Policy Document: Consensus & Evidence-based INOSA Guidelines 2014 (First edition)

Abstract

Obstructive sleep apnoea (OSA) and obstructive sleep apnoea syndrome (OSAS) are subsets of sleep-disordered breathing. Awareness about OSA and its consequences amongst the general public as well as the majority of primary care physcians across India is poor. This necessiated the development of the INdian initiative on Obstructive sleep apnoea (INOSA) guidelines under the auspices of Department of Health Research, Ministry of Health & Family Welfare, Government of India. OSA is the occurrence of an average five or more episodes of obstructive respiratory events per hour of sleep with either sleep related symptoms or co-morbidities or ≥ 15 such episodes without any sleep related symptoms or co-morbidities. OSAS is defined as OSA associated with daytime symptoms, most often excessive sleepiness. Patients undergoing routine health check-up with snoring, daytime sleepiness, obesity, hypertension, motor vehicular accidents and high risk cases should undergo a comprehensive sleep evaluation. Medical examiners evaluating drivers, air pilots, railway drivers and heavy machinery workers should be educated about OSA and should comprehensively evaluate applicants for OSA. Those suspected to have OSA on comprehensive sleep evaluation should be referred for a sleep study. Supervised overnight polysomnography (PSG) is the “gold standard” for evaluation of OSA. Positive airway pressure (PAP) therapy is the mainstay of treatment of OSA. Oral appliances are indicated for use in patients with mild to moderate OSA who prefer oral appliances to PAP, or who do not respond to PAP or who fail treatment attempts with PAP or behavioural measures. Surgical treatment is recommended in patients who have failed or are intolerant to PAP therapy.

Stellate ganglion block rectifies excessive daytime sleepiness: a case report

“…The main causes are central nervous system (CNS) disorders, obstructive sleep apnea syndrome, metabolic diseases, 11 and depression. 12 Irregular sleepiness patterns; sleep fragmentation; 13 abnormal concentrations of γ-aminobutyric acid (GABA), growth hormone-releasing hormone (GHRH), and melatonin (MT); 14 and hypothalamic dysfunction may serve as underlying mechanisms. 15 In the present case, the patient reported no history of CNS-, respiratory-, metabolism-, or psychology-related abnormalities.…”

Obstructive sleep apnea risk and its associated factors among type 2 diabetes mellitus patients at wolkite university specialized hospital, Wolkite, Southern Ethiopia, 2021. A comparative cross-sectional study

“…The nocturnal symptoms include frequent snoring, breathing pauses, choking/gasping, insomnia and paroxysmal nocturnal dyspnea. The daytime symptoms include morning headache, excessive daytime sleepiness, irritability, memory lapses and decreased concentration [ 11 ].…”