发展指南

AASM Clinical Practice Guidelines provide physicians with recommendations for the evaluation, diagnosis, treatment and follow-up of patients with sleep disorders.

ASAM指南咨询小组审查和优先事项提出了临床实践指导方针，以确定最适合进一步追求的课题。董事会委员会批准了发展的主题，然后邀请睡眠和昼夜科学研究和睡眠医学专家开发指导。

The task force performs a systematic review of all published evidence on the topic, and then assesses the evidence using年级(Grading of Recommendations Assessment, Development and Evaluation). Evidence-based clinical practice recommendations are developed to provide overall diagnostic or treatment strategies for patients, taking into account the quality of evidence, balance of benefits versus harms, patient values and preferences and resource use.

A draft of the guideline will be made available for a 4-week public comment period before it is approved by the AASM Board of Directors for publication.

Clinical Practice Guideline for the Management of REM Behavior Disorder

This clinical practice guideline will provide practice recommendations for the management of REM Sleep Behavior Disorders (RBD). This guideline will update and replace the existing best practice guide for the treatment of RBD.

Task Force Chair:Michael Howell, MD

工作队员：

  • Alon Y. Avidan, MD, MPH (Vice Chair)
  • Emmanuel During, MD
  • Nancy Foldvary-Schaefer, DO, MS
  • Roneil Malkani, MD
  • Stuart J. McCarter, MD
  • 约书亚罗兰，MD

BOD Liaison:
汉南拉马尔，MD，MD

GAP联络：
Shelley Zak, MD

职员：Gerard Carandang, MS

Patient Populations:

  1. Idiopathic RBD
  2. 次要RBD由于医疗状况
  3. Drug-induced RBD

干预措施：

  1. Clonazepam
  2. 褪黑激素
  3. 多巴胺能药物（例如，普拉米脂，L-DOPA）
  4. Acetylcholinesterase inhibitors (e.g., Donepezil, Rivastigmine)
  5. 苯二氮卓岛受体激动剂（例如，Zopiclone，Zolpidem）
  6. 苯二氮卓类（例如，Temazepam，Trizzolam，Alprazolam）
  7. 膳食/草药补充剂（例如，色氨酸，Valerian，Yi-GaN San）
  8. Desipramine
  9. Clozapine
  10. 抗癫痫药物（例如，Carbamazepine，Levetiracetam）
  11. 大麻
  12. 氧氢钠
  13. Ramelteon
  14. 雅各菜子
  15. Memantine
  16. Antihypertensive medications (e.g., Prazosin, Clonidine)
  17. Bupropion
  18. Plasma exchange, Intravenous immunoglobin (IVIG)
  19. 深脑刺激
  20. PAP疗法
  21. 毒品停药

Outcomes:

  • 重大床伴频率睡眠中断
  • 梦想颁布频率造成伤害
  • Frequency of dream enactment episodes without injury
  • 令人不快的梦想和噩梦的频率和/或强度
  • Change in REM motor tone – tonic and/or phasic
  • 生活质量
  • 镇静或认知障碍的治疗相关恶化
  • 步态稳定性的治疗相关性
  • Treatment-related worsening in symptoms of depression or anxiety

The final recommendations will be based upon the available evidence, and must be approved by the
AASM董事会。

Clinical Practice Guideline for the Management of Sleep-Disordered Breathing in Inpatients

该临床实践指南将为住院患者提供睡眠无障碍呼吸的练习建议。

Task Force Chair:Reena Mehra, MD, MS

工作队员：

  • 丹尼斯奥克利，MD（副主席）
  • Martha Billings, MD
  • Karin Johnson，MD
  • Rami Khayat, MD
  • CinthyaPena orbea，MD
  • SUSHEEL PATIL，MD，PHD
  • Ashima Sahni, MD
  • Sunil Sharma，MD

BOD和GAP联络：
Vishesh Kapur，MD，MPH

职员：Gerard Carandang, MS

Patient Populations:

Adult patients at risk for sleep-disordered breathing (or with a pre-admission diagnosis of sleep apnea) admitted to the hospital.

