"Obstructive sleep apnoea is very common, affecting both paediatric and adult populations 1-3. The disorder is more common in males and in adults, its incidence increases with age with a plateau after 65 years of age 1-3,21. Although global prevalence varies, in the USA, it is estimated that ~30% of adults have obstructive sleep apnoea, ~60% of those being males 22."
"During sleep, especially REM sleep, there is relaxation of the upper airway muscles, including the tongue and pharyngeal dilator muscles (e.g. genioglossus) 1-4. In those with anatomical risk factors for obstructive sleep apnoea, relaxation of upper airway muscles while supine may lead to decreased pharyngeal cross-sectional area 1-4. When this obstruction is complete there is clinical apnoeas with hypoxaemia and hypercarbia. These events in turn lead to arousal from sleep in order to increase upper airway tone 1-4. This leads to the cessation of apnoea or hypopnoea, and return to normal unobstructed upper airway flow 1-4. When sleep recommences, this cycle may repeat itself 1-4."
Expected headings
"Associations"
"Obstructive sleep apnoea (OSA), also known as obstructive sleep apnoea syndrome (OSAS), is a disorder characterised by repetitive episodes of paused (i.e. apnoeas) or reduced (i.e. hypopnoeas) ventilation due to total or partial collapse of the upper airway during sleep."
"Obstructive sleep apnoea is diagnosed via polysomnogram 1-3. This test may include all or some of electroencephalography (EEG), electrooculography (EOG), chin electromyography (EMG), electrocardiography (ECG), respiratory inductance plethysmography, nasal-oral airflow measurements, pulse oximetry, expired carbon dioxide monitoring, transcutaneous carbon dioxide monitoring, and video monitoring 1-3."
"genetic syndromes, e.g. Down syndrome, Marfan syndrome, muscular dystrophies, Prader-Willi syndrome, achondroplasia 1,6,9,17,18"
"Obstructive sleep apnoea is diagnosed via polysomnogram 1-3. This test may include all or some of electroencephalography (EEG), electrooculography (EOG), chin electromyography (EMG), electrocardiography (ECG), respiratory inductance plethysmography, nasal-oral airflow measurements, pulse oximetry, expired carbon dioxide monitoring, transcutaneous carbon dioxide monitoring, and video monitoring 1-3."
"Obstructive sleep apnoea has a varied clinical presentation 1-3. Signs and symptoms include daytime somnolence, gasping, or choking awakenings, pauses in breathing during sleep, snoring during sleep (less prominent in paediatrics), nocturnal bradyarrhythmias, morning headache, and behavioural sequela of poor sleep such as lack of concentration and irritability (more prominent in paediatrics) 1-3. Given many of these clinical features occur during sleep, affected patients may often be unaware of these, even in severe cases of obstructive sleep apnoea 2."
"Invasive management includes device implantation such as a hypoglossal nerve stimulator (e.g. Inspire®, Genio®), and surgery, such as uvulopalatopharyngoplasty, adenotonsillectomy, or nasal surgery 1,3,8. The utility of these surgical options depends on the patient's individual anatomical risk factors for obstructive sleep apnoea 1,3."