Adult obstructive sleep apnoea: Pathogenesis, importance, diagnosis and imaging

Area of Science:

• Radiology
• Sleep Medicine
• Anatomy

Background:

• Obstructive sleep apnoea (OSA) is a prevalent global health issue, affecting up to 50% of middle-aged men and 25% of women.
• OSA significantly increases mortality risk and is often underdiagnosed due to lack of awareness and symptoms.
• Anatomical abnormalities in the upper airway are key contributors to OSA development.

Purpose of the Study:

• To discuss the role of medical imaging in evaluating the anatomical basis of obstructive sleep apnoea.
• To highlight imaging findings associated with OSA and its systemic consequences.
• To emphasize the importance of recognizing upper airway narrowing in OSA diagnosis.

Main Methods:

• Review of imaging findings in patients with obstructive sleep apnoea.
• Correlation of upper airway anatomy with OSA severity and related health issues.
• Discussion of the diagnostic utility of imaging in suggesting OSA.

Main Results:

• Narrowed and elongated oropharynx, and increased nasal resistance are linked to increased upper airway collapsibility and OSA.
• Radiologists often overlook significant upper airway narrowing, which is crucial for OSA.
• Imaging findings can strongly suggest OSA, though polysomnography is required for definitive diagnosis.

Conclusions:

• Medical imaging plays a vital role in identifying anatomical risk factors for obstructive sleep apnoea.
• Increased awareness and reporting of upper airway narrowing in imaging are crucial for improving OSA diagnosis.
• While positive airway pressure is effective, limited compliance necessitates exploration of alternative treatments for OSA.