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Sleep Apnea


Affiliations
1 Assistant Professor, Department of Pulmonary Medicine, D. Y. Patil University School of Medicine, Navi Mumbai :, India
2 Assistant Professor, India
3 Associate Professor, India
4 Professor, Department of Pulmonary Medicine, India
5 Professor and Head, Department of Internal Medicine, D. Y. Patil University School of Medicine, Navi Mumbai, India
     

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Obstructive sleep apnea is one of the well recognized sleep-related breathing disorders characterized by snoring, episodic cessation (apnea) or reduction (hypopnea) of breathing during sleep and excessive sleepiness during the daytime. The prevalence of sleep apnea shows a rising trend in both developed as well as developing countries. If undiagnosed or untreated, sleep apnea can lead to adverse cardio-pulmonary, metabolic and neurocognitive outcomes including road traffic accidents. Early screening for symptoms and risk factors by the family physician, followed by referral of patients at risk to a sleep centre or specialist for timely diagnosis by polysomnography and effective treatment by positive airway pressure therapy is the standard of care.

Keywords

Sleep disorders, apnea, polysomnography, OSA, OSAHS, PAP.
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  • Makker HK. Epidemiology of Obstructive Sleep Apnea. In: Manual on Tuberculosis, HIV and Lung Diseases: A Practical Approach. Arora VK (Ed.) Delhi: Jaypee publishers;2009.ISBN 978-81-8448-630-8.

  • Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med. 1993 Apr 29;328(17):1230-5. DOI: 10.1056/NEJM199304293281704. PMID: 8464434.

  • Stradling JR, Crosby JH. Predictors and prevalence of obstructive sleep apnoea and snoring in 1001 middle aged men. Thorax. 1991 Feb;46(2):85-90. DOI: 10.1136/thx.46.2.85. PMID: 2014507; PMCID: PMC462949.

  • Davies RJ, Stradling JR. The epidemiology of sleep apnoea. Thorax. 1996 Aug;51 Suppl 2(Suppl 2):S65-70. DOI: 10.1136/ thx.51.suppl_2.s65. PMID: 8869356; PMCID: PMC1090710.

  • Udwadia ZF, Doshi AV, Lonkar SG, Singh CI. Prevalence of sleep-disordered breathing and sleep apnea in middleaged urban Indian men. Am J Respir Crit Care Med. 2004 Jan 15;169(2):168-73. DOI: 10.1164/rccm.200302-265OC. Epub 2003 Nov 6. PMID: 14604837.

  • Sharma SK, Kumpawat S, Banga A, Goel A. Prevalence and risk factors of obstructive sleep apnea syndrome in a population of Delhi, India. Chest. 2006 Jul;130(1):149-56. DOI: 10.1378/chest.130.1.149. PMID: 16840395.

  • Eikermann M, Jordan AS, Chamberlin NL, Gautam S, Wellman A, Lo YL, White DP, Malhotra A. The influence of aging on pharyngeal collapsibility during sleep. Chest. 2007 Jun;131(6):1702-9. DOI: 10.1378/chest.06-2653. Epub 2007 Apr 5. PMID: 17413053; PMCID: PMC2278166.

  • Lam B, Ip MS, Tench E, Ryan CF. Craniofacial profile in Asian and white subjects with obstructive sleep apnoea. Thorax. 2005 Jun;60(6):504-10. DOI: 10.1136/thx.2004.031591. PMID: 15923252; PMCID: PMC1747424.

  • Peppard PE, Austin D, Brown RL. Association of alcohol consumption and sleep disordered breathing in men and women. J Clin Sleep Med. 2007 Apr 15;3(3):265-70. PMID: 17561593; PMCID: PMC2564771.

  • Wetter DW, Young TB, Bidwell TR, Badr MS, Palta M. Smoking as a risk factor for sleep-disordered breathing. Arch Intern Med. 1994 Oct 10;154(19):2219-24. PMID: 7944843.

  • Simpson R, Oyekan AA, Ehsan Z, Ingram DG. Obstructive sleep apnea in patients with Down syndrome: current perspectives. Nat Sci Sleep. 2018 Sep 13;10:287-93. DOI: 10.2147/ NSS.S154723. PMID: 30254502; PMCID: PMC6143127.

  • Akre H, Øverland B, Åsten P, Skogedal N, Heimdal K. Obstructive sleep apnea in Treacher Collins syndrome. Eur Arch Otorhinolaryngol. 2012 Jan;269(1):331-7. DOI: 10.1007/ s00405-011-1649-0. Epub 2011 May 29. PMID: 21626120; PMCID: PMC3249173.

  • Newman AB, Foster G, Givelber R, Nieto FJ, Redline S, Young T. Progression and regression of sleep-disordered breathing with changes in weight: the Sleep Heart Health Study. Arch Intern Med. 2005 Nov 14;165(20):2408-13. DOI: 10.1001/archinte.165.20.2408. PMID: 16287771.

