Obstructive sleep apnea/hypopnea syndrome
- PMID: 23676959
Obstructive sleep apnea/hypopnea syndrome
Abstract
Obstructive sleep apnea/hypopnea syndrome (OSAHS) is characterized by recurrent episodes of partial or complete upper airway collapse during sleep that is highlighted by a reduction in, or complete cessation of, airflow despite documented on going inspiratory efforts. Due to the lack of adequate alveolar ventilation that results from the upper airway narrowing, oxygen saturation may drop and partial pressure of CO2 may occasionally increase. The events are mostly terminated by arousals. Clinical consequences are excessive daytime sleepiness related to the sleep disruption. Minimal diagnostic criteria have been defined for OSAHS. Patients should have excessive daytime sleepiness that can not be better explained by other factors, or experience two or more of the following symptoms, again that are not better explained by other factors: choking or gasping during sleep; recurrent awakenings from sleep; un-refreshing sleep; daytime fatigue; and impaired concentration. All patients should have more than five obstructed breathing events per hour during sleep. An obstructive apnea or hypopnoea can be defined as an event that lasts for ≥ 10 s and is characterized by an absence or a decrease from baseline in the amplitude of a valid measure of breathing during sleep that either reaches >50% with an oxygen desaturation of 3% or an arousal (alternatively a 30% reduction with 4% desaturation). The American Academy of Sleep Medicine (AASM) recommends these definitions. The Task Force of the AASM also states that there are common pathogenic mechanisms for obstructive apnea syndrome, central apnea syndrome, sleep hypoventilation syndrome and Cheyne-Stokes breathing. It was more preferable to discuss each of these separately; although, they could be placed under the common denominator of "sleep-disordered breathing syndrome". The definition of OSAHS using two components, daytime symptoms and breathing pattern disturbances during sleep, may suggest that there is a tight correlation between the two. However, unfortunately this is not the case. The breathing pattern abnormalities, mostly described by an Apnea/Hypopnoea Index (AHI), only weakly correlate with quantified measures of sleepiness, such as the Epworth Sleepiness Scale (ESS). This probably means that interindividual sensitivity, with some individuals coping better with sleep fragmentation than others, does compromise the relationship between the AHI and daytime sleepiness scores. In addition, epidemiological studies show a broad range of sleepiness in the general population. Obviously, epidemiological studies investigating the prevalence of OSAHS are all biased by the lack of a uniform definition. The prevalence of an AHI of >5 events · h-1 in a general population (without taking into account symptoms of sleepiness) has previously been estimated to be 24% in a male population. When symptoms of sleepiness were also taken into account, the prevalence decreased to 4% in males and 2% in females.
Similar articles
-
Residual sleepiness in sleep apnea patients treated by continuous positive airway pressure.J Sleep Res. 2013 Aug;22(4):389-97. doi: 10.1111/jsr.12039. Epub 2013 Feb 15. J Sleep Res. 2013. PMID: 23409736
-
Rules for scoring respiratory events in sleep: update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events. Deliberations of the Sleep Apnea Definitions Task Force of the American Academy of Sleep Medicine.J Clin Sleep Med. 2012 Oct 15;8(5):597-619. doi: 10.5664/jcsm.2172. J Clin Sleep Med. 2012. PMID: 23066376 Free PMC article.
-
[Association between residual sleepiness and central sleep apnea events in patients with obstructive sleep apnea syndrome].Zhonghua Jie He He Hu Xi Za Zhi. 2008 Sep;31(9):664-9. Zhonghua Jie He He Hu Xi Za Zhi. 2008. PMID: 19080566 Clinical Trial. Chinese.
-
Sleep apnea: clinical investigations in humans.Sleep Med. 2007 Jun;8(4):400-26. doi: 10.1016/j.sleep.2007.03.003. Epub 2007 May 2. Sleep Med. 2007. PMID: 17478121 Review.
-
[Sleep apnea syndromes and cardiovascular disease].Bull Acad Natl Med. 2005 Mar;189(3):445-59; discussion 460-4. Bull Acad Natl Med. 2005. PMID: 16149210 Review. French.
Cited by
-
Circ-CIMIRC inhibition alleviates CIH-induced myocardial damage via FbxL4-mediated ubiquitination of PINK1.iScience. 2024 Jan 20;27(2):108982. doi: 10.1016/j.isci.2024.108982. eCollection 2024 Feb 16. iScience. 2024. PMID: 38333696 Free PMC article.
-
Assessing the contribution of mild high-altitude exposure to obstructive sleep apnea-hypopnea syndrome comorbidities.Front Neurol. 2024 Jan 8;14:1191233. doi: 10.3389/fneur.2023.1191233. eCollection 2023. Front Neurol. 2024. PMID: 38259645 Free PMC article.
-
Hsa_circ_0081065 exacerbates IH-induced EndMT via regulating miR-665/HIF-1α signal axis and HIF-1α nuclear translocation.Sci Rep. 2024 Jan 9;14(1):904. doi: 10.1038/s41598-024-51471-3. Sci Rep. 2024. PMID: 38195914 Free PMC article.
-
Heart Failure with Preserved Ejection Fraction and Obstructive Sleep Apnea: A Novel Paradigm for Additional Cardiovascular Benefit of SGLT2 Inhibitors in Subjects With or Without Type 2 Diabetes.Adv Ther. 2022 Nov;39(11):4837-4846. doi: 10.1007/s12325-022-02310-2. Epub 2022 Sep 16. Adv Ther. 2022. PMID: 36112311 Free PMC article. Review.
-
Research on the Association Between Obstructive Sleep Apnea Hypopnea Syndrome Complicated With Coronary Heart Disease and Inflammatory Factors, Glycolipid Metabolism, Obesity, and Insulin Resistance.Front Endocrinol (Lausanne). 2022 Jul 1;13:854142. doi: 10.3389/fendo.2022.854142. eCollection 2022. Front Endocrinol (Lausanne). 2022. PMID: 35846285 Free PMC article.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical