Purpose: To determine current management strategies of otolaryngologists involved in the treatment of sleep-disordered breathing.
Materials and methods: Survey of practitioners regarding their workup and treatment of patients suspected of obstructive sleep apnea.
Results: Of 305 respondents, 280 actively treated patients with obstructive sleep apnea or snoring, form the basis for this study. Respondents were from assorted practice settings, from a diverse geographic background, and varied length of time in practice. Although 48% see more than 3 new outpatients a week for snoring or obstructive sleep apnea, only 46% routinely ask their patients about sleep problems, and 49 % fail to ask all of their patients with sleep apnea about sleep-related automobile accidents. Although most regularly use nasopharyngoscopy, a significant proportion seldom uses the Müller maneuver. Most tend to rely predominantly on whole-night polysomnography, rather than split night or home testing. Half of respondents offer their patients with simple snoring more than 1 method of treatment. Although many different surgical procedures are offered by most, only 28% of respondents offer patients any procedure aimed at airway obstruction at the base of tongue level.
Conclusions: Otolaryngologists, with their unique expertise in airway management, need to be more vigilant for patients with sleep-disordered breathing. The hypopharynx fails to be frequently addressed by the respondents and could lead to inadequate treatment of obstructive sleep apnea. Further research should seek to develop an evidence-based standard of care such that this disorder might be most effectively managed in the future.