Obstructive sleep apnea
An in-depth report about the causes, diagnosis, treatment, and prevention of obstructive sleep apnea.
Obstructive Sleep Apnea
Obstructive sleep apnea (OSA) is a common sleep disorder. It occurs when tissues in the upper airways come too close to each other during sleep, temporarily blocking the inflow of air.
Who is at Risk
OSA can develop in anyone at any age but most often occurs in people who are:
- Age 40 and older
Guidelines for Obstructive Sleep Apnea in Adults
Recent guidelines on diagnosis and treatment of adult OSA from the American College of Physicians recommend:
- Sleep tests should be reserved for patients who experience daytime sleepiness (the main symptom of OSA).
- Overnight sleep tests in a sleep center lab (polysomnography) are the best way to diagnose OSA. Home sleep tests using portable monitors are an option for patients who do not have access to sleep centers, but they are not appropriate for patients who have serious health conditions.
- Losing weight is an important first step for patients with OSA who are overweight or obese.
- Continuous positive airway pressure (CPAP) is the most effective treatment for moderate-to-severe OSA. Although these devices can take some time to get used to, most patients find that CPAP greatly improves their symptoms and quality of life.
- Mandibular advancement devices (MADs), a type of dental device, may be an alternative therapy for patients with mild sleep apnea and who cannot tolerate or use CPAP treatment.
Recommendations for Obstructive Sleep Apnea in Children
Basic recommendations for children include:
- Surgical removal of enlarged adenoids and tonsils (adenotonsillectomy) is the first-line treatment for childhood OSA.
- CPAP treatment is recommended if the sleep apnea persists.
- Intranasal corticosteroids are an option for children with mild obstructive sleep apnea.
- Weight loss is recommended in addition to other therapies for children who are overweight or obese.
New Nerve Stimulator Device Approved
In 2014, the FDA approved the Inspire Upper Airway Stimulator for select adult patients with moderate-to-severe OSA who cannot tolerate CPAP. The nerve stimulator is surgically implanted in the chest and controlled by the patient with a remote control. The device stimulates a nerve in the jaw that controls tongue movement to help keep the airways open during sleep.
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