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Year : 2018  |  Volume : 6  |  Issue : 3  |  Page : 16-22

Obstructive sleep apnoea

Dept of Pulmonology and Internal Medicine, Narayana Hrudayalaya-MSMC., Bangalore, India

Correspondence Address:
B V Murali Mohan
Department of Pulmonology and Internal Medicine Narayana Hrudayalaya- Mazumdar Shaw Medical Center, Bangalore
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Source of Support: None, Conflict of Interest: None

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Identified as a clinical entity only about 50 years ago, OSAS is now recognised as one of the most important clinical conditions with manifestations affecting different organ systems. Studies indicate a prevalence of at least 2-4% of the population aged over 40 years. Worldwide, at least a similar prevalence is reported, though all may be underestimates. OSAS is more often identified in the obese, but it is increasingly being diagnosed in the non-obese. Other identifiers like cranio-facial abnormalities, associations like refractory hypertension and poorly controlled diabetes, cardiac conditions like coronary artery disease, unexplained heart failure and cardiac arrhythmias and neurological conditions like strokes and neurocognitive problems may all give clues to its presence. Patients commonly present with excessive daytime sleepiness and loud snoring, with good quality sleep being interrupted by the recurrent apnoeas and hyponoeas. Poor sleep quality impairs the ability to concentrate, affects social functioning, with consequently poorer academic and work performance and increases the risk of accidents including road traffic accidents. The diagnosis is made by polysomnography, but increasingly home based polygraphy studies are found adequate to confirm the diagnosis and initiate treatment. The treatment of choice is nocturnal continuous positive airway pressure; it is highly effective clinically, but compliance with treatment is often poor. Alternative strategies include surgery, mandibular advancement devices and hypoglossal nerve stimulation devices, the effectiveness and wide-scale applicability of which are still under evaluation.

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