The Management of Chronic Insomnia Disorder & Obstructive Sleep Apnea in US Military Personnel

Research Paper Title

The Management of Chronic Insomnia Disorder and Obstructive Sleep Apnea: Synopsis of the 2019 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guidelines.

Background

In September 2019, the U.S. Department of Veterans Affairs (VA) and the US Department of Defence (DoD) approved a new joint clinical practice guideline for assessing and managing patients with chronic insomnia disorder and obstructive sleep apnea (OSA).

This guideline is intended to give health care teams a framework by which to screen, evaluate, treat, and manage the individual needs and preferences of VA and DoD patients with either of these conditions.

Methods

In October 2017, the VA/DoD Evidence-Based Practice Work Group initiated a joint VA/DoD guideline development effort that included clinical stakeholders and conformed to the Institute of Medicine’s tenets for trustworthy clinical practice guidelines.

The guideline panel developed key questions, systematically searched and evaluated the literature, created three 1-page algorithms, and advanced 41 recommendations using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system.

Recommendations

This synopsis summarises the key recommendations of the guideline in 3 areas: diagnosis and assessment of OSA and chronic insomnia disorder, treatment and management of OSA, and treatment and management of chronic insomnia disorder.

Three clinical practice algorithms are also included.

Reference

Mysliwiec, V., Martin, J.L., Ulmer, C.S., Chowdhuri, S., Brock, M.S., Spevak, C. & Sall, J. (2020) The Management of Chronic Insomnia Disorder and Obstructive Sleep Apnea: Synopsis of the 2019 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guidelines. Annals of Internal Medicine. 172(5), pp.325-336. doi: 10.7326/M19-3575. Epub 2020 Feb 18.

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