干预措施：

  1. Sleep apnea screening vs no screening
  2. 住院评估与门诊评估
  3. 正气道压力/补充氧气/替代疗法VS无需治疗
  4. 住院入住睡眠咨询服务与其他提供商VS
  5. 住院性的生理学监测与监测没有监测
  6. 与睡眠医学的出院后管理与睡眠医学没有排放后管理

Outcomes:

  • Mortality
  • 住院时间
  • Readmission
  • Positive airway pressure adherence
  • 睡眠无序呼吸相关的合并症的发病率（例如高血压，心血管事件）
  • 白天嗜睡
  • 生活质量
  • 睡眠无序的呼吸诊断
  • Stroke recovery
  • 预防护理水平升级（例如，插管，RRT支持）
  • Time to diagnosis
  • 治疗时间
  • Time to post-discharge follow-up
  • 睡觉质量
  • Dyspnea

最终建议将基于可用的证据，必须由AASM董事会批准。

Clinical Practice Guideline for the Treatment of Restless Legs Syndrome and Periodic Limb Movement Disorder

This clinical practice guideline will provide recommendations for the treatment of restless legs syndrome and periodic limb movement disorder in adults and pediatric patients. This guideline will update and replace the existing practice parameters.

Task Force Chair:亚瑟·沃尔特斯，MD

工作队员：

  • John W. Winkelman，MD，博士（副主席）
  • Lourdes M. Del Rosso, MD
  • Denise Sharon，MD，PHD
  • Matthew Scharf，MD博士
  • J. Andrew Berkowski, MD
  • Brian Koo, MD

BOD Liason:Anita Shelgikar, MD, MHPE

职员：克里斯托弗·哈罗德, MS

Patient Populations:

  1. 成年患者具有特发性/原发性RLS
  2. 成年患者继发于医疗条件
  3. 成年患者难治性RLS
  4. 成人患者普利
  5. 特识性RLS的小儿科患者
  6. 儿科患者患有次级的RLS到医疗条件

干预措施：

  1. Pharmacological management (dopamine agonists, dopaminergic agents, anticonvulsants, opioids, adrenergic agonists, hypnotics, other medications)
  2. Surgical management (subthalamic deep brain stimulation, for secondary RLS-hemodialysis, nerve decompression surgery, endovenous laser ablation)
  3. Non-pharmacological management (avoidance of caffeine, alcohol, nicotine; sleep hygiene; supplementation with one of several minerals or vitamins; valerian root extract; acupuncture; physical treatment methods)

Outcomes:

  1. 疾病严重程度;包括增强率
  2. 生活质量
  3. 睡觉质量
  4. Sleep efficiency
  5. 睡眠延迟
  6. Wake after sleep onset (WASO)
  7. 白天过度嗜睡
  8. 工作损失/学校生产力
  9. Periodic Limb Movement frequency
  10. Depression/anxiety/mood disturbance
  11. 分辨率的ADHD症状（在PED人口中）
  12. 与研究中的不利影响 - 相关的下降/停药/退出
  13. 疲劳
  14. 工作/学校表现不佳/考勤

最终建议将基于可用的证据，必须由AASM董事会批准。

临床实践指南治疗外在昼夜节律睡眠术语障碍

This clinical practice guideline will provide recommendations for the treatment of extrinsic circadian rhythm sleep-wake disorders in adults and children. This guideline will update and replace the existing practice parameters.

Task Force Chair:肯尼斯赖特，博士

工作队员：

  • Sabra Abbott，MD，博士（副主席）
  • Liza H Ashbrook, MD
  • 克里斯托弗德雷克，博士
  • Erin Flynn-Evans, PhD
  • Catherine McCall, MD

BOD和GAP LIASON：Lynn Marie Trotti，MD，MSC

职员：Uzma Kazmi, MPH

Patient Populations:

成人换班工作障碍或喷气式滞后障碍

干预措施：

  1. 计划睡眠时间表/小睡
  2. Timed light and or dark exposure
  3. Timed melatonin/melatonin agonist administration or other chronobiotic administration
  4. Sleep promoting medications (e.g., benzodiazepines, benzodiazepine receptor agonists) or substances
  5. 兴奋剂药物/唤醒药物或物质
  6. 咖啡因
  7. Timed physical activity/exercise
  8. 饮食和膳食时间
  9. Combination treatments, CBT-I or sleep hygiene
  10. 计划工作时间表

Outcomes:

  • Excessive sleepiness/alertness
  • 总睡眠时间
  • 睡觉质量
  • 昼夜协调
  • 生活质量
  • Mental health
  • Cognitive performance/ work performance
  • Accident risk
  • Sleep efficiency
  • GI symptoms

最终建议将基于可用的证据，必须由AASM董事会批准。