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Contemporary Concepts in the Diagnosis and Management of Obstructive Sleep Apnea

Contemporary Concepts in the Diagnosis and Management of Obstructive Sleep Apnea

Rajasekar Arumugam (Manchester University, UK & NHS Foundation Trust, UK)
Copyright: © 2021 |Pages: 17
DOI: 10.4018/978-1-7998-8018-9.ch001
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Abstract

Optimal sleep is an inseparable component of both physical and psychological well-being. With the widespread increase in the prevalence of sleep disorders, there has been an immense interest among the global researchers in exploring the molecular biology of sleep and innovative modalities for diagnosing and treating sleep disorders. Notably, sleep disorders encompass a wide spectrum of sleep disturbances with potential multisystem complications. Polysomnography is an overnight sleep study that is widely considered as the gold standard objective diagnostic method for diagnosing obstructive sleep apnea (OSA) and provision of continuous positive airway pressure (CPAP), which maintains airway patency during sleep remains the cornerstone therapy for OSA. Although CPAP remains the mainstay of therapy for OSA, various oral appliances and surgical interventions have widely been considered for OSA. This chapter provides a comprehensive overview of contemporary diagnostic and therapeutic approaches available in clinical practice for sleep-related breathing disorders with particular emphasis on OSA.
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Sleep Disordered Breathing

The term apnea is defined as episodes of complete cessation of respiratory airflow for at least 10 seconds, whereas the confusing terminology hypopnea involves airflow reductions associated with at least 3% decline in oxygen saturation with arousal episodes, or a 4% decline in oxygen saturation.(Kapur et al., 2017) The AASM scoring manual defines apnea-hypopnea index (AHI) as the measure of number of abnormal respiratory episodes namely apnea and hypopnea per hour, and respiratory disturbance index (RDI) as the sum of apneic and hypopneic episodes and respiratory effort-related arousals (RERAs) that happens during an hour of sleep i.e. RDI= AHI+RERA index.(Chung et al., 2008; Kapur et al., 2017) Accordingly, AASM grading of severity on the basis of respiratory disturbance index (RDI) is given as follows,

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