Snoring and breathing pauses during sleep: telephone interview survey of a United Kingdom population sample

Abstract

Objective: To examine the research evidence for the health consequences of obstructive sleep apnoea and the effectiveness of continuous positive airways pressure. Design: A systematic review of published research, studies being identified by searching Medline (1966-96), Embase (1974-96), and CINAHL (Cumulative Index to Nursing and Allied Health Literature) ; scanning citations; and consulting experts. Studies in all languages were considered which either investigated the association between obstructive sleep apnoea in adults and key health outcomes or evaluated the effectiveness of treatment of obstructive sleep apnoea with continuous positive airways pressure in adults. Main outcome measures: Mortality, systematic hypertension, cardiac arrhythmias, ischaemic heart disease, left ventricular hypertrophy, pulmonary hypertension, stroke, vehicle accidents, measures of daytime sleepiness, and quality of life. Results: 54 epidemiological studies examined the association between sleep apnoea and health related outcomes. Most were poorly designed and only weak or contradictory evidence was found of an association with cardiac arrhythmias, ischaemic heart disease, cardiac failure, systemic or pulmonary hypertension, and stroke. Evidence of a link with sleepiness and road traffic accidents was stronger but inconclusive. Only one small randomised controlled trial evaluated continuous positive airways pressure. Five non-randomised controlled trials and 38 uncontrolled trials were identified. Small changes in objectively measured daytime sleepiness were consistently found, but improvements in morbidity, mortality, and quality of life indicators were not adequately assessed. Conclusions:The relevance of sleep apnoea to public health has been exaggerated. The effectiveness of continuous positive airways pressure in improving health outcomes has been poorly evaluated. There is enough evidence suggesting benefit in reducing daytime sleepiness in some patients to warrant large randomised placebo controlled trials of continuous positive airways pressure versus an effective weight reduction programme and other interventions.

Sleep apnea in patients with chronic kidney disease: a single center experience

“…[35][36][37] As cardiovascular event rates are already high in CKD patients, a comprehensive approach to reducing the risk should be employed. Evidence suggests that continuous positive airway pressure (CPAP) treatment for sleep apnea reduces cardiovascular events and mortality.…”

High prevalence of sleep‐disordered breathing in patients with primary open‐angle glaucoma

“…In recent epidemiological studies, these symptoms related to SDB are largely assessed with interviewer administered questionnaires. The prevalence of SDB is between 2% and 20% in most studies (Ferrini-Stambi et al 1999;Marin et al 1997;Ohayon et al 1997), although reports vary considerably according to the population being studied and the diagnostic criteria. Age predisposes to SDB (Fleury 1992).…”

The attitudes of general dental practitioners and medical specialists to the provision of intra–oral appliances for the management of snoring and sleep apnoea

“…[3][4][5][6] Uncomplicated snoring occurs in approximately 40% of the adult population in the UK and approximately 10% of these snorers have OSA. 7 Intra-oral appliances were fi rst used for the control of snoring and OSA in Canada and the USA in the late 1980s 8,9 and in the UK in the mid-1990s. 10,11 The increased availability of intra-oral appliances, almost exclusively mandibular advancement appliances (MAA), has undoubtedly contributed to the increased public awareness of the possibility of controlling snoring and sleep apnoea.…”