Treatment of central sleep apnea in adults: an American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment

Introduction: This systematic review provides supporting evidence for the accompanying clinical practice guideline on the treatment of central sleep apnea syndrome in adults. Methods: The American Academy of Sleep Medicine commissioned a task force of experts in sleep medicine. A systematic review was conducted to identify studies that compared the use of positive airway pressure therapies, non–positive airway pressure therapies, and pharmacological treatment to no treatment to improve patient-important outcomes. Statistical analyses were performed to determine the clinical meaningfulness of using various interventions to treat central sleep apnea in adults. The Grading of Recommendations Assessment, Development, and Evaluation process was used to assess the evidence for making recommendations. Results: The literature search resulted in 6,701 articles, of which 103 articles provided data suitable for statistical analyses. The task force provided a detailed summary of the evidence along with the certainty of evidence, the balance of benefits and harms, patient values and preferences, and resource use considerations.