Canadian Thoracic Society guidelines: Diagnosis and treatment of sleep disordered breathing in adults

The Canadian Thoracic Society (CTS) guidelines for the diagnosis and treatment of sleep disordered breathing in adults were developed over the past year. A one-day meeting was held in Montreal, Quebec, on October 28, 2005, just before the annual CTS meeting. The meeting was facilitated by Dr R Davies (Oxford, United Kingdom), and speakers included D Morrison (Halifax, Nova Scotia), J Kimoff (Montreal), J Fleetham (Vancouver, British Columbia), C George (London, Ontario), M Kryger (Winnipeg, Manitoba), P Hanly (Calgary, Alberta), F Hill (Saskatoon, Saskatchewan), D Bradley (Toronto, Ontario), N Ayas (Vancouver), M Fitzpatrick (Kingston, Ontario), F Series (Quebec City, Quebec), K Ferguson (London) and W Tsai (Calgary). This meeting was attended by 28 Canadian physicians with an interest in sleep disordered breathing. A draft of an Executive Summary was developed, and then reviewed and finalized by the CTS Sleep Disordered Breathing Committee at a one-day meeting in Toronto on February 17, 2006. The Committee members then individually ranked the level of evidence as: grade A – high-quality meta-analysis or single randomized clinical trial (RCT) that had a low risk of bias; grade B – high-quality systematic review of cohort studies or single cohort study with a low risk of bias or extrapolated evidence from high-quality RCTs or RCTs with a risk of bias; grade C – case-control studies or cohort studies with a risk of bias; or grade D – case series, case reports or expert opinion. The Committee members also ranked their agreement with each statement (strongly agree, agree, neutral, disagree or strongly disagree). No statement was included unless at least 90% of the Committee either strongly agreed or agreed with it.