Description
Sleep-disordered breathing (SDB), including obstructive sleep apnea, is a common condition with significant health consequences if left untreated. Advances in diagnostic tools such as home sleep testing, wearable devices, and improved polysomnography have made evaluation more accessible and accurate. Treatment options have also evolved, with innovations in positive airway pressure therapies, mandibular advancement devices, and minimally invasive surgical techniques. Lifestyle modifications and weight management remain essential components of care. Newer approaches, including hypoglossal nerve stimulation, are transforming management in resistant cases. These advances are improving patient outcomes, adherence, and overall quality of life.
Summary Listen
- Sleep disorders are a significant health concern, encompassing a wide spectrum of conditions from chronic snoring to severe obstructive sleep apnea (OSA). OSA, characterized by frequent upper airway obstructions during sleep, is the most prevalent type. Diagnosing sleep disorders is often delayed due to a lack of awareness and difficulties in recognition.
- OSA is characterized by complete or partial upper airway collapse during sleep, leading to recurrent arousals, oxygen desaturation, and daytime symptoms like sleepiness. Risk factors include obesity, advancing age, male sex, family history, and alcohol/sedative use. Structural issues like nasal obstruction, tonsillar hypertrophy, and craniofacial abnormalities can contribute to OSA. Non-structural factors include upper airway muscle dysfunction and airway collapsibility.
- Diagnosis of OSA involves detailed patient and bed partner interviews to assess symptoms like snoring, choking, and daytime sleepiness. Polysomnography, or sleep studies, are the gold standard for confirming OSA and determining the apnea-hypopnea index (AHI). Recent advancements include artificial intelligence and machine learning algorithms for analyzing sleep study data.
- Treatment for OSA includes general measures like weight reduction, avoiding alcohol and sedatives, and maintaining good sleep hygiene. Nasal continuous positive airway pressure (CPAP) is the primary treatment, delivering continuous airflow to keep airways open. Other treatments, such as oral appliances and surgery, may be considered in specific cases.
- Central sleep apnea, characterized by a lack of respiratory effort during sleep, is another type of sleep disorder, often associated with other conditions. Nocturnal limb movement disorder, featuring restless legs and periodic limb movements, requires a different treatment approach. REM sleep behavior disorder involves acting out dreams during sleep.
- Insomnia, difficulty initiating or maintaining sleep, can have significant daytime consequences. Pediatric sleep apnea is increasingly recognized in children and needs attention. Overall, sleep disorders are important health issues that require effective diagnosis and management. Advances in technology and data analysis hold potential for optimizing the diagnostic and treatment path, but the clinician remains central.
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About the Speakers
Dr. S. K. Jindal
Former Professor & Head, Department of Pulmonary Medicine at the PGI, Chandigarh
Financial Disclosure
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