Managements for Obstructive Sleep Apnea in Adults: Review

Overview

Journal Cureus

Specialty Biomedical Engineering

Date 2020 Sep 24

PMID 32968568

Citations 6

Authors

Gantuya Tserenpil

Meklit Gebre

Azka Shahid Zergham

Amanpreet Kaur Sekhon

Bilal Haider Malik

Affiliations

Soon will be listed here.

Abstract

Obstructive sleep apnea (OSA) is characterized by recurrent obstruction of the pharyngeal airway during sleep, with resultant hypoxia and sleep fragmentation. It is more common in middle-aged obese men and prevalence is higher in most obese people. However, prevalence is high in African-Americans. OSA is associated with major comorbidities including excessive daytime sleepiness and increased risk of cardiovascular diseases. First and foremost, OSA management starts from educating patients about short-term consequences like motor vehicle accidents, behavioral modifications, long term consequences like cardiopulmonary disease, and resistant high blood pressure. Various types of management options are available for OSA such as weight loss, CPAP, oral appliances, and surgery. The review aims to explain the pathophysiology and cause of the obstruction of the airway in order to choose proper management carefully to decrease the symptoms and cure the disease.

Citing Articles

Obstructive Sleep Apnea and Its Cardiac Implications in the United States: An Age-Stratified Analysis Between Young and Older Adults.

Strenth C, Wani A, Alla R, Khan S, Schneider F, Thakur B J Am Heart Assoc. 2024; 13(12):e033810.

PMID: 38842290 PMC: 11255750. DOI: 10.1161/JAHA.123.033810.

Demographic, anthropometric, and metabolic characteristics of obstructive sleep apnea patients from Romania before the COVID-19 pandemic.

Neagos A, Vrinceanu D, Dumitru M, Costache A, Cergan R Exp Ther Med. 2021; 22(6):1487.

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Identification of key genes and immune infiltration modulated by CPAP in obstructive sleep apnea by integrated bioinformatics analysis.

Fan C, Huang S, Xiang C, An T, Song Y PLoS One. 2021; 16(9):e0255708.

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Nocturnal blood pressure and nocturnal blood pressure fluctuations: the effect of short-term CPAP therapy and their association with the severity of obstructive sleep apnea.

Picard F, Panagiotidou P, Tammen A, Wolf-Putz A, Steffen M, Gerhardy H J Clin Sleep Med. 2021; 18(2):361-371.

PMID: 34314347 PMC: 8804991. DOI: 10.5664/jcsm.9564.

Transcriptomic Changes of Murine Visceral Fat Exposed to Intermittent Hypoxia at Single Cell Resolution.

Khalyfa A, Warren W, Andrade J, Bottoms C, Rice E, Cortese R Int J Mol Sci. 2021; 22(1).

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References

Frey W, Pilcher J . Obstructive sleep-related breathing disorders in patients evaluated for bariatric surgery. Obes Surg. 2003; 13(5):676-83. DOI: 10.1381/096089203322509228. View

Baran A, Richert A, Douglass A, May W, Ansarin K . Change in periodic limb movement index during treatment of obstructive sleep apnea with continuous positive airway pressure. Sleep. 2003; 26(6):717-20. DOI: 10.1093/sleep/26.6.717. View

Raveendran R, Wong J, Singh M, Wong D, Chung F . Obesity hypoventilation syndrome, sleep apnea, overlap syndrome: perioperative management to prevent complications. Curr Opin Anaesthesiol. 2016; 30(1):146-155. DOI: 10.1097/ACO.0000000000000421. View

Sankri-Tarbichi A, Rowley J, Badr M . Expiratory pharyngeal narrowing during central hypocapnic hypopnea. Am J Respir Crit Care Med. 2009; 179(4):313-9. PMC: 2643080. DOI: 10.1164/rccm.200805-741OC. View

Orem J, Lovering A, Dunin-Barkowski W, Vidruk E . Tonic activity in the respiratory system in wakefulness, NREM and REM sleep. Sleep. 2002; 25(5):488-96. View

