Sleep Apnea Syndrome (SAS) Clinical Practice Guidelines 2020

Abstract

The prevalence of sleep-disordered breathing (SDB) is reportedly very high. Among SDBs, the incidence of obstructive sleep apnea (OSA) is higher than previously believed, with patients having moderate-to-severe OSA accounting for approximately 20% of adult males and 10% of postmenopausal women not only in Western countries but also in Eastern countries, including Japan. Since 1998, when health insurance coverage became available, the number of patients using continuous positive airway pressure (CPAP) therapy for sleep apnea has increased sharply, with the number of patients about to exceed 500,000 in Japan. Although the “Guidelines for Diagnosis and Treatment of Sleep Apnea Syndrome (SAS) in Adults” was published in 2005, a new guideline was prepared to indicate the standard medical care based on the latest trends, as supervised by and in cooperation with the Japanese Respiratory Society and the “Survey and Research on Refractory Respiratory Diseases and Pulmonary Hypertension” Group, of Ministry of Health, Labor and Welfare and other related academic societies, including the Japanese Society of Sleep Research, in addition to referring to the previous guidelines. Since sleep apnea is an interdisciplinary field covering many areas, this guideline was prepared including 36 clinical questions (CQs). In the English version, therapies and managements for SAS, which were written from CQ16 to 36, were shown. The Japanese version was published in July 2020 and permitted as well as published as one of the Medical Information Network Distribution Service (Minds) clinical practice guidelines in Japan in July 2021.

Association of continuous positive airway pressure therapy on cardiac hypertrophy in patients with sleep apnea comorbid with type 2 diabetes mellitus

“…Patients who were visiting the clinics affiliated with the Minato Mirai group for sleep disorders and/or diabetes mellitus between January 1, 2015 and August 31, 2018 were included in this study. Patients aged ≥20 years, who had been diagnosed with insomnia, SRBD (based on the International Classification Sleep Disorders, Third Edition diagnostic classifications), and diabetes mellitus (based on the diabetes guidelines), were included in this study [4,18]. Moreover, all included patients have had consultations in the hospital for >3 years after having been introduced to CPAP therapy.…”

“…paucity of studies with regard to obstructive sleep apnea syndrome (OSAS). The 2020 guidelines on sleep apnea syndrome define OSAS as an apnea hypopnea index (AHI) ≥15, affecting approximately 10% of women and 10-20% of men in Japan [4]. A previous study reported that 80.5% of patients with diabetes mellitus had OSAS [5].…”

Sleep disordered breathing and haemoglobin A1c levels within or over normal range and ageing or sex differences: the Nagahama study

“…To argue the limitations for using pulse oximetry with actigraphy, we presented validation data using a hospital-based cohort, which used polysomnography (PSG) for assessing OSA. For the coherency of terminology between these two cohorts, we described SDB in the population-based cohort as OSA because most SDB is usually due to OSA, especially in the general population (Akashiba et al, 2022).…”

The role of ferroptosis in chronic intermittent hypoxia-induced lung injury

“…Obstructive sleep apnea (OSA) is a chronic respiratory disease with high incidence. The prevalence of OSA has reached 20% in men and 10% in women both in Western countries and Eastern countries [1]. The pathophysiological characteristics of OSA include chronic intermittent hypoxia (CIH) induced by periodic upper airway collapse or obstruction [1].…”

“…The prevalence of OSA has reached 20% in men and 10% in women both in Western countries and Eastern countries [1]. The pathophysiological characteristics of OSA include chronic intermittent hypoxia (CIH) induced by periodic upper airway collapse or obstruction [1]. Target organ injury in OSA patients has received widespread attention.…”