SHM's Clinical Quick Talks-Obstructive Sleep Apnea

Pdf Summary

Obstructive Sleep Apnea (OSA) is defined by episodes of complete or partial upper airway collapse, decreasing oxygen saturation or leading to arousal from sleep. It is diagnosed with an Apnea-Hypoxia Index (AHI) of at least 5 events per hour of sleep. OSA is the most common sleep-related breathing disorder, affecting 15-30% of men and 10-15% of women in North America. Globally, about 1 billion people have mild OSA, with approximately 425 million experiencing moderate to severe forms.<br /><br />Several risk factors are associated with OSA, including both anatomic factors like craniofacial abnormalities and non-anatomic factors such as obesity, age, male gender, and lifestyle choices like alcohol use and smoking. Clinical symptoms often include excessive daytime sleepiness, loud snoring, and observed apneic events.<br /><br />Screening is commonly performed using the STOP-BANG questionnaire, assessing snoring, tiredness, observed apneas, blood pressure, BMI, age, neck circumference, and gender. A high risk for OSA is indicated with a score of 5 or more, while 3 is considered low risk.<br /><br />Diagnosis often involves polysomnography or home sleep studies, confirming at least 5 obstructive events per hour alongside clinical symptoms. Severity is categorized into mild (5-15 events/hour), moderate (15-30 events/hour), and severe (over 30 events/hour).<br /><br />Treatment focuses primarily on Positive Airway Pressure (PAP) therapy, along with behavioral modifications like weight loss and repositioning during sleep, and possibly surgical interventions. OSA is linked to significant cardiovascular complications, including arrhythmias and increased risk of heart disease, emphasizing the importance of treatment even in asymptomatic individuals. Educating patients on managing OSA as a chronic condition is vital to prevent long-term health issues. Various treatment options, including different PAP delivery methods, should be discussed, considering patient preferences and adherence challenges.

Asset Subtitle

Michael LaLoggia, Hera Jamal , Kathryn Haroldson

Keywords

Obstructive Sleep Apnea

Apnea-Hypoxia Index

sleep-related breathing disorder

STOP-BANG questionnaire

polysomnography

Positive Airway Pressure therapy

craniofacial abnormalities

cardiovascular complications

daytime sleepiness

snoring