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Obstructive sleep apnea. Trends in therapy

R W Riley1, N B Powell, C Guilleminault

  • 1Stanford University Sleep Disorders and Research Center, Palo Alto, CA 94304, USA.

The Western Journal of Medicine
|February 1, 1995
PubMed
Summary
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Obstructive sleep apnea (OSA) is a serious sleep disorder linked to significant health risks and economic costs. Early identification and appropriate management by primary care physicians are crucial for patient outcomes.

Area of Science:

  • Sleep Medicine
  • Cardiovascular Health
  • Public Health

Background:

  • The National Commission on Sleep Disorders Research highlighted a general lack of understanding of sleep disorders within primary care.
  • Obstructive sleep apnea (OSA) is associated with considerable morbidity and mortality.
  • Excessive daytime sleepiness, a symptom of OSA, leads to decreased work performance and increased accident rates, costing over $20 billion annually in lost productivity.

Purpose of the Study:

  • To underscore the importance of primary care in recognizing and managing obstructive sleep apnea.
  • To review the risks, risk factors, and current treatment modalities for OSA.
  • To present a surgical protocol demonstrating efficacy comparable to nasal continuous positive airway pressure.

Main Methods:

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  • Literature review and synthesis of findings regarding OSA prevalence, impact, and management.
  • Discussion of diagnostic methods, including polysomnography.
  • Presentation of medical and surgical treatment options for OSA.

    • Main Results:

    • OSA is strongly linked to hypertension, myocardial infarction, and stroke.
    • Key risk factors for OSA include male sex, obesity, older age, craniofacial anomalies, and family history.
    • Both nasal continuous positive airway pressure and a presented surgical protocol show efficacy in treating OSA.

    Conclusions:

    • Primary care physicians must take responsibility for identifying at-risk patients for OSA and ensuring appropriate referrals.
    • Effective management of OSA requires a comprehensive approach, including diagnosis, treatment, and patient support for compliance.
    • Surgical interventions can be a viable alternative for patients unresponsive to nasal continuous positive airway pressure therapy.