Pathophysiology and Treatment Options in Obstructive Sleep Apnoea: A Review of the Literature

Abstract

Obstructive sleep apnoea, OSA, is formally defined as an apnoea-hypopnoea index (AHI) of at least 5 episodes/hour (mild). Obesity, alcohol, smoking and sedatives may contribute to the development of OSA, as well as tonsilar hypertrophy and maxillary and/or mandibular retrognathia. Endocrine conditions such as hypothyroidism and acromegaly have also been reported associated with OSA. Except for excessive daytime sleepiness, headaches and irritability, OSA may lead to hypertension, heart failure, MI and stroke. Management involves reduction of predisposing factors such as obesity and alcohol. Treatment with continuous positive airway pressure (CPAP) is currently most common and best documented. Also uvulopalatopharyngeal surgery and so called phase II surgery, which means advancement of the jaw(s) with orthognatic surgical methods are used. Treatment with dental appliances is getting increasingly popular but the long term outcome remains debatable.

Systematic Review and Meta-Analysis of the Palatal Surgeries in the Treatment of Obstructive Sleep Apnea

“…Mixed sleep apnea is defined when there is both central sleep apnea and obstructive sleep apnea. Obstructive Sleep Apnea is a common condition affecting 4% of men and 2% of women [3]. Presenting symptoms are variable including restless sleep, snoring, excessive daytime somnolence, fatigue, memory loss, decreased cognitive function, mood changes, nocturnal enuresis, nocturnal sweating and observed choking or gasping at night.…”