American Academy of Sleep Medicine

View all recommendations from this society

Released December 2, 2014; Updated December 21, 2021

Don’t routinely perform positive airway pressure (PAP) re-titration sleep studies in patients with sleep apnea who are PAP-adherent unless there is an indication that current therapy may be inadequate.

Re-titration of PAP with overnight polysomnography is not indicated for adult patients with obstructive sleep apnea with stable weight whose symptoms are well-controlled by their current PAP treatment. A follow-up diagnostic or re-titration study can be used to reassess patients with recurrent or persistent symptoms, despite good PAP adherence, especially if they have gained substantial weight (e.g., 10% of original weight) since the last titration study. A new diagnostic or re-titration study may be indicated for patients who have lost substantial weight to determine whether PAP treatment is still necessary. A polysomnogram can be considered in a patient without symptoms or weight change, who is adherent to PAP but has unexplained PAP device-generated data.

These items are provided solely for informational purposes and are not intended as a substitute for consultation with a medical professional. Patients with any specific questions about the items on this list or their individual situation should consult their physician.

How The List Was Created

The Executive Committee of the American Academy of Sleep Medicine developed 21 candidate recommendations for ways in which medical waste could be minimized while care for patients with sleep disorders is improved. Members of the Executive Committee then voted to assign priorities to each, and the top five were selected. Final wording of the five statements were approved by the full Board of Directors of the American Academy of Sleep Medicine in 2014. The American Academy of Sleep Medicine developed rationale and references for each recommendation. The final statements, explanations and citations were approved by a final vote of the Board of Directors. The list was reviewed and updated by the Guidelines Advisory Panel with final revisions approved by the Executive Committee in 2021.

The AASM disclosure and conflict of interest policy can be found at


Caples SM, Anderson WM, Calero K, Howell M, Hashmi SD. Use of polysomnography and home sleep apnea tests for the longitudinal management of obstructive sleep apnea in adults: an American Academy of Sleep Medicine clinical guidance statement. J Clin Sleep Med. 2021;17(6):1287–1293.

Epstein LJ, Kristo D, Strollo PJ Jr, Friedman N, Malhotra A, Patil SP, Ramar K, Rogers R, Schwab RJ, Weaver EM, Weinstein MD; Adult Obstructive Sleep Apnea Task Force of the American Academy of Sleep Medicine. Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. J Clin Sleep Med. 2009 Jun 15;5(3):263-76.