This ACCP clinical practice guideline evaluated how to screen, diagnose, treat, and follow up obstructive sleep apnea (OSA) in pregnant patients, using a systematic PICO-based literature review of MEDLINE and the Cochrane Library.
Nine conditional recommendations were issued: screen all pregnant patients with a pregnancy-specific or standard OSA questionnaire; use HST or in-lab PSG for those at risk; treat with APAP when AHI 5–15 plus symptoms/comorbidities, or AHI ≥15 regardless of symptoms; consider scheduled naps for residual symptoms; reassess OSA postpartum in select patients.
All nine recommendations are conditional due to low certainty of evidence, reflecting a sparse and methodologically limited literature base. The guideline relies heavily on expert consensus rather than high-quality RCT data.
Screen every pregnant patient for OSA using a validated tool; if at risk, diagnose with HST or PSG and treat with APAP when AHI thresholds or symptom criteria are met. Plan postpartum OSA reassessment for appropriate patients.
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