Obstructive Sleep Apnea Diagnosis and Management
Summary
Obstructive sleep apnoea (OSA) is a highly prevalent disorder in which repetitive collapse of the upper airway during sleep leads to apnoea and hypopnoea, intermittent hypoxia and sleep fragmentation. Risk factors include obesity, craniofacial anatomy, neuromuscular tone and fluid redistribution. The clinical spectrum ranges from snoring and daytime sleepiness to cardiovascular, metabolic and neurocognitive comorbidities. Diagnosis typically relies on clinical assessment, questionnaires such as the STOP-Bang and objective measurement by polysomnography or home sleep testing devices. Severity is classified by the apnoea–hypopnoea index (AHI) and guides therapeutic decisions. First-line management emphasises lifestyle modifications, weight loss and avoidance of alcohol or sedatives. Continuous positive airway pressure (CPAP) remains the gold-standard therapy, with proven benefit for blood pressure control and daytime alertness, yet adherence often limits effectiveness. Alternative strategies include mandibular advancement devices, positional therapy, nasal and oropharyngeal surgery and emerging hypoglossal nerve stimulation. Personalised care pathways, informed by phenotypic traits and patient preference, are increasingly advocated to optimise outcomes. Recent advances in portable monitoring, digital health platforms and machine-learning analysis of physiological signals promise to expand access to diagnosis and to refine treatment adherence monitoring on a global scale.
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Obstructive Sleep Apnea Diagnosis and Management publication trend
The graph below shows the total number of articles in obstructive sleep apnea diagnosis and management across all publications each year (not limited to Nature Index journals).
Technical terms
Apnoea–Hypopnoea Index (AHI): Number of apnoea and hypopnoea events per hour of sleep, used to quantify OSA severity.
Continuous Positive Airway Pressure (CPAP): A therapeutic device that delivers a constant flow of air to maintain airway patency during sleep.
Intermittent Hypoxia (IH): Repeated episodes of reduced blood oxygen saturation caused by transient airway obstruction.
Polysomnography (PSG): A multi-parametric sleep study recording brain activity, respiratory effort, airflow and oxygen saturation to diagnose sleep disorders.
References
- Pathophysiological mechanisms and therapeutic approaches in obstructive sleep apnea syndrome. Signal Transduction and Targeted Therapy (2023).
- High night-to-night variability in sleep apnea severity is associated with uncontrolled hypertension. npj Digital Medicine (2023).
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