title: Mild obstructive sleep apnoea: clinical relevance and approaches to management.
abstract: Obstructive sleep apnoea is highly prevalent in the general population worldwide, especially in its mild form. Clinical manifestations correlate poorly with disease severity measured by the apnoea-hypopnoea index (AHI), which complicates diagnosis. Full polysomnography might be more appropriate to assess suspected mild cases because limited ambulatory diagnostic systems are least accurate in mild disease. Treatment options in mild obstructive sleep apnoea include continuous positive airway pressure (CPAP) and oral appliance therapy, in addition to positional therapy and weight reduction when appropriate. The superior efficacy of CPAP in reducing AHI is offset by greater tolerance of oral appliances, especially in mild disease. Although severe obstructive sleep apnoea is associated with adverse health consequences, including cardiometabolic comorbidities, the association with mild disease is unclear, and reports differ regarding the clinical relevance of mild obstructive sleep apnoea. Improved diagnostic techniques and evidence-based approaches to management in mild obstructive sleep apnoea require further research.
authors.affiliation: Department of Respiratory and Sleep Medicine, St Vincent's University Hospital, Dublin, Ireland; School of Medicine and Medical Science, University College Dublin, Dublin, Ireland. Electronic address: walter.mcnicholas@ucd.ie.
authors.forename: Walter T
authors.initials: WT
authors.lastname: McNicholas
authors.affiliation: DiBiMIS, University of Palermo, Palermo, Italy; CNR Institute of Biomedicine and Molecular Immunology (IBIM), Palermo, Italy.
authors.forename: Maria R
authors.initials: MR
authors.lastname: Bonsignore
authors.affiliation: Univ Grenoble Alpes, Inserm U1042, and Grenoble University Hospital, Grenoble, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Lévy
authors.affiliation: Department of Respiratory and Sleep Medicine, St Vincent's University Hospital, Dublin, Ireland; School of Medicine and Medical Science, University College Dublin, Dublin, Ireland.
authors.forename: Silke
authors.initials: S
authors.lastname: Ryan
mesh_terms: D045422:Continuous Positive Airway Pressure / Q000379:methods*; D019468:Disease Management; D006801:Humans; D056888:Patient Positioning / Q000379:methods*; D012138:Respiratory Therapy / Q000295:instrumentation / Q000379:methods*; D020181:Sleep Apnea, Obstructive / Q000628:therapy*