Update on Research and Practices in Major Sleep Disorders: Part I. Obstructive Sleep Apnea Syndrome

Abstract

Purpose The purpose of this first of two review articles providing an update on sleep disorders was to examine the pathophysiology, epidemiology, and treatment of obstructive sleep apnea (OSA). OSA is a common sleep disorder whose prevalence is similar to asthma. As with other sleep disorders, OSA has a broad impact on individuals, affecting their daily behaviors, cognitive abilities, and performance, and putting them at increased risk for accidents, mood disorders, cancer, cardiovascular disease, and hypertension. Thus, early recognition and management, much of which can be implemented by nurses, can reduce health and accident risks and improve daily functioning. Methods This narrative review utilized medical databases such as PubMed to identify relevant English language original and systematic review articles predominantly from peer‐reviewed journals from 2012 to 2018. However, as background, findings from classic articles prior to 2012 were also included. Clinical Relevance OSA is a common condition with considerable impact on daily functioning and potential for accidents and serious comorbidities such as hypertension, cardiovascular disease, diabetes, and depressed mood. The impairments and comorbidities associated with OSA can be reduced through early detection, encouraging treatment, providing education about sleep and OSA, and, importantly, promoting adherence to the predominant therapy, positive airway pressure.

Valerian Root in Treating Sleep Problems and Associated Disorders—A Systematic Review and Meta-Analysis

“…5,6 Problems with sleep are widely prevalent, 4 affecting 70 million (9-20%) of adults in the US and 45 million (7%) of adults in Europe. 7,8 Typical manifestation of sleep disorders include sleep deprivation or fragmentation and events that occur during sleep. 4 The major sleep disorders are insomnia, restless leg syndrome (RLS), 9 obstructive sleep apnea syndrome, and narcolepsy, 10,11 among which insomnia is the most common.…”

Novel Aspects of CPAP Treatment and Interventions to Improve CPAP Adherence

“…Through conversational exchange, the goal of CBT is to correct the patient's beliefs that are incorrect or unfounded in order to bring about a change in their behavior [15]. Motivational enhancement therapy applies motivational interviewing to elicit the patient's thought processes, reinforcing the patient's own motivating statements through directed interview questions [1,16]. Inherent in the application of MET is the assessment of the patient's conviction and confidence in making a change [17].…”

“…Continuous positive airway pressure (CPAP) treatment for obstructive sleep apnea (OSA) improves daily functioning, cognitive processing, and mood, while positively affecting insulin resistance and possibly reducing the risk of stroke, hypertension, and cardiovascular disease [1]. The use of CPAP has also decreased traffic and other work-related accidents in addition to enhancing work productivity [1]. Despite these very significant effects that influence quality of life, adherence to this treatment remains a formidable obstacle to its effectiveness.…”

“…Gains in both objective and subjective outcomes such as daytime sleepiness and daily functioning are greater with higher use, with the goal of >4 hours use per night [2][3][4]. Unfortunately, less than half of CPAP users apply it every night as prescribed [1]. Indeed, even skipping one night of treatment returns the number of apnea and hypopnea events, subjective and objective daytime sleepiness, and cognitive processing to baseline levels [5].…”

Clinical and Research Solutions to Manage Obstructive Sleep Apnea: A Review

“…The use of CPAP could reduce the comorbidities of cardiovascular disease, hypertension, and diabetes while improving the quality of life [ 40 ]. It also reduces blood pressure for patients with cardiovascular diseases and multiple cardiovascular risks in the middle-aged population [ 41 ].…”