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.