| Summary: | Obstructive sleep apnea (OSA) is a condition in which the repetitive, partial, or complete closure of the upper airway results in repeated, reversible blood oxygen desaturation and sleep fragmentation. A Canadian Community Health Survey in 2009 reported a 3% prevalence of OSA in Canadians adults. OSA is determined by a number of sleep parameter abnormalities measured by polysomnography such as AHI, arousal index, and minimum oxygen saturation (SpO2). OSA is associated with neurobehavioral morbidities reflected by a reduction in the Epworth Sleepiness Score (ESS) and quality of life; increased cardiovascular diseases such as high blood pressure, heart failure; and metabolic morbidities such as oxidative stress. OSA is associated with substantial costs to society due to its morbidities, with costs of untreated OSA potentially doubling medical expenses, mainly because of cardiovascular diseases. OSA-related motor vehicle collisions in 2000 were estimated at US$15.9 billion in damages and health-related costs. Treatment of OSA includes a wide range of options, such as changes in diet and lifestyle to reduce risk factors for OSA, pharmacotherapy, the use of continuous airway pressure (CPAP) and various oral devices to splint the airway open to facilitate airflow, to upper airway surgical treatment. In Ontario, patients waited a mean 11.6 months from the time being referred to a sleep clinic to the time of medical therapy initiation, and 16.2 months to surgical therapy initiation. This Rapid Response report aims to review the clinical and cost-effectiveness of CPAP as compared to oral devices and lifestyle changes in the treatment of OSA.
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