Sleep apnea

Obstructive Sleep Apnea Syndrome

Obstructive sleep apnea syndrome may be defined as a cessation of breathing characterized by repetitive episodes of airway obstruction caused by collapse of the upper airway during sleep. Classic features of patients with obstructive sleep apnea syndrome include:

• Excessive daytime sleepiness
• Loud snoring during sleep
• Fatigue
• Obesity or being overweight
  

Research has suggested that there is a strong association between obstructive sleep apnea syndrome and cardiovascular diseases including:

• Hypertension - high blood pressure
• Congestive heart failure - accumulation of fluids in the lungs and other body tissues caused by insufficient pumping of blood by the heart muscles
• Arrhythmias - irregular heart beats
• Stroke
• Angina pectoris - chest pain that occurs in people with underlying coronary artery disease
  

Polysomnography (overnight sleep test) is considered to be the most accurate test available for establishing the diagnosis of obstructive sleep apnea syndrome in adults. During polysomnography, episodes of apnea (cessation of breathing lasting for 10 seconds or longer) and hypopnea (decreased rate and depth of breathing lasting 10 seconds or longer) are recorded. The number of apnea/hypopnea episodes per hour of sleep is calculated and is expressed as the apnea-hypopnea index (AHI). Most experts agree that an AHI score of 5 or higher in patients with excessive daytime sleepiness is sufficient to establish the diagnosis of obstructive sleep apnea syndrome.

In general, the treatment options for patients with obstructive sleep apnea syndrome include:

• Lifestyle modifications (e.g., weight loss; smoking cessation; avoiding sleeping in the supine position)
• Continuous positive airway pressure (CPAP)
• Oral appliances
• Surgery

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