Obstructive sleep apnoea

Author(s):  
Terry Robinson ◽  
Jane Scullion

This chapter covers the causes, signs, and symptoms of obstructive sleep apnoea (OSA). It explains the process of diagnosis, from a history, medications, family, and psychosocial history, occupation, and diagnostic procedures. Differential diagnoses that should be excluded are listed. The prevalence of OSA is estimated to be around 4% of the population. It is quite a common disorder, although this figure may be an underestimate as many people may not seek treatment. Prevalence figures also vary according to the chosen threshold for defining a significant sleep abnormality and symptoms. Treatment options are also outlined, and the specific aspects of nursing care are listed.

2011 ◽  
Vol 23 (5) ◽  
pp. 201-209 ◽  
Author(s):  
Abdulkader Alam ◽  
Kadiamada Nanaiah Roy Chengappa

Alam A, Chengappa KNR. Obstructive sleep apnoea and schizophrenia: a primer for psychiatristsObjective:The main objective of this review is to improve psychiatric clinician awareness of obstructive sleep apnoea (OSA) and its potential consequences in patients with schizophrenia. This article will also discuss the diagnosis and treatment options for OSA while considering the significant role psychiatrists can play in facilitating the diagnosis and treatment of OSA.Data sources:Ovid, Medline and PsychInfo databases were searched for articles between 1960 and 2010. Search terms used wereSleep apnoeaorapnoeaandschizophreniaorpsychosis. The number of articles retrieved was 38. Articles were carefully reviewed for any data pertinent to OSA in patients with schizophrenia.Conclusions:OSA is a common disorder that is frequently unrecognised. As a chronic breathing condition, OSA is associated with adverse health outcomes and high mortality. OSA may co-occur with schizophrenia or evolve over time, especially with weight gain. The diagnosis should be considered whenever a patient presents with risk factors or clinical manifestations that are highly suggestive of OSA. Those who report snoring, daytime sleepiness and are obese or have a large neck circumference should be considered for an OSA diagnosis. Appropriate diagnosis and treatment of OSA can reduce daytime sleepiness, improve cardiovascular and other medical conditions, as well as reduce mortality. Psychiatrists can play very important role in suspecting OSA in their patients and making the initial referral. Furthermore, behavioural management, especially promoting weight loss and smoking cessation, are effective components of OSA treatment that psychiatrists are positioned to facilitate with their patients.


1996 ◽  
Vol 23 (4) ◽  
pp. 315-324 ◽  
Author(s):  
Joanna M. Battagel

Obstructive sleep apnoea (OSA) is a recognized clinical disorder in which periods of cessation of breathing occur in the presence of inspiratory effort. Because this may have serious cardio-vascular and pulmonary consequences, diagnosis, and adequate treatment are important. Apart from its medical repercussions, OSA adversely affects the quality of life of both the sufferer and his family. This paper aims to give an overview of the complaint, defining and describing the disorder, reporting its signs and symptoms, and discussing its diagnosis and treatment. Particular attention will be given to those areas in which the orthodontist may play an active role.


2017 ◽  
Vol 26 (146) ◽  
pp. 170069 ◽  
Author(s):  
Maria R. Bonsignore ◽  
Monique C. Suarez Giron ◽  
Oreste Marrone ◽  
Alessandra Castrogiovanni ◽  
Josep M. Montserrat

In all fields of medicine, major efforts are currently dedicated to improve the clinical, physiological and therapeutic understanding of disease, and obstructive sleep apnoea (OSA) is no exception. The personalised medicine approach is relevant for OSA, given its complex pathophysiology and variable clinical presentation, the interactions with comorbid conditions and its possible contribution to poor outcomes. Treatment with continuous positive airway pressure (CPAP) is effective, but CPAP is poorly tolerated or not accepted in a considerable proportion of OSA patients. This review summarises the available studies on the physiological phenotypes of upper airway response to obstruction during sleep, and the clinical presentations of OSA (phenotypes and clusters) with a special focus on our changing attitudes towards approaches to treatment. Such major efforts are likely to change and expand treatment options for OSA beyond the most common current choices (i.e. CPAP, mandibular advancement devices, positional treatment, lifestyle changes or upper airway surgery). More importantly, treatment for OSA may become more effective, being tailored to each patient's need.


2018 ◽  
Vol 4 (1) ◽  
pp. 23
Author(s):  
Refika Ersu ◽  

Prompt diagnosis and treatment of obstructive sleep apnoea in children is essential to prevent multiple health consequences, but distinctive symptoms are scarce. While overnight polysomnography is the standard diagnostic tool, it is not widely available. Nocturnal oximetry, respiratory polygraphy and standardised questionnaires are useful alternatives. Treatment options include positive airway pressure, weight loss interventions and anti-inflammatory treatment with nasal corticosteroids and/or oral montelukast. Combined treatment modalities may improve outcomes.


2018 ◽  
Vol 132 (4) ◽  
pp. 293-298 ◽  
Author(s):  
L Pabla ◽  
J Duffin ◽  
L Flood ◽  
K Blackmore

AbstractBackground:Despite the plethora of publications on the subject of paediatric obstructive sleep apnoea, there seems to be wide variability in the literature and in practice, regarding recourse to surgery, the operation chosen, the benefits gained and post-operative management. This may reflect a lack of high-level evidence.Methods:A systematic review of four significant controversies in paediatric ENT was conducted from the available literature: tonsillectomy versus tonsillotomy, focusing on the evidence base for each; anaesthetic considerations in paediatric obstructive sleep apnoea surgery; the objective evidence for the benefits of surgical treatment for obstructive sleep apnoea; and the medical treatment options for residual obstructive sleep apnoea after surgical treatment.Results and conclusion:There are many gaps in the evidence base for the surgical correction of obstructive sleep apnoea. There is emerging evidence favouring subtotal tonsillectomy. There is continuing uncertainty around the prediction of the level of post-operative care that any individual child might require. The long-term benefit of surgical correction is a particularly fertile ground for further research.


2017 ◽  
Vol 2 (2) ◽  
pp. 19
Author(s):  
Nurul Yaqeen Mohd Esa ◽  
Ahmad Izuanuddin Ismail

Obstructive sleep apnoea (OSA) is increasingly seen as a major health threat globally. However, it is still underdiagnosed mainly among Asian population partly due to lack of understanding on the pathophysiology, and limited access to the diagnostic and management aspect of the disease. Recurring complete and/or partial collapses of the upper airways define OSA. Based on the number of apnoeas and/or hypopnoeas per hour of sleep, OSA is categorized as mild, moderate and severe. Both the American Association of Sleep Medicine (AASM) and American College of Physicians (ACP) has published guidelines regarding the management of OSA in adults. Three recommendations have been suggested by the guidelines which can be used to tailor the management of OSA. The aim of this article is to select relevant recommendations from these guidelines in epidemiology, pathophysiology, diagnostic procedures and treatment for proper management of OSA, while considering specific patient populations, such as hypertensive, diabetic, obese and Asian patients.


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