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 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Obstructive sleep apnea is a chronic condition characterized by frequent episodes of upper airway collapse during sleep. Its effect on nocturnal sleep quality and ensuing daytime fatigue and sleepiness are widely acknowledged. Increasingly, obstructive sleep apnea is also being recognized as an independent risk factor for several clinical consequences, including systemic hypertension, cardiovascular disease, stroke, and abnormal glucose metabolism. Estimates of disease prevalence are in the range of 3% to 7%, with certain subgroups of the population bearing higher risk. Factors that increase vulnerability for the disorder include age, male sex, obesity, family history, menopause, craniofacial abnormalities, and certain health behaviors such as cigarette smoking and alcohol use. Despite the numerous advancements in our understanding of the pathogenesis and clinical consequences of the disorder, a majority of those affected remain undiagnosed. Simple queries of the patient or bed-partner for the symptoms and signs of the disorder, namely, loud snoring, observed apneas, and daytime sleepiness, would help identify those in need of further diagnostic evaluation. The primary objective of this article is to review some of the epidemiologic aspects of obstructive sleep apnea in adults.
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PMID:The epidemiology of adult obstructive sleep apnea. 1825 Feb 5

Obstructive sleep apnea is the most frequent sleep disorder. The prevalence of sleep apnea in the general population is 2-4% and the main characteristic of the disease is the intermittent cessation or substantial reduction of airflow during sleep, caused by complete, or near complete upper airway obstruction. Decreased airflow is followed by oxygen desaturation and intermittent arousals. The clinical presentation of the disorder is complex. Loud snoring with breathing pauses and daytime sleepiness should raise the suspicion of sleep apnea, but we have to consider this disease if the patient has therapy resistant hypertension, heart failure, arrhythmias, stroke, depression or memory problems. Family physicians have an important role in recognizing sleep apnea. High risk patients can easily be identified by the main symptoms and using the Berlin sleep apnea questionnaire. These patients should be referred to a sleep laboratory for polysomnographic assessment and, if necessary, for further treatment.
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PMID:[The role of family physicians in the recognition and screening of obstructive sleep apnea]. 1902 51

Obstructive sleep apnea (OSA) and stroke are frequent, multifactorial entities that share risk factors, and for which case-control and cross-sectional studies have shown a strong association. Stroke of respiratory centers can lead to apnea. Snoring preceding stroke, documentation of apneas immediately prior to transient ischemic attacks, the results of autonomic studies, and the circadian pattern of stroke, suggest that untreated OSA can contribute to stroke. Although cohort studies indicate that OSA is a stroke risk factor, controversy surrounds the cost-effectiveness of the screening for and treatment of OSA once stroke has occurred.
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PMID:Obstructive sleep apnea and stroke. 1999 68

According to various data, snoring may affect about 2 billion people worldwide, with about 8 million adult people in Poland being estimated to snore. Apart from being disturbing for other people, it brings about a measurable risk for the patient, which results from transient anoxia. As a consequence, it may increase the risk of arterial hypertension, myocardial infarction, cerebral stroke and impotency, as well as mental disturbances like depression or anxiety states. The physician a snoring patient may consult in the first instance is the laryngologist. He determines whether upper airway obturation (in contrast to central sleep apnea) is dealt with, and takes a decision about treatment method, or redirects the patient to another specialist. In this paper, the position of a laryngologist in the diagnosis and treatment of snoring is presented. The material consisted of patients presenting with this problem at the otolaryngology department. The proceedings with patients in the admission office setting were described as well as qualification methods for further medical and operative treatment. A review of the applied procedures was made, in particular allowing for the most recent therapeutic methods.
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PMID:Snoring - the role of the laryngologist in diagnosing and treating its causes. 2015 29

Obstructive sleep apnoea (OSA) is increasingly being recognized as an important health issue in the last two to three decades. It is characterized by frequent episodes of upper airway collapse during sleep, causing recurrent arousals, intermittent hypoxaemia, sleep fragmentation and poor sleep quality. There is accumulating evidence that OSA is being considered as an independent risk factor for hypertension, glucose intolerance / diabetes mellitus, cardiovascular diseases and stroke, leading to increased cardiometabolic morbidity and mortality. The prevalence rates of OSA have been estimated in the range of 2 to 10 per cent worldwide, and the risk factors for obstructive sleep apnoea include advanced age, male sex, obesity, family history, craniofacial abnormalities, smoking and alcohol consumption. The common clinical presenting symptoms are heavy snoring, witnessed apnoeas and daytime hypersomnolence, which would help to identify the affected individuals. With increasing awareness of this disease entity and associated complications in our society, there have been increased referrals to sleep physicians or expertise for further investigations and diagnostic evaluation. Early recognition and treatment of obstructive sleep apnoea may prevent from adverse health consequences. Some of the epidemiological aspects of obstructive sleep apnoea in adults are reviewed.
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PMID:Obstructive sleep apnoea: definitions, epidemiology & natural history. 2030 41

In some studies, snoring has been associated with an increased risk of hypertension, ischemic heart disease and stroke. Although the mechanisms involved in these associations are unknown, they are probably mediated by obstructive sleep apnea. Nevertheless, most snorers do not have sleep apnea. Whether snoring itself increases the risk of cardiovascular disease remains controversial.
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PMID:[Consequences of untreated snoring]. 2094 78

