Recent advances in the diagnosis and management of obstructive sleep apnea.
Affecting a large number of middle-aged, frequently overweight subjects, obstructive sleep apnea (OSA) is the most common sleep related breathing disorder. Partial or complete upper airway (UA) collapse during sleep causing repeated apneic episodes, which is the leading pathophysiological mechanism underlying the disorder, results in arterial oxygen desaturation and recurrent arousals from sleep to re-establish airway patency. Untreated OSA is commonly associated with a range of adverse consequences, including cardiovascular complications, such as arterial and/or pulmonary hypertension, arrhythmias, stroke, as well as diabetes mellitus and metabolic syndrome, and motor vehicle accidents. Evidence-based guidelines are presently available for the diagnosis and management of OSA, and a variety of updated testing and treatment procedures and devices including some that are able to identify the site and degree of airway obstruction are becoming increasingly available. As the "one size fits all" approach falls to the wayside, a tailored personal therapeutic strategy is becoming increasingly popular in the field of sleep medicine. The aim of this review is to provide an overview for practicing clinicians on recent advances in the evaluation and management of obstructive sleep apnea in adults.
Respiratory Pathophysiology Division, Department of Cardiac, Thoracic and Vascular Sciences, University-City Hospital of Padua, Padua, Italy - andrea.vianello@sanita.padova.it.
Andrea
A
Vianello
Valeria
V
Bisogni
Claudia
C
Rinaldo
Federico
F
Gallan
Giuseppe
G
Maiolino
Fausto
F
Braccioni
Luca
L
Guarda-Nardini
Beatrice
B
Molena
Gian P
GP
Rossi
Rosario
R
Marchese-Ragona
D001944:Breath Tests; D003663:Decision Trees; D003948:Diagnostic Techniques, Respiratory System / Q000295:instrumentation; D004724:Endoscopy; D006801:Humans; D056888:Patient Positioning; D011175:Positive-Pressure Respiration; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000628:therapy*; D004561:Transcutaneous Electric Nerve Stimulation