP on Blood Pressure Parameter Across Different Severities of Obstructive Sleep Apnoea: A Meta-Analysis. J Sleep Res . 2025 Oct. 34 (5):e70072. [QxMD MEDLINE Link] .
  • Pépin JL, Tamisier R, Barone-Rochette G, Launois SH, Lévy P, Baguet JP. Comparison of continuous positive airway pressure and valsartan in hypertensive patients with sleep apnea. Am J Respir Crit Care Med . 2010 Oct 1. 182 (7):954-60. [QxMD MEDLINE Link] .
  • Shukla A, Aizer A, Holmes D, Fowler S, Park DS, Bernstein S, et al. Effect of Obstructive Sleep Apnea Treatment on Atrial Fibrillation Recurrence: A Meta-Analysis. JACC Clin Electrophysiol . 2015 Mar-Apr. 1 (1-2):41-51. [QxMD MEDLINE Link] .
  • Li X, Zhou X, Xu X, Dai J, Chen C, Ma L, et al. Effects of continuous positive airway pressure treatment in obstructive sleep apnea patients with atrial fibrillation: A meta-analysis. Medicine (Baltimore) . 2021 Apr 16. 100 (15):e25438. [QxMD MEDLINE Link] .
  • Caples SM, Mansukhani MP, Friedman PA, Somers VK. The impact of continuous positive airway pressure treatment on the recurrence of atrial fibrillation post cardioversion: A randomized controlled trial. Int J Cardiol . 2019 Mar 1. 278:133-136. [QxMD MEDLINE Link] .
  • Valham F, Mooe T, Rabben T, Stenlund H, Wiklund U, Franklin KA. Increased risk of stroke in patients with coronary artery disease and sleep apnea: a 10-year follow-up. Circulation . 2008 Aug 26. 118 (9):955-60. [QxMD MEDLINE Link] .
  • McEvoy RD, Antic NA, Heeley E, Luo Y, Ou Q, Zhang X, et al. CPAP for Prevention of Cardiovascular Events in Obstructive Sleep Apnea. N Engl J Med . 2016 Sep 8. 375 (10):919-31. [QxMD MEDLINE Link] .
  • Barbé F, Durán-Cantolla J, Sánchez-de-la-Torre M, Martínez-Alonso M, Carmona C, Barceló A, et al. Effect of continuous positive airway pressure on the incidence of hypertension and cardiovascular events in nonsleepy patients with obstructive sleep apnea: a randomized controlled trial. JAMA . 2012 May 23. 307 (20):2161-8. [QxMD MEDLINE Link] .
  • Lin HJ, Yeh JH, Hsieh MT, Hsu CY. Continuous positive airway pressure with good adherence can reduce risk of stroke in patients with moderate to severe obstructive sleep apnea: An updated systematic review and meta-analysis. Sleep Med Rev . 2020 Dec. 54:101354. [QxMD MEDLINE Link] .
  • Shieu MM, Zaheed AB, Shannon C, Chervin RD, Conceicao A, Paulson HL, et al. Positive Airway Pressure and Cognitive Disorders in Adults With Obstructive Sleep Apnea: A Systematic Review of the Literature. Neurology . 2022 Jul 25. 99 (4):e334-e346. [QxMD MEDLINE Link] .
  • Lal C, Ayappa I, Ayas N, Beaudin AE, Hoyos C, Kushida CA, et al. The Link between Obstructive Sleep Apnea and Neurocognitive Impairment: An Official American Thoracic Society Workshop Report. Ann Am Thorac Soc . 2022 Aug. 19 (8):1245-1256. [QxMD MEDLINE Link] .
  • Herth J, Sievi NA, Schmidt F, Kohler M. Effects of continuous positive airway pressure therapy on glucose metabolism in patients with obstructive sleep apnoea and type 2 diabetes: a systematic review and meta-analysis. Eur Respir Rev . 2023 Sep 30. 32 (169): [QxMD MEDLINE Link] .
  • Martínez-García MA, Soler-Cataluña JJ, Ejarque-Martínez L, Soriano Y, Román-Sánchez P, Illa FB, et al. Continuous positive airway pressure treatment reduces mortality in patients with ischemic stroke and obstructive sleep apnea: a 5-year follow-up study. Am J Respir Crit Care Med . 2009 Jul 1. 180 (1):36-41. [QxMD MEDLINE Link] .
