International Consensus Statement on Obstructive Sleep Apnea

Abstract

Background: Evaluation and interpretation of the literature on obstructive sleep apnea (OSA) allows for consolidation and determination of the key factors important for clinical management of the adult OSA patient. Toward this goal, an international collaborative of multidisciplinary experts in sleep apnea evaluation and treatment have produced the International Consensus statement on Obstructive Sleep Apnea (ICS:OSA). Methods: Using previously defined methodology, focal topics in OSA were assigned as literature review (LR), evidence-based review (EBR), or evidencebased review with recommendations (EBR-R) formats. Each topic incorporated the available and relevant evidence which was summarized and graded on study quality. Each topic and section underwent iterative review and the ICS:OSA was created and reviewed by all authors for consensus. Results: The ICS:OSA addresses OSA syndrome definitions, pathophysiology, epidemiology, risk factors for disease, screening methods, diagnostic testing types, multiple treatment modalities, and effects of OSA treatment on multiple OSA-associated comorbidities. Specific focus on outcomes with positive airway pressure (PAP) and surgical treatments were evaluated. Conclusion:This review of the literature consolidates the available knowledge and identifies the limitations of the current evidence on OSA. This effort aims to create a resource for OSA evidence-based practice and identify future research needs. Knowledge gaps and research opportunities include improving the metrics of OSA disease, determining the optimal OSA screening paradigms, developing strategies for PAP adherence and longitudinal care, enhancing selection of PAP alternatives and surgery, understanding health risk outcomes, and translating evidence into individualized approaches to therapy.

Relationship between Degrees of Nasal Obstruction and Obstructive Sleep Apnea

“…This study is inconsistent with data showing that the prevalence of OSA in the general population is higher in men than in women, with a male: female ratio of 3:1 [42]. The mechanism underlying the incidence of OSA is more in males than females is not fully understood, but differences in fat distribution, upper airway anatomy, hormones, and aging are thought to play a role in these differences [43].…”

“…However, using these devices is expensive, time-consuming, and requires trained operators, so many sufferers of OSA go undetected. Therefore, some experts suggest using a questionnaire as a detection for OSA [4].…”

Non-dipping blood pressure pattern is associated with higher risk of new-onset diabetes in hypertensive patients with obstructive sleep apnea: UROSAH data

“…OSA was defined as an apnea-hypopnea index (AHI) ≥5 events per hour based on polysomnography (PSG) examination. Severity of OSA was defined as follows: mild OSA (5≤AHI<15 events per hour) and moderate-severe OSA (AHI≥15 events per hour) ( 5 ).…”

“…Obstructive sleep apnea (OSA), a condition characterized by intermittent hypoxia and sleep fragmentation due to a complete or partial collapse of the upper airway, is highly prevalent in parallel with the obesity epidemic trends in the general population ( 4 ), with estimated nearly one billion worldwide ( 5 ). OSA and hypertension (HTN) are highly prevalent conditions in the general population, approximately 50% of OSA patients noted to have HTN ( 6 ).…”

Chronic intermittent hypoxia reveals role of the Postinspiratory Complex in the mediation of normal swallow production

“…Obstructive sleep apnea (OSA) is highly prevalent and a major public health concern ( Chang et al, 2023 ; McNicholas et al, 2015 ; Phillipson, 1993 ; Ramirez et al, 2013 ; Roberts et al, 2022 ; Wright and Sheldon, 1998 ). It is characterized by frequent bouts of apnea during sleep caused by pharyngeal collapse, resulting in multiple bouts of hypoxia referred to as chronic intermittent hypoxia (CIH).…”