The Natural History of Obstructive Sleep Apnea: A Scoping Review

Area of Science:

• Sleep Medicine
• Pulmonology
• Pediatrics

Background:

• Obstructive sleep apnea (OSA) is a prevalent disorder characterized by repeated upper airway collapse during sleep.
• It affects all age groups, with distinct causes and progression patterns in children versus adults.
• Untreated OSA can lead to significant health deterioration and reduced quality of life.

Purpose of the Study:

• To provide a life-course perspective on the natural history of OSA.
• To integrate pediatric and adult data, treatment effects, and emerging therapies.
• To identify opportunities for early, targeted interventions to modify OSA progression.

Main Methods:

• Review of pediatric and adult longitudinal data on OSA.
• Analysis of treatment-modified disease trajectories.
• Inclusion of emerging therapeutic strategies for OSA and obesity.

Main Results:

• OSA progression can be influenced by age, lifestyle factors (especially obesity), and comorbidities.
• Weight loss (≥5%) significantly reduces OSA progression risk; bariatric surgery offers high remission rates.
• Continuous positive airway pressure (CPAP) is effective for symptom control in adults, but adherence varies.

Conclusions:

• Early identification and intervention are crucial for managing OSA and preventing severe disease.
• Weight management is a key disease-modifying strategy for obese individuals with OSA.
• A life-course approach, considering phenotype and comorbidities, can optimize OSA management and outcomes.