  • Lui MMS, Hui CKM, Ip MSM. Obstructive Sleep Apnea In: Textbook of Pulmonary and Critical Care Medicine (2nd Ed.) Jindal SK (Ed.) Delhi: Jaypee publishers; 2017.ISBN 978-93- 85999-99-4

  • Kalpaklioğlu AF, Kavut AB, Ekici M. Allergic and nonallergic rhinitis: the threat for obstructive sleep apnea. Ann Allergy Asthma Immunol. 2009 Jul;103(1):20-5. DOI: 10.1016/ S1081-1206(10)60138-X. PMID: 19663122.

  • Hira HS. Obstructive Sleep Apnea-Hypopnea Syndrome. In: Textbook of Pulmonary and Critical Care Medicine (2nd Ed.) Jindal SK (Ed.) Delhi: Jaypee publishers; 2017.ISBN 978- 93-85999-99-4

  • Gold AR, Marcus CL, Dipalo F, Gold MS. Upper airway collapsibility during sleep in upper airway resistance syndrome. Chest. 2002 May;121(5):1531-40. DOI: 10.1378/ chest.121.5.1531. PMID: 12006440.

  • Togeiro SM, Chaves CM Jr, Palombini L, Tufik S, Hora F, Nery LE. Evaluation of the upper airway in obstructive sleep apnoea. Indian J Med Res. 2010 Feb;131:230-5. PMID: 20308748.

  • Mezzanotte WS, Tangel DJ, White DP. Waking genioglossal electromyogram in sleep apnea patients versus normal controls (a neuromuscular compensatory mechanism). J Clin Invest. 1992 May;89(5):1571-9. DOI: 10.1172/JCI115751. PMID: 1569196; PMCID: PMC443031.

  • Deacon NL, Catcheside PG. The role of high loop gain induced by intermittent hypoxia in the pathophysiology of obstructive sleep apnoea. Sleep Med Rev. 2015 Aug;22:3-14. DOI: 10.1016/j.smrv.2014.10.003. Epub 2014 Oct 15. PMID: 25454671.

  • Andrade FM, Pedrosa RP. The role of physical exercise in obstructive sleep apnea. J Bras Pneumol. 2016 NovDec;42(6):457-464. DOI: 10.1590/S1806-37562016000000156. PMID: 28117479; PMCID: PMC5344097.

  • Bansal R, Weingarten JA. Approach to Respiratory Sleep Disorders. In: Textbook of Pulmonary and Critical Care Medicine (2nd Ed.) Jindal SK (Ed.) Delhi: Jaypee publishers; 2017.ISBN 978-93-85999-99-4

  • Myers KA, Mrkobrada M, Simel DL. Does this patient have obstructive sleep apnea?: The Rational Clinical Examination systematic review. JAMA. 2013 Aug 21;310(7):731-41. DOI: 10.1001/jama.2013.276185. PMID: 23989984.

  • Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991 Dec;14(6):540- 5. DOI: 10.1093/sleep/14.6.540. PMID: 1798888.

  • Chung F, Abdullah HR, Liao P. STOP-Bang Questionnaire: A Practical Approach to Screen for Obstructive Sleep Apnea. Chest. 2016 Mar;149(3):631-8. DOI: 10.1378/chest.15-0903. Epub 2016 Jan 12. PMID: 26378880.

  • Yu X, Fujimoto K, Urushibata K, Matsuzawa Y, Kubo K. Cephalometric analysis in obese and nonobese patients with obstructive sleep apnea syndrome. Chest. 2003 Jul;124(1):212- 8. DOI: 10.1378/chest.124.1.212. PMID: 12853525.

  • Kapur VK, Auckley DH, Chowdhuri S, Kuhlmann DC, Mehra R, Ramar K, Harrod CG. Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline. J Clin Sleep Med. 2017 Mar 15;13(3):479-504. DOI: 10.5664/jcsm.6506. PMID: 28162150; PMCID: PMC5337595.

  • Berry RB, Albertario CL, Harding SM, Lloyd RM, Plante DT, and Quan SF for the American Academy of Sleep Medicine. The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications, Version 2.5. www.aasmnet.org

  • Salas RE, Chakravarthy R, Sher A, Gamaldo CE. Management of sleep apnea in the neurology patient: Five new things. Neurol Clin Pract. 2014 Feb;4(1):44-52. DOI: 10.1212/01.CPJ.0000442583.87327.5d. PMID: 29473567; PMCID: PMC5765590.

  • Warvedaker NV, et. al. Best Practice of Medicine. Sept 1999

  • Punjabi NM, Aurora RN, Patil SP. Home sleep testing for obstructive sleep apnea: one night is enough! Chest. 2013 Feb 1;143(2):291-294. DOI: 10.1378/chest.12-2699. PMID: 23381307; PMCID: PMC3566993.

  • Martin JL, Hakim AD. Wrist actigraphy. Chest. 2011 Jun;139(6):1514-1527. DOI: 10.1378/chest.10-1872. PMID: 21652563; PMCID: PMC3109647.

