Obstructive Sleep Apnea and Its Management: A Narrative Review

Area of Science:

• Sleep Medicine
• Respiratory Medicine
• Cardiology

Background:

• Obstructive sleep apnea (OSA) is a common disorder characterized by recurrent upper airway collapse during sleep, leading to intermittent hypoxia and sleep fragmentation.
• Pathogenesis is multifactorial, involving factors like reduced upper airway dilator muscle function, low respiratory drive, and anatomical abnormalities.
• High-risk individuals include those who are overweight, male, aging, have adenotonsillar hypertrophy, or engage in smoking.

Purpose of the Study:

• To review the pathogenesis, risk factors, clinical signs, diagnostic methods, and management strategies for obstructive sleep apnea (OSA).
• To highlight the systemic complications associated with OSA and discuss current treatment modalities.

Main Methods:

• Screening involves sleep history, symptom assessment, and physical examination to identify individuals requiring further testing.
• Diagnosis is confirmed through polysomnography (PSG) or home sleep apnea tests (HSAT), though HSAT accuracy can be variable.
• Review of existing literature on OSA's impact, associations, and treatment efficacy.

Main Results:

• OSA is linked to significant comorbidities including systemic hypertension, diabetes mellitus, congestive heart failure (CHF), cerebral infarction, and myocardial infarction.
• Common symptoms include loud snoring, daytime sleepiness, and witnessed apneas.
• Continuous positive airway pressure (CPAP) is the preferred treatment, with adherence rates around 60-70%.

Conclusions:

• OSA is a prevalent condition with diverse risk factors and significant systemic health implications.
• Effective management includes CPAP, weight reduction, oral appliances, and surgical correction of anatomical obstructions.
• Early diagnosis and treatment are crucial to mitigate associated health risks and improve patient outcomes.