Obstructive sleep apnoea (OSA) syndrome in adult is defined as an Apnoea-Hypopnoea Index (AHI) of 5 or more per hour of sleep in a context of excessive daytime sleepiness and snoring. OSA is considered as mild with an AHI of 5-15, moderate with an AHI of 15-30, and severe with an AHI greater than 30. OSA is a highly prevalent disease since it should affect 7-15% of the middle-aged population, but most patients are not yet diagnosed for OSA. Middle age, male gender, obesity and arterial hypertension are main risk factors for OSA in adults. OSA patients are exposed to higher neurological and cardiovascular morbidity, including stroke, depression, hypertension, coronary artery disease, heart failure, arrhythmias. Because OSA may lead to life-threatening problems if undiagnosed, anaesthesiologists should be aware of their screening role in the preoperative period. In that way, the STOP-BANG questionnaire is a well-adapted instrument to screen patients for OSA during the preoperative visit. OSA patients are exposed to higher preoperative morbidity in relation with OSA severity, particularly difficult manual ventilation with mask, difficult tracheal intubation and postoperative upper airway obstruction. The unknown diagnosis of OSA is one major contributor to facilitate the occurrence of those events. In the postoperative period, early resuming continuous positive airway pressure and installing the OSA patient in a nonsupine position could be effective in preventing pharyngeal obstruction. Considering the timing of postoperative complications, a careful monitoring in the post-anesthesia care unit for three hours is an appropriate strategy for a majority of OSA patients. Alternatives to opioids should be promoted for postoperative pain control.
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PMID:[Obstructive sleep-apnoea syndrome in adult and its perioperative management]. 2096 87

Obstructive sleep apnea (OSA) is a condition in which the upper airway becomes constricted or occluded during sleep, leading to decreased or absent airflow, hypoxia, and sympathetic activation. This chain of events, occurring dozens of times an hour, can contribute to the development of hypertension, coronary artery disease, heart failure, and stroke. This article discusses the epidemiology of comorbid OSA and cardiovascular disease, the pathophysiology of OSA, how it acts as a risk factor for cardiovascular problems, and how appropriate treatment of OSA ameliorates the consequences. The importance of having a high suspicion for OSA in people with risk factors (including obesity, middle age, male or postmenopausal female) or symptoms (snoring, excessive daytime sleepiness, difficulty concentrating) is pointed out. The article concludes with clinical and research implications.
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PMID:Obstructive sleep apnea: a risk factor for cardiovascular disease. 2107 17

Obstructive sleep apnea syndrome (OSAS) is a chronic disease characterized by recurrent episodes of partial or complete upper airway collapse and obstruction during sleep, associated with intermittent oxygen desaturation, sleep fragmentation, and symptoms of disruptive snoring and daytime sleepiness. Increasing focus is being placed on the relationship between OSAS and all-cause and cardiovascular disease-related mortality, but it still largely unclear whether this association is causative or simply speculative and epidemiological. Basically, reliable clinical evidence supports the hypothesis that OSAS might be associated with essential and resistant hypertension, as well as with an incremental risk of developing stroke, cardiac rhythm perturbations (e.g., atrial fibrillation, bradyarrhythmias, supraventricular and ventricular arrhythmias), coronary artery disease, acute myocardial infarction, and heart failure. Although it is still unclear whether OSAS might represent an independent risk factor for several acute or chronic conditions, or rather might trigger cardiovascular disease in the presence of traditional cardiovascular risk factors (e.g., obesity, diabetes, and dyslipidemia), there is a plausible biological background underlying this association, in that most of the mechanisms implicated in the pathogenesis of OSAS (i.e., hypoxia, hypercapnia, negative intrathoracic pressure, micro-arousal, sympathetic hyperactivity, metabolic and hormonal changes, oxidative stress, phlogosis, endothelial dysfunction, hypercoagulability, and genetic predisposition) might also be involved in the pathogenesis of cardiovascular disorders. In this article we discuss the different aspects of the relationship between OSAS and pathogenically different conditions such as systemic hypertension, coronary artery disease, stroke, metabolic abnormalities, arrhythmias, and heart failure, and we also discuss the kaleidoscope of phenomena implicated in the pathogenesis of this challenging disease.
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PMID:Obstructive sleep apnea syndrome and cardiovascular diseases. 2145 62

Chronic migraine (CM) is the most disabling of the 4 types of primary chronic daily headache (CDH) of long duration, a syndrome defined by primary headaches 15 or more days per month for at least 3 months with attacks that last 4 hours or more per day on average. CDH of long duration includes CM, chronic tension-type headache, new daily persistent headache, and hemicrania continua. CM affects approximately 2% of the adult population in Western countries, imposing substantial burdens on individual sufferers and their families and, more broadly, upon society. Although this disorder is highly disabling and prevalent, it remains largely underdiagnosed and undertreated. Diagnosing CM requires a systematic approach that includes these steps: (1) exclude a secondary headache disorder, and (2) diagnose a specific primary headache syndrome based on frequency and duration, for example, short-duration episodic, long-duration episodic, or long-duration chronic. CM usually develops as a complication of episodic migraine after a period of increasing headache frequency. This migraine transformation is associated with a number of risk factors, some of which cannot be modified, including age and race. Other risk factors for CM are modifiable, such as obesity, snoring, head injury, stressful life events, and overuse of opioids and barbiturates. However, risk factor modification has not yet been shown to decrease the likelihood of CM onset. According to a cross-sectional analysis of data from the American Migraine Prevalence and Prevention study published this year in Journal of Neurology, Neurosurgery, and Psychiatry, when compared to patients with episodic migraine, patients with CM were significantly less likely to be employed full-time and almost twice as likely to be occupationally disabled. In addition, patients with CM were nearly twice as likely to have anxiety, chronic pain, or depression. Furthermore, patients with CM had higher cardiovascular and respiratory risk, were 40% more likely to have heart disease and angina, and were 70% more likely to have a history of stroke. These findings highlight the paramount importance of clinical vigilance, accurate diagnosis, and appropriate, effective management - including treatment or referrals - to improve patient outcomes.
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PMID:Chronic migraine, classification, differential diagnosis, and epidemiology. 2177 Sep 29


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