  • Sánchez-de-la-Torre M, Gracia-Lavedan E, Benitez ID, Sánchez-de-la-Torre A, Moncusí-Moix A, Torres G, et al. Adherence to CPAP Treatment and the Risk of Recurrent Cardiovascular Events: A Meta-Analysis. JAMA . 2023 Oct 3. 330 (13):1255-1265. [QxMD MEDLINE Link] .
  • Platt AB, Field SH, Asch DA, Chen Z, Patel NP, Gupta R, et al. Neighborhood of residence is associated with daily adherence to CPAP therapy. Sleep . 2009 Jun. 32 (6):799-806. [QxMD MEDLINE Link] .
  • McMillan A, Bratton DJ, Faria R, Laskawiec-Szkonter M, Griffin S, Davies RJ, et al. Continuous positive airway pressure in older people with obstructive sleep apnoea syndrome (PREDICT): a 12-month, multicentre, randomised trial. Lancet Respir Med . 2014 Oct. 2 (10):804-12. [QxMD MEDLINE Link] .
  • May AM, Patel SR, Yamauchi M, Verma TK, Weaver TE, Chai-Coetzer CL, et al. Moving toward Equitable Care for Sleep Apnea in the United States: Positive Airway Pressure Adherence Thresholds: An Official American Thoracic Society Policy Statement. Am J Respir Crit Care Med . 2023 Feb 1. 207 (3):244-254. [QxMD MEDLINE Link] .
  • Patil SP, Collop NA, Chediak AD, Olson EJ, Vohra KP, ONMAP Technical Expert Panel. Optimal NIV Medicare Access Promotion: Patients With OSA: A Technical Expert Panel Report From the American College of Chest Physicians, the American Association for Respiratory Care, the American Academy of Sleep Medicine, and the American Thoracic Society. Chest . 2021 Nov. 160 (5):e409-e417. [QxMD MEDLINE Link] .
  • Schwab RJ, Badr SM, Epstein LJ, Gay PC, Gozal D, Kohler M, et al. An official American Thoracic Society statement: continuous positive airway pressure adherence tracking systems. The optimal monitoring strategies and outcome measures in adults. Am J Respir Crit Care Med . 2013 Sep 1. 188 (5):613-20. [QxMD MEDLINE Link] .
  • Weaver TE, Maislin G, Dinges DF, Bloxham T, George CF, Greenberg H, et al. Relationship between hours of CPAP use and achieving normal levels of sleepiness and daily functioning. Sleep . 2007 Jun. 30 (6):711-9. [QxMD MEDLINE Link] . [Full Text] .
  • Jeppesen K, Jennum PJ, Moos C, Ibsen R, Ibsen M, Kørvel-Hanquist A, et al. Clinical phenotypes and predictors of adherence to continuous positive airway pressure therapy in obstructive sleep apnoea: A multicentre cohort study. Sleep Med . 2026 May. 141:108822. [QxMD MEDLINE Link] . [Full Text] .
  • Popescu G, Latham M, Allgar V, Elliott MW. Continuous positive airway pressure for sleep apnoea/hypopnoea syndrome: usefulness of a 2 week trial to identify factors associated with long term use. Thorax . 2001 Sep. 56 (9):727-33. [QxMD MEDLINE Link] . [Full Text] .
  • Aloia MS, Arnedt JT, Stanchina M, Millman RP. How early in treatment is PAP adherence established? Revisiting night-to-night variability. Behav Sleep Med . 2007. 5 (3):229-40. [QxMD MEDLINE Link] .
  • Aloia MS, Arnedt JT, Stepnowsky C, Hecht J, Borrelli B. Predicting treatment adherence in obstructive sleep apnea using principles of behavior change. J Clin Sleep Med . 2005 Oct 15. 1(4):346-53. [QxMD MEDLINE Link] .
  • McArdle N, Devereux G, Heidarnejad H, Engleman HM, Mackay TW, Douglas NJ. Long-term use of CPAP therapy for sleep apnea/hypopnea syndrome. Am J Respir Crit Care Med . 1999 Apr. 159 (4 Pt 1):1108-14. [QxMD MEDLINE Link] .
