Obstructive sleep apnoea syndrome and its management

Abstract

Abstract:Obstructive sleep apnoea (OSA) is a common disorder characterized by repetitive episodes of nocturnal breathing cessation due to upper airway collapse. OSA causes severe symptoms, such as excessive daytime somnolence, and is associated with a significant cardiovascular morbidity and mortality. Different treatment options are now available for an effective management of this disease. After more than three decades from its first use, continuous positive airway pressure (CPAP) is still recognized as the gold standard treatment. Nasal CPAP (nCPAP) is highly effective in controlling symptoms, improving quality of life and reducing the clinical sequelae of sleep apnoea. Other positive airway pressure modalities are available for patients intolerant to CPAP or requiring high levels of positive pressure. Mandibular advancement devices, particularly if custom made, are effective in mild to moderate OSA and provide a viable alternative for patients intolerant to CPAP therapy. The role of surgery remains controversial. Uvulopalatopharyngoplasty is a well established procedure and can be considered when treatment with CPAP has failed, whereas maxillarmandibular surgery can be suggested to patients with a craniofacial malformation. A number of minimally invasive procedures to treat snoring are currently under evaluation. Weight loss improves symptoms and morbidity in all patients with obesity and bariatric surgery is an option in severe obesity. A multidisciplinary approach is necessary for an accurate management of the disease.

Mandibular Repositioning Appliance in the Treatment of Obstructive Sleep Apnea Syndrome-Mini Review

“…Currently, in addition to CPAP, treatment for OSA involves behavioral measures, surgeries, and mandibular repositioning appliances [22]. Considered a gold standard for OSAS, CPAP consists of the use of a nasal or oronasal mask, attached to equipment that generates pressurized airflow to the upper airflow producing elevation of intraluminal pressure [23][24][25][26]. From a physiological point of view, CPAP acts by providing pneumatic support that prevents the collapse of the upper airway and, consequently, abnormal respiratory events.…”

“…From a physiological point of view, CPAP acts by providing pneumatic support that prevents the collapse of the upper airway and, consequently, abnormal respiratory events. There is no doubt that the constant nocturnal use of CPAP (At least 5 h) produces improvement in the quality of life of patients and, in many cases, of their roommates [23][24][25]. It has been shown to reduce excessive daytime sleepiness and cognitive changes associated with OSAS.…”

Repercusiones del uso de Dispositivos de Avance Mandibular como Terapia para el Síndrome de Apnea Obstructiva del Sueño en el Complejo Temporomandibular. Revisión Narrativa

“…El tratamiento gold standard para esta patología es el dispositivo de presión positiva continua de la vía aérea (CPAP) sin embargo, este genera severos problemas en cuanto a la adherencia al tratamiento por parte de los pacientes (Weaver et al, 2008;Spicuzza et al, 2015). Entre sus alternativas encontramos múltiples opciones; desde las más conservadoras como cambio de hábitos y estilo de vida (higiene del sueño, dieta, actividad física) hasta las alternativas quirúrgicas, las cuales pretenden ampliar la vía aérea.…”

Obstructive Sleep Apnoea: A Risk Factor for Hypertension

“…As per this report, the prevalence of hypertensive individuals is extremely high and previous studies most likely underestimate the prevalence in this context. On the other hand, obstructive sleep apnoea (OSA), also known as obstructive sleep apnoeahypopnea, is a disorder that involves repetitive episodes of complete or partial cessation of airflow (breathing) during sleep, due to collapse of the upper airway (Oropharyngeal tract) with a consequent decrease in oxygen saturation 7 . The airway collapse during sleep leads to fragmented sleep pattern.…”