Obstructive sleep apnoea in adults

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Date
2012-11-17
Authors
Usmani, Zafar Ahmad
Chai-Coetzer, Ching Li
Antic, Nicholas Alexander
McEvoy, Ronald Douglas
Journal Title
Journal ISSN
Volume Title
Publisher
BMJ Group
Rights
Rights Holder
BMJ Group
Abstract
Obstructive sleep apnoea (OSA) is characterised by repetitive closure of the upper airway, repetitive oxygen desaturations and sleep fragmentation. The prevalence of adult OSA is increasing because of a worldwide increase in obesity and the ageing of populations. OSA presents with a variety of symptoms the most prominent of which are snoring and daytime tiredness. Interestingly though, a significant proportion of OSA sufferers report little or no daytime symptoms. OSA has been associated with an increased risk of cardiovascular disease, cognitive abnormalities and mental health problems. Randomised controlled trial evidence is awaited to confirm a causal relationship between OSA and these various disorders. The gold standard diagnostic investigation for OSA is overnight laboratory-based polysomnography (sleep study), however, ambulatory models of care incorporating screening questionnaires and home sleep studies have been recently evaluated and are now being incorporated into routine clinical practice. Patients with OSA are very often obese and exhibit a range of comorbidities, such as hypertension, depression and diabetes. Management, therefore, needs to be based on a multidisciplinary and holistic approach which includes lifestyle modifications. Continuous positive airway pressure (CPAP) is the first-line therapy for severe OSA. Oral appliances should be considered in patients with mild or moderate disease, or in those unable to tolerate CPAP. New, minimally invasive surgical techniques are currently being developed to achieve better patient outcomes and reduce surgical morbidity. Successful longterm management of OSA requires careful patient education, enlistment of the family’s support and the adoption of self-management and patient goal-setting principles.
Description
Keywords
Sleep apnea, Sleep Research
Citation
Usmani, Z.A., Chai-Coetzer, C.L., Antic, N.A. and McEvoy, R.D., 2013. Obstructive sleep apnoea in adults. Postgraduate Medical Journal, 89(1049), 148-156.