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. 2011 Nov 29;3(3):e15.
doi: 10.4081/ni.2011.e15. Epub 2011 Dec 2.

Obstructive sleep apnea

Matthew L Ho  1 , Steven D Brass
Affiliations

Obstructive sleep apnea

Matthew L Ho et al. Neurol Int. .

Abstract

Obstructive sleep apnea (OSA) affects millions of Americans and is estimated to be as prevalent as asthma and diabetes. Given the fact that obesity is a major risk factor for OSA, and given the current global rise in obesity, the prevalence of OSA will increase in the future. Individuals with sleep apnea are often unaware of their sleep disorder. It is usually first recognized as a problem by family members who witness the apneic episodes or is suspected by their primary care doctor because of the individual's risk factors and symptoms. The vast majority remain undiagnosed and untreated, despite the fact that this serious disorder can have significant consequences. Individuals with untreated OSA can stop breathing hundreds of times a night during their sleep. These apneic events can lead to fragmented sleep that is of poor quality, as the brain arouses briefly in order for the body to resume breathing. Untreated, sleep apnea can have dire health consequences and can increase the risk of hypertension, diabetes, heart disease, and heart failure. OSA management has also become important in a number of comorbid neurological conditions, including epilepsy, stroke, multiple sclerosis, and headache. Diagnosis typically involves use of screening questionnaires, physical exam, and an overnight polysomnography or a portable home study. Treatment options include changes in lifestyle, positive airway pressure, surgery, and dental appliances.

Keywords: apnea; apnea hypopnea index; hypopnea; obstructive sleep apnea; respiratory disturbance index; respiratory event related arousals..

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Figures

Figure 1
Figure 1
Reprinted with permission of the American Thoracic Society. Copyright (c) 2011 American Thoracic Society. White D. Pathogenesis of obstructive and central sleep apnea. Am J Resp Crit Care Med. 2005; 172: 1363-1370. Official Journal of the American Thoracic Society.
Figure 2
Figure 2
Mallampati score. Author Jmarchn. January 29, 2011. Permission is granted to copy, distribute and/or modify this document under the terms of the GNU Free Documentation License, Version 1.2 or any later version published by the Free Software Foundation. [online] Available from: http://en.wikipedia.org/wiki/Mallampati_score.
Figure 3
Figure 3
Reprinted with permission of the American Thoracic Society. Copyright (c) 2011 American Thoracic Society. Won C, Li K, Guilleminault C. Surgical treatment of obstructive sleep apnea: upper airway and maxillomandibular surgery. Proc Am Thorac Soc. 2008; 5: 193–199. Official Journal of the American Thoracic Society.
Figure 4
Figure 4
Reprinted with permission of the American Thoracic Society. Copyright (c) 2011 American Thoracic Society. Won C, Li K, Guilleminault C. Surgical treatment of obstructive sleep apnea: upper airway and maxillomandibular surgery. Proc Am Thorac Soc. 2008; 5: 193–199. Official Journal of the American Thoracic Society.
Figure 5
Figure 5
Evaluation of OSA. Approach to initiation, management, and follow-up of treatment.
See this image and copyright information in PMC

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