目的·对全球范围内已发表的阻塞性睡眠呼吸暂停（obstructive sleep apnea，OSA）临床实践指南进行质量评价。方法·检索PubMed、Embase、中国知网、万方数据知识服务平台、中国生物医学文献数据库、梅斯医学、The Cochrane Library、医脉通、美国预防服务工作组网站、英国国家卫生与临床优化研究所网站、新西兰指南工作组网站、苏格兰校际指南网络、国际指南协作网等中的OSA相关指南，检索时间限定为建库至2022年12月。由2名研究人员独立筛选文献和提取信息，采用指南研究和评估工具Ⅱ（Appraisal of Guidelines for Research and Evaluation Ⅱ，AGREE Ⅱ）和国际实践指南报告标准（Reporting Items for Practice Guidelines in Healthcare，RIGHT）对纳入的指南进行质量评价，并按不同指南发布地区进行亚组分析；评价者间一致性采用组内相关系数（intra-class correlation coefficient，ICC）进行检验。对所有纳入指南进行全文阅读，汇总其提出的临床问题。结果·共纳入35篇OSA相关指南。评价者ICC为0.975，显示评价者间一致性较好。AGREE Ⅱ的评价结果显示：纳入指南的平均整体质量分值为（63.60±16.45）%，最低为23.40%，最高为91.67%；6个领域中严谨性［（56.07±25.89）%］和应用性［（53.57±15.52）%］得分较低。RIGHT的评价结果显示，纳入指南的平均总报告率为（67.84±20.03）%，最低为14.29%，最高为94.29%，其中平均报告率较低的领域为评审和质量保证［（31.40±45.51）%］、资金资助和利益冲突声明与管理［（56.43±33.95）%］和其他方面［（56.19±36.85）%］。亚组分析表明，亚洲地区的指南在AGREE Ⅱ的严谨性及整体的质量得分显著低于美洲和欧洲地区的指南（均P<0.05），在RIGHT的证据和其他方面2个领域的报告率也均显著低于美洲和欧洲地区的指南（P<0.05）。纳入的35部指南主要关注了OSA的筛查诊断、治疗及疾病管理3个方面42个临床问题。结论·目前全球OSA指南质量差异较大，各个地区的指南在严谨性、应用性、评审和质量保证、资金资助和利益冲突声明与管理等方面都有待加强，尤其是亚洲地区的指南。

Objective ·To evaluate the quality of clinical practice guidelines of obstructive sleep apnea (OSA) published worldwide. Methods ·The guidelines of OSA were retrieved in PubMed, Embase, China National Knowledge Infrastructure (CNKI), Wanfang Data, SinoMed, MedSci, The Cochrane Library, and the websites such as Medlive, U. S. Preventive Services Task Force (USPSTF), National Institute for Health and Care Excellence (NICE), New Zealand Guidelines Group (NZGG), Scottish Intercollegiate Guidelines Network (SIGN), and Guidelines International Network (GIN) from establishment to December 2022. Two reviewers screened the literature and extracted the main information independently, using the Appraisal of Guidelines for Research and Evaluation Ⅱ (AGREE Ⅱ) and Reporting Items for Practice Guidelines in Healthcare (RIGHT) to evaluate the quality of the included OSA guidelines. Subgroup analysis was performed according to the publication regions of guidelines. The inter-evaluator consistency test was also performed and the results were expressed as the intra-class correlation coefficient (ICC). All the included guidelines were read entirely and the clinical questions they raised were summarized. Results ·A total of 35 OSA guidelines were included. The ICC value of 0.975 showed a good inter-evaluator agreement. The results of AGREE Ⅱ showed that the average score of all guidelines was (63.60±16.45)%, with a minimum of 23.40% and a maximum of 91.67%. In the six domains, the scores of "Rigor of development" [(56.07±25.89)%] and "Applicability" [(53.57±15.52)%] were relative low. The average reporting rate of RIGHT of all the included guidelines was (67.84±20.03)%, with a minimum of 14.29% and a maximum of 94.29%, and the three domains with the lowest reporting rates were "Review and quality assurance" [(31.40±45.51)%], "Funding and conflict of interest declaration and management" [(56.43±33.95)%] and "Other aspects" [(56.19±36.85)%]. Subgroup analysis showed that guidelines in Asian had a lower score in "Rigor of development" and a lower overall score of AGREE Ⅱ than the guidelines in America and Europe (both P<0.05), and the reporting rates in the domains of "Evidence" and "Other information" of RIGHT of the Asian guidelines were also lower than those in the guidelines in America and Europe (P<0.05). These guidelines focused on 42 clinical questions which were classified to 3 aspects, i.e. screening and diagnosis, treatment and long-term management of OSA. Conclusion ·The quality of current global OSA guidelines varies a lot, and they need to be strengthened in terms of rigor of development, applicability, review and quality assurance, funding and conflict of interest declaration and management, especially those in Asia.