Harding S . Complications and consequences of obstructive sleep apnea. Curr Opin Pulm Med. 2000; 6(6):485-9. DOI: 10.1097/00063198-200011000-00004. View

Dempsey J, Veasey S, Morgan B, ODonnell C . Pathophysiology of sleep apnea. Physiol Rev. 2010; 90(1):47-112. PMC: 3970937. DOI: 10.1152/physrev.00043.2008. View

Peppard P, Young T, Barnet J, Palta M, Hagen E, Hla K . Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol. 2013; 177(9):1006-14. PMC: 3639722. DOI: 10.1093/aje/kws342. View

Epstein L, Kristo D, Strollo Jr P, Friedman N, Malhotra A, Patil S . Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. J Clin Sleep Med. 2009; 5(3):263-76. PMC: 2699173. View

10.

Khoo M . Determinants of ventilatory instability and variability. Respir Physiol. 2000; 122(2-3):167-82. DOI: 10.1016/s0034-5687(00)00157-2. View

11.

Ballard R, Gay P, Strollo P . Interventions to improve compliance in sleep apnea patients previously non-compliant with continuous positive airway pressure. J Clin Sleep Med. 2008; 3(7):706-12. PMC: 2556913. View

12.

Bakker J, Marshall N . Flexible pressure delivery modification of continuous positive airway pressure for obstructive sleep apnea does not improve compliance with therapy: systematic review and meta-analysis. Chest. 2011; 139(6):1322-1330. DOI: 10.1378/chest.10-2379. View

13.

Szollosi I, Roebuck T, Thompson B, Naughton M . Lateral sleeping position reduces severity of central sleep apnea / Cheyne-Stokes respiration. Sleep. 2006; 29(8):1045-51. DOI: 10.1093/sleep/29.8.1045. View

14.

Qaseem A, Holty J, Owens D, Dallas P, Starkey M, Shekelle P . Management of obstructive sleep apnea in adults: A clinical practice guideline from the American College of Physicians. Ann Intern Med. 2013; 159(7):471-83. DOI: 10.7326/0003-4819-159-7-201310010-00704. View

15.

de Vries G, Hoekema A, Doff M, Kerstjens H, Meijer P, van der Hoeven J . Usage of positional therapy in adults with obstructive sleep apnea. J Clin Sleep Med. 2014; 11(2):131-7. PMC: 4298770. DOI: 10.5664/jcsm.4458. View

16.

Redline S, Tishler P, Hans M, Tosteson T, Strohl K, Spry K . Racial differences in sleep-disordered breathing in African-Americans and Caucasians. Am J Respir Crit Care Med. 1997; 155(1):186-92. DOI: 10.1164/ajrccm.155.1.9001310. View

17.

Sforza E, Bacon W, Weiss T, Thibault A, Petiau C, Krieger J . Upper airway collapsibility and cephalometric variables in patients with obstructive sleep apnea. Am J Respir Crit Care Med. 2000; 161(2 Pt 1):347-52. DOI: 10.1164/ajrccm.161.2.9810091. View

18.

Tarraubella N, Sanchez-de-la-Torre M, Nadal N, de Batlle J, Benitez I, Cortijo A . Management of obstructive sleep apnoea in a primary care vs sleep unit setting: a randomised controlled trial. Thorax. 2018; 73(12):1152-1160. DOI: 10.1136/thoraxjnl-2017-211237. View

19.

Uniken Venema J, Doff M, Joffe-Sokolova D, Wijkstra P, van der Hoeven J, Stegenga B . Long-term obstructive sleep apnea therapy: a 10-year follow-up of mandibular advancement device and continuous positive airway pressure. J Clin Sleep Med. 2020; 16(3):353-359. PMC: 7075089. DOI: 10.5664/jcsm.8204. View

20.

Mutter T, Chateau D, Moffatt M, Ramsey C, Roos L, Kryger M . A matched cohort study of postoperative outcomes in obstructive sleep apnea: could preoperative diagnosis and treatment prevent complications?. Anesthesiology. 2014; 121(4):707-18. DOI: 10.1097/ALN.0000000000000407. View