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Obstructive sleep apnoea (OSA) is a complex condition often diagnosed using the apnoea-hypopnoea index (AHI). However, hypoxia degree is increasingly used for severity, with continuous positive airway pressure (CPAP) as a primary treatment.

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Area of Science:

  • Sleep Medicine
  • Cardiology

Background:

  • Obstructive sleep apnoea (OSA) is a complex condition with varied phenotypes.
  • Traditionally defined by the apnoea-hypopnoea index (AHI), its correlation with symptoms and comorbidities is weak.
  • Hypoxia degree is increasingly utilized for OSA severity assessment.

Purpose of the Study:

  • To review the evolving definitions and treatments for obstructive sleep apnoea syndrome (OSAS).
  • To highlight the role of hypoxia in OSA severity and the primary treatment options.
  • To discuss newer therapeutic interventions and the current understanding of OSA's cardiovascular impact.

Main Methods:

  • Literature review of OSA definitions, diagnostic criteria, and therapeutic approaches.
  • Analysis of the relationship between AHI, hypoxia, and clinical presentation.
  • Examination of evidence regarding CPAP, position trainers, and hypoglossal nerve stimulation.

Main Results:

  • The AHI's limitations in reflecting OSA severity are recognized.
  • Hypoxia is emerging as a key metric for defining OSA severity.
  • Continuous positive airway pressure (CPAP) remains the first-line treatment for severe OSA; other therapies are patient-specific.

Conclusions:

  • OSA diagnosis and severity assessment are evolving beyond the AHI.
  • Effective management of OSA, particularly severe cases with CPAP, is crucial.
  • While OSA is a cardiovascular risk factor, definitive evidence of treatment impact on cardiovascular outcomes and mortality from clinical trials is still pending.