Obstructive Sleep Apnea Syndromes
Complete or partial collapse of the upper airway during sleep has different effects on the human body ranging from noisy breathing (snoring) to significant cardiovascular sequelae as seen in obstructive sleep apnea (OSA). Snoring is very common in the adult population and has been associated with morbidity in epidemiological studies. A variety of treatments may be used for primary snoring (snoring without symptoms) but none are universally successful. The upper airway resistance syndrome is thought to occur when incomplete obstruction of the upper airway results in frequent disruptions in sleep.
Whether it is a true ‘‘syndrome’’ or just one end of the continuum of OSA is unclear. Obstructive sleep apnea causes not only sleep disruption but oxygen desaturation. It has been associated with numerous cardiovascular sequelae, including hypertension (systemic and pulmonary), arrhythmias, and stroke. Nasal continuous positive airway pressure (CPAP) is the current treatment of choice, with lesser alternatives including oral appliances, surgery, and weight loss. Further study on outcomes is required to determine how aggressively to treat these syndromes.
There are several forms of sleep-disordered breathing, including obstructive sleep apnea (OSA)syndromes, central sleep apnea syndromes, and hypoventilation syndromes. This article focuses on the OSA syndromes. Included in this categorization are primary snoring, upper airway resistance syndrome, and OSA. In common with all these entities is narrowing or complete obstruction of the upper airway. The comments herein will refer to adult populations.
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