  • Elbaz M, Roue GM, Lofaso F, Quera Salva MA. Utility of actigraphy in the diagnosis of obstructive sleep apnea. Sleep. 2002 Aug 1;25(5):527-31. PMID: 12150319.

  • Schnall RP, Sheffy JK, Penzel T. Peripheral arterial tonometry-PAT technology. Sleep Med Rev. 2022 Feb;61:101566. DOI: 10.1016/j.smrv.2021.101566. Epub 2021 Nov 11. PMID: 34920273.

  • Tauman R, Berall M, Berry R, et al. Watch-PAT is Useful in the Diagnosis of Sleep Apnea in Patients with Atrial Fibrillation. Nat Sci Sleep. 2020 Dec 3;12:1115-1121. DOI: 10.2147/NSS. S278752. PMID: 33299372; PMCID: PMC7721305.

  • Romero-Corral A, Caples SM, Lopez-Jimenez F, Somers VK. Interactions between obesity and obstructive sleep apnea: implications for treatment. Chest. 2010 Mar;137(3):711- 9. DOI: 10.1378/chest.09-0360. PMID: 20202954; PMCID: PMC3021364.

  • Kim Y, Koo YS, Lee HY, Lee SY. Can Continuous Positive Airway Pressure Reduce the Risk of Stroke in Obstructive Sleep Apnea Patients? A Systematic Review and MetaAnalysis. PLoS One. 2016 Jan 5;11(1):e0146317. DOI: 10.1371/journal.pone.0146317. PMID: 26731604; PMCID: PMC4701420.

  • Gay P, Weaver T, Loube D, Iber C; Positive Airway Pressure Task Force; Standards of Practice Committee; American Academy of Sleep Medicine. Evaluation of positive airway pressure treatment for sleep related breathing disorders in adults. Sleep. 2006 Mar;29(3):381-401. DOI: 10.1093/ sleep/29.3.381. PMID: 16553025.

  • Kaneko Y, Floras JS, Usui K, Plante J, Tkacova R, Kubo T, Ando S, Bradley TD. Cardiovascular effects of continuous positive airway pressure in patients with heart failure and obstructive sleep apnea. N Engl J Med. 2003 Mar 27;348(13):1233-41. DOI: 10.1056/NEJMoa022479. PMID: 12660387.

  • Sharma SK, Agrawal S, Damodaran D, Sreenivas V, Kadhiravan T, Lakshmy R, Jagia P, Kumar A. CPAP for the metabolic syndrome in patients with obstructive sleep apnea. N Engl J Med. 2011 Dec 15;365(24):2277-86. DOI: 10.1056/NEJMoa1103944. Retraction in: Sharma SK, Agrawal S, Damodaran D, Sreenivas V, Kadhiravan T, Lakshmy R, Jagia P, Kumar A. N Engl J Med. 2013 Oct 31;369(18):1770. PMID: 22168642.

  • Veasey SC, Guilleminault C, Strohl KP, Sanders MH, Ballard RD, Magalang UJ. Medical therapy for obstructive sleep apnea: a review by the Medical Therapy for Obstructive Sleep Apnea Task Force of the Standards of Practice Committee of the American Academy of Sleep Medicine. Sleep. 2006 Aug;29(8):1036-44. DOI: 10.1093/sleep/29.8.1036. PMID: 16944672.

  • Veasey S, White DP. Obstructive sleep apnea pharmacotherapy: one step closer. Am J Respir Crit Care Med. 2013 Feb 1;187(3):226-7. DOI: 10.1164/rccm.201211-2047ED. PMID: 23378437.


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  • Sleep Apnea

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Authors

Nikhil Sarangdhar
Assistant Professor, Department of Pulmonary Medicine, D. Y. Patil University School of Medicine, Navi Mumbai :, India
Priya Deshpande
Assistant Professor, India
Shahid Patel
Associate Professor, India
Girija Nair
Assistant Professor, India
Abhay Uppe
Professor, Department of Pulmonary Medicine, India
Nivedita Moulick
Professor and Head, Department of Internal Medicine, D. Y. Patil University School of Medicine, Navi Mumbai, India

Abstract


Obstructive sleep apnea is one of the well recognized sleep-related breathing disorders characterized by snoring, episodic cessation (apnea) or reduction (hypopnea) of breathing during sleep and excessive sleepiness during the daytime. The prevalence of sleep apnea shows a rising trend in both developed as well as developing countries. If undiagnosed or untreated, sleep apnea can lead to adverse cardio-pulmonary, metabolic and neurocognitive outcomes including road traffic accidents. Early screening for symptoms and risk factors by the family physician, followed by referral of patients at risk to a sleep centre or specialist for timely diagnosis by polysomnography and effective treatment by positive airway pressure therapy is the standard of care.

Keywords


Sleep disorders, apnea, polysomnography, OSA, OSAHS, PAP.

References