  • Reeves-Hoché MK, Hudgel DW, Meck R, Witteman R, Ross A, Zwillich CW. Continuous versus bilevel positive airway pressure for obstructive sleep apnea. Am J Respir Crit Care Med . 1995 Feb. 151 (2 Pt 1):443-9. [QxMD MEDLINE Link] .
  • Gay PC, Herold DL, Olson EJ. A randomized, double-blind clinical trial comparing continuous positive airway pressure with a novel bilevel pressure system for treatment of obstructive sleep apnea syndrome. Sleep . 2003 Nov 1. 26 (7):864-9. [QxMD MEDLINE Link] .
  • Askland K, Wright L, Wozniak DR, Emmanuel T, Caston J, Smith I. Educational, supportive and behavioural interventions to improve usage of continuous positive airway pressure machines in adults with obstructive sleep apnoea. Cochrane Database Syst Rev . 2020 Apr 7. 4 (4):CD007736. [QxMD MEDLINE Link] .
  • Labarca G, Schmidt A, Dreyse J, Jorquera J, Barbe F. Telemedicine interventions for CPAP adherence in obstructive sleep apnea patients: Systematic review and meta-analysis. Sleep Med Rev . 2021 Dec. 60:101543. [QxMD MEDLINE Link] .
  • Lacroix J, Tatousek J, Den Teuling N, Visser T, Wells C, Wylie P, et al. Effectiveness of an Intervention Providing Digitally Generated Personalized Feedback and Education on Adherence to Continuous Positive Airway Pressure: Randomized Controlled Trial. J Med Internet Res . 2023 May 22. 25:e40193. [QxMD MEDLINE Link] .
  • Andrade RGS, Viana FM, Nascimento JA, Drager LF, Moffa A, Brunoni AR, et al. Nasal vs Oronasal CPAP for OSA Treatment: A Meta-Analysis. Chest . 2018 Mar. 153 (3):665-674. [QxMD MEDLINE Link] .
  • Wang D, Tang Y, Chen Y, Zhang S, Ma D, Luo Y, et al. The effect of non-benzodiazepine sedative hypnotics on CPAP adherence in patients with OSA: a systematic review and meta-analysis. Sleep . 2021 Aug 13. 44 (8): [QxMD MEDLINE Link] .
  • Lettieri CJ, Collen JF, Eliasson AH, Quast TM. Sedative use during continuous positive airway pressure titration improves subsequent compliance: a randomized, double-blind, placebo-controlled trial. Chest . 2009 Nov. 136 (5):1263-1268. [QxMD MEDLINE Link] .
  • Sweetman A, Lack L, Catcheside PG, Antic NA, Smith S, Chai-Coetzer CL, et al. Cognitive and behavioral therapy for insomnia increases the use of continuous positive airway pressure therapy in obstructive sleep apnea participants with comorbid insomnia: a randomized clinical trial. Sleep . 2019 Dec 24. 42 (12): [QxMD MEDLINE Link] .
  • Alessi CA, Fung CH, Dzierzewski JM, Fiorentino L, Stepnowsky C, Rodriguez Tapia JC, et al. Randomized controlled trial of an integrated approach to treating insomnia and improving the use of positive airway pressure therapy in veterans with comorbid insomnia disorder and obstructive sleep apnea. Sleep . 2021 Apr 9. 44 (4): [QxMD MEDLINE Link] .
  • Bakker JP, Marshall NS. Flexible pressure delivery modification of continuous positive airway pressure for obstructive sleep apnea does not improve compliance with therapy: systematic review and meta-analysis. Chest . 2011 Jun. 139 (6):1322-1330. [QxMD MEDLINE Link] .
  • Collen J, Holley A, Lettieri C, Shah A, Roop S. The impact of split-night versus traditional sleep studies on CPAP compliance. Sleep Breath . 2010 Jun. 14 (2):93-9. [QxMD MEDLINE Link] .
  • Smith I, Lasserson TJ. Pressure modification for improving usage of continuous positive airway pressure machines in adults with obstructive sleep apnoea. Cochrane Database Syst Rev . 2009 Oct 7. CD003531. [QxMD MEDLINE Link] .
