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Obstructive sleep apnea and related disorders

R D Chervin1, C Guilleminault

  • 1Department of Neurology, University of Michigan Medical Center, Ann Arbor, USA.

Neurologic Clinics
|August 1, 1996
PubMed
Summary

Obstructive Sleep Apnea Syndrome (OSAS) and Upper Airway Resistance Syndrome (UARS) disrupt sleep due to airway closure. Diagnosis involves history, physical exam, and polysomnography, with treatments ranging from CPAP to surgery.

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Area of Science:

  • Sleep Medicine
  • Otolaryngology
  • Respiratory Medicine

Background:

  • Obstructive Sleep Apnea Syndrome (OSAS) is a severe upper airway obstruction disorder causing disrupted sleep and excessive daytime sleepiness (EDS).
  • Related conditions include Upper Airway Resistance Syndrome (UARS) with increased breathing effort and primary snoring.
  • Clinical suspicion arises from symptoms like loud snoring, EDS, insomnia, witnessed apneas, fatigue, and behavioral issues in children.

Purpose of the Study:

  • To outline the clinical presentation, diagnostic methods, and treatment options for OSAS and related upper airway disorders.
  • To differentiate OSAS from less severe conditions like UARS and primary snoring.
  • To provide an overview of current management strategies.

Main Methods:

  • Clinical history and physical examination to identify risk factors and symptoms.
  • Overnight polysomnography (PSG) to confirm diagnosis.
  • Multiple Sleep Latency Test (MSLT) to assess daytime sleepiness.
  • Esophageal manometry during PSG for UARS diagnosis.

Main Results:

  • Key diagnostic clues include loud snoring, EDS, witnessed apneas, and specific physical findings like obesity or retrognathia.
  • Polysomnography is essential for confirmation, with esophageal manometry aiding UARS diagnosis.
  • Treatment effectiveness varies, with nasal CPAP/BPAP being common, but compliance issues may favor surgery.

Conclusions:

  • OSAS and related disorders are diagnosed through a combination of clinical assessment and objective sleep studies.
  • Treatment approaches are diverse, including positive airway pressure, surgery, dental appliances, medications, weight loss, and positional therapy.
  • Tailoring treatment to the specific disorder and patient is crucial for managing upper airway obstruction during sleep.

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