title: Obstructive sleep apnoea syndrome.
abstract: Obstructive sleep apnoea syndrome (OSAS) is a common clinical condition in which the throat narrows or collapses repeatedly during sleep, causing obstructive sleep apnoea events. The syndrome is particularly prevalent in middle-aged and older adults. The mechanism by which the upper airway collapses is not fully understood but is multifactorial and includes obesity, craniofacial changes, alteration in upper airway muscle function, pharyngeal neuropathy and fluid shift towards the neck. The direct consequences of the collapse are intermittent hypoxia and hypercapnia, recurrent arousals and increase in respiratory efforts, leading to secondary sympathetic activation, oxidative stress and systemic inflammation. Excessive daytime sleepiness is a burden for the majority of patients. OSAS is also associated with cardiovascular co-morbidities, including hypertension, arrhythmias, stroke, coronary heart disease, atherosclerosis and overall increased cardiovascular mortality, as well as metabolic dysfunction. Whether treating sleep apnoea can fully reverse its chronic consequences remains to be established in adequately designed studies. Continuous positive airway pressure (CPAP) is the primary treatment modality in patients with severe OSAS, whereas oral appliances are also widely used in mild to moderate forms. Finally, combining different treatment modalities such as CPAP and weight control is beneficial, but need to be evaluated in randomized controlled trials. For an illustrated summary of this Primer, visit: http://go.nature.com/Lwc6te.
authors.affiliation: Grenoble University Hospital, Department of Physiology, Sleep Laboratory, BP 53, 38041 Grenoble, Cedex 9, France.|Hypoxia-Pathophysiology Laboratory (HP2), University Grenoble Alpes, Grenoble, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Lévy
authors.affiliation: Department of Pulmonology, University Hospital of Zurich, Zurich, Switzerland.
authors.forename: Malcolm
authors.initials: M
authors.lastname: Kohler
authors.affiliation: Pulmonary and Sleep Disorders Unit, University College Dublin, Dublin, Ireland.
authors.forename: Walter T
authors.initials: WT
authors.lastname: McNicholas
authors.affiliation: Respiratory Department, Arnau de Vilanova and Santa Maria University Hospital, Leida, Spain.|Respiratory Research Group, CIBERES, Madrid, Spain.
authors.forename: Ferran
authors.initials: F
authors.lastname: Barbé
authors.affiliation: Adelaide Institute for Sleep Health, Adelaide, Australia.
authors.forename: R Doug
authors.initials: RD
authors.lastname: McEvoy
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
authors.forename: Virend K
authors.initials: VK
authors.lastname: Somers
authors.affiliation: The Rappaport Faculty of Medicine, Unit of Anatomy and Cell Biology, Technion - Israel Institute of Technology, Haifa, Israel.
authors.forename: Lena
authors.initials: L
authors.lastname: Lavie
authors.affiliation: Grenoble University Hospital, Department of Physiology, Sleep Laboratory, BP 53, 38041 Grenoble, Cedex 9, France.|Hypoxia-Pathophysiology Laboratory (HP2), University Grenoble Alpes, Grenoble, France.
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Pépin
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000150:complications; D045422:Continuous Positive Airway Pressure / Q000379:methods; D005260:Female; D006801:Humans; D006935:Hypercapnia / Q000209:etiology; D000860:Hypoxia / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010614:Pharynx / Q000503:physiopathology; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000503:physiopathology / Q000628:therapy