Obstructive Sleep Apnea in Adults: What Primary Care Physicians Need to Know

Abstract

Obstructive sleep apnea (OSA) remains a prominent disease state characterized as the recurrent collapse of the upper airway while sleeping and is estimated to plague 936 million adults globally. Although the initial clinical presentation of OSA appears harmless, it increases the risk of cardiovascular diseases such as heart failure, stroke, and hypertension; metabolic disorders; and an overall decrease in quality of life, in addition to increasing mortality. Current treatment of OSA includes lifestyle changes, behavioral modification, mandibular advancement devices, surgical treatment, and continuous positive airway pressure, which remains the gold standard. It is crucial to identify OSA early on and initiate treatment to mitigate the adverse health risks it imposes. This review will discuss the pathophysiology, epidemiology, management strategies, and medical treatment of OSA.

Keywords: bilevel positive airway pressure; comorbidities; continous positive airway pressure; nonsurgical treatment; obstructive sleep apnea (osa); osa; pathophysiology; risk factors for obstructive sleep apnea (osa); surgical treatment.

Figure 1. The multifactorial pathogenesis of OSA and how the combined effects can increase the risk of outcomes.

↑ = increased; ↓ = decreased; RAAS = renin-angiotensin-aldosterone system; TNF-α = tumor necrosis factor alpha; IL-6 = interleukin 6; ROS = reactive oxygen species; IFG = impaired fasting glycemia; T2DM = type 2 diabetes mellitus; OSA = obstructive sleep apnea