  • Kennedy B, Lasserson TJ, Wozniak DR, Smith I. Pressure modification or humidification for improving usage of continuous positive airway pressure machines in adults with obstructive sleep apnoea. Cochrane Database Syst Rev . 2019 Dec 2. 12 (12):CD003531. [QxMD MEDLINE Link] .
  • [Guideline] Centers for Medicare and Medicaid Services (CMS). Decision Memo: Sleep Testing for Obstructive Sleep Apnea (OSA) CAG # 00405N. CMS.gov. Available at https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?proposed=N&NCAId=227&ver . March 3, 2009; Accessed: Mary 29, 2024.
  • [Guideline] Ramar K, Dort LC, Katz SG, Lettieri CJ, Harrod CG, Thomas SM, et al. Clinical Practice Guideline for the Treatment of Obstructive Sleep Apnea and Snoring with Oral Appliance Therapy: An Update for 2015. J Clin Sleep Med . 2015 Jul 15. 11 (7):773-827. [QxMD MEDLINE Link] . [Full Text] .
  • Yu M, Ma Y, Han F, Gao X. Long-term efficacy of mandibular advancement devices in the treatment of adult obstructive sleep apnea: A systematic review and meta-analysis. PLoS One . 2023. 18 (11):e0292832. [QxMD MEDLINE Link] .
  • Lazard DS, Blumen M, Lévy P, Chauvin P, Fragny D, Buchet I, et al. The tongue-retaining device: efficacy and side effects in obstructive sleep apnea syndrome. J Clin Sleep Med . 2009 Oct 15. 5 (5):431-8. [QxMD MEDLINE Link] . [Full Text] .
  • American Sleep Disorders Association. Practice parameters for the treatment of snoring and obstructive sleep apnea with oral appliances. American Sleep Disorders Association. Sleep . 1995 Jul. 18 (6):511-3. [QxMD MEDLINE Link] .
  • Petri N, Christensen IJ, Svanholt P, Sonnesen L, Wildschiødtz G, Berg S. Mandibular advancement device therapy for obstructive sleep apnea: a prospective study on predictors of treatment success. Sleep Med . 2019 Feb. 54:187-194. [QxMD MEDLINE Link] .
  • Hamza A, Giri S, Liu E, Schulte P, Beltrand E, Del Carpio D, et al. Clinical and craniofacial predictors of patient-reported and respiratory outcomes with oral appliance therapy. Sleep Med . 2026 Jun. 142:108868. [QxMD MEDLINE Link] .
  • Engleman HM, McDonald JP, Graham D, Lello GE, Kingshott RN, Coleman EL, et al. Randomized crossover trial of two treatments for sleep apnea/hypopnea syndrome: continuous positive airway pressure and mandibular repositioning splint. Am J Respir Crit Care Med . 2002 Sep 15. 166 (6):855-9. [QxMD MEDLINE Link] .
  • Phillips CL, Grunstein RR, Darendeliler MA, Mihailidou AS, Srinivasan VK, Yee BJ, et al. Health outcomes of continuous positive airway pressure versus oral appliance treatment for obstructive sleep apnea: a randomized controlled trial. Am J Respir Crit Care Med . 2013 Apr 15. 187 (8):879-87. [QxMD MEDLINE Link] .
  • Tsai WH, Vazquez JC, Oshima T, Dort L, Roycroft B, Lowe AA, et al. Remotely controlled mandibular positioner predicts efficacy of oral appliances in sleep apnea. Am J Respir Crit Care Med . 2004 Aug 15. 170 (4):366-70. [QxMD MEDLINE Link] .
  • Raphaelson MA, Alpher EJ, Bakker KW, Perlstrom JR. Oral appliance therapy for obstructive sleep apnea syndrome: progressive mandibular advancement during polysomnography. Cranio . 1998 Jan. 16 (1):44-50. [QxMD MEDLINE Link] .
  • Pételle B, Vincent G, Gagnadoux F, Rakotonanahary D, Meyer B, Fleury B. One-night mandibular advancement titration for obstructive sleep apnea syndrome: a pilot study. Am J Respir Crit Care Med . 2002 Apr 15. 165 (8):1150-3. [QxMD MEDLINE Link] .
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