Topic reviewed by Waiz Wasey, MD, Board-certified sleep medicine physician
Def: Recurrent episodes of complete (apnea) or partial (hypopnea) upper airway collapse during sleep, despite ongoing respiratory effort, Leads to intermittent hypoxia, sleep fragmentation and arousals
Most common type of SDB of medical concern
OSA + excessive daytime sleepiness = OSA syndrome
Affects up to 10% of middle-aged men and 3% of middle-aged women
Severity: Mild OSA: AHI 5-14.9/hr ; Moderate OSA: AHI 15-29.9/hr ; Severe OSA: AHI ≥30/hr
Associated conditions: CVD, esp HTN, T2DM, Cognitive impairment, Mood d/o, Respiratory dz: asthma, ILD, GERD
Treatment
General: Weight loss if indicated, Avoid supine sleep, Avoid sedatives, centrally relaxing agents, alcohol
Specific tx: depends on severity
- CPAP
- Mandibular advancement device (MAD)
- Excite OSA
- Bongo Rx
- iNAP
- EMST
- ENT surgery, e.g. excise enlarged tonsils, polyps, adenoids
- Hypoglossal nerve stimulation
- Oxford Handbook of Sleep Medicine 2022