Should the diagnosis and management of OSA move into general practice? (original) (raw)
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Obstructive Sleep Apnea (OSA) as a Cause of Sleep Disorders
eScientific, 2021
Introduction: OSA is a medical disorder characterized by repeated episodes of the upper airway closure during sleep. The correct diagnosis of OSA is essential, through a complete clinical history and thorough evaluation of the anatomical area of the upper airway. Literature Review: The inability to recognize OSA can adversely affect health conditions, as this disease is associated with significant morbidity and mortality. Obesity is a major risk factor for the incidence of OSA. Surgical management was considered in patients with AHI> 15 events / hour and unable to tolerate or reject CPAP. Conclusion: Identifying the pattern and pathophysiology of airway obstruction in OSA is essential. The gold standard examination for OSA is polysomnography. An initial oropharyngeal anatomical evaluation to predict success management of OSA patients is necessary.
RUHS Journal of Health Science, 2018
Obstructive sleep apnea syndrome (OSAS) is a highly prevalent yet under recognized sleep disorder, characterized by repeated disruptions of breathing during sleep. Not just merely a local phenomenon of upper respiratory tract obstruction, this has many consequences that includes intermittent hypoxia, intermittent hypercapnia, reoxygenation, intra thoracic pressure changes, sympathetic activation, micro-awakenings and sleep fragmentation leading to metabolic dysregulation, endothelial dysfunction, systemic inflammation, oxidative stress, hypercoagulation, and neurohumoral changes that causes excessive daytime sleepiness, neurocognitive deterioration, endocrine, metabolic and other systemic effects including poor quality of life. There are increasing evidences to suggest that OSAS is a systemic inflammatory disease. Epidemiological studies have identified OSAS as an independent risk factor in cardiovascular diseases, metabolic syndrome and bronchial asthma. Patho-physiological changes in OSAS are causally linked to the hypertension with increase risk for heart failure, stroke and cardiovascular mortality. In addition, OSAS is associated with several other disorders and comorbidities that may affect almost every organ systems of our body. Despite having many complex systemic consequences, OSAS and its secondary effects are mostly controllable by continuous positive air pressure (CPAP). This disorder largely remains an underestimated clinical entity due to unawareness by both the patient and physician alike. There is need for awareness regarding this entity among all specialties of medicine and surgery as the so called undetected/occult disease if remain untreated may lead to significant systemic morbidities and at times mortality. like micrognathia, retrognathia, high arched palate, macroglossia, nasal polyp, deviated nasal septum, genetic predisposition, familial aggregation, cigarette smoking, menopause, alcohol intake, night time nasal congestion, endocrine abnormalities (hypothyroidism/acromegaly, polycystic ovarian syndrome), Down's syndrome, drugs like benzodiazepines, muscle relaxants, testosterone therapy7'8 etc. Recently bronchial asthma, chronic obstructive pulmonary disease (COPD), metabolic syndrome, certain psychiatric problems etc has also emerged as important risk factors for development of OSAS. Poor control of these disorders has been consistently associated with poor sleep, restlessness, breathlessness and poor quality of life among these patients.
The Obstructive Sleep Apnea Syndrome (OSAS)
Journal of Otolaryngology-ENT Research, 2016
Respiratory disorders are a big issue that affects around 60% of the population all over the world. It varies from simple snoring up to severe stridor which appears mainly during sleep. The cause of all respiratory disorders depends on obstruction, vibration or both. We can also find respiratory disorders in some rare cases like Obesity Hypoventilation Syndrome or Multisystem Disease. The respiratory events start with simple snoring without symptoms of dyspnea or hypopnea. It may extend to arousals due to respiratory efforts (RERAs Syndrome).
Management of Obstructive Sleep Apnoea
Ministry Of Health Malaysia, 2023
Obstructive Sleep Apnoea (OSA) is a common sleep-related breathing disorder caused by repetitive upper airway collapse resulting in partial or complete breathing cessation. Symptoms include unrefreshed sleep, daytime sleepiness, fatigue, insomnia, awakening with a gasping or choking sensation and loud snoring. Sleep disordered breathing (SDB) and obstructive sleep apnoea syndrome (OSAS) are commonly described as OSA in the literature. For the purpose of this document, we will use OSA as the referring terminology. This disease affects both children and adults and is associated with significant morbidity. A recent review estimated that nearly one billion adults aged 30 - 69 years worldwide could have OSA. The number of people with moderate to severe OSA in whom treatment was highly recommended was estimated to be at least 425 million.1, level III In children, the prevalence of OSA was reported to be up to 5.7%. Obesity was identified as an independent risk factor for OSA in this group.2, level I Early recognition and treatment are essential in preventing sequelae from OSA. This medical condition increases all cause and cardiovascular (CV)-related mortality predominantly among the middle- aged group. It is also associated with other co-morbidities including metabolic and cognitive consequences. Therefore, it is important to be aware of the disease and updated with its management. The management of OSA has evolved since its discovery in 1965, especially after the introduction of Continuous Positive Airway Pressure (CPAP) therapy via nasal mask in 1981 as a form of treatment for OSA. To date, there is no specific local CPG addressing the management of OSA. Thus, it is timely to have the first Malaysian CPG on OSA to guide local healthcare providers in managing this common disorder. It will provide a standard framework for the management of OSA based on the latest evidence available.
Obstructive Sleep Apnea -A Review Review Article
SciDoc Publishers, 2020
Obstructive sleep apnea (OSA) is a common sleeping disorder. As the name suggests, it is associated with apneic and hypopneic breathing due to some kind of obstruction in the respiratory passage and thereby interferes with sleep. This review aims to give a concise overview on the disease, its pathophysiology, clinical presentation, diagnosis and various methods of management.