nasal cpap (ncpap) is highly effective in controlling symptoms, improving quality of life and reducing the clinical sequelae of sleep apnoea. this further impairs performance at work with a remarkable effect on the quality of life [vaessen et al. the management of patients with osa requires a multidisciplinary approach and many treatment options are currently available. the elimination of nocturnal apnoeic events and intermittent hypoxia is a key goal to controlling osa effectively. 2012], there is little doubt that a constant nocturnal treatment (at least 5 h) with cpap produces a dramatic improvement in the quality of life of the patients and, in many cases, of their bed partners [patel et al. another recent meta-analysis systematically analyzed six studies addressing the effect of cpap on diurnal blood pressure in patients with osa and drug-resistant hypertension and found a favourable reduction after treatment with cpap [iftikhar et al. indeed, the association of cpap and weight loss provides the best approach to improve glucose metabolism in patients with obesity and osa [chirinos et al. whatever is the reason for scarce tolerance, adherence to the treatment represents a major issue as compliance with cpap has been reported to be from 50% to 80% of patients [jordan et al. the supine position, mainly due to the effect of the gravity on tongue and soft palate position, is generally associated with an increased number of apnoeas/hypopnoeas [bidarian-moniri et al.
over the last 10 years, oral appliances have gained increasing recognition as a useful alternative to cpap for the treatment of patients with mild to moderate osa and for those patients with severe disease intolerant to cpap [ngiam et al. in addition, the long-term effect of treatment with oral devices on cardiovascular health and all other health outcomes is still uncertain [sutherland et al. although promising, there is still insufficient evidence to recommend the use of these oral appliances in clinical practice [randerath et al. this technique consists of the resection of uvula, part of the soft palate and tissue excess in the oropharynx, and is usually performed with simultaneous tonsillectomy [aurora et al. stiffening of the soft palate to reduce snoring and apnoeas can also be obtained by the insertion of polyester implants in the soft palate (pillar palatal implants), but again good evidence for treating patients with osa is lacking [gillespie et al. weight loss is therefore a main goal in the management osa and all patients should be encouraged to control their weight [tuomilehto et al. a number of novel treatment alternatives to ncpap are now under evaluation for the management of patients with osa. although this is a very well tolerated treatment, the efficacy in patients with moderate to severe osa is controversial [rossi et al. all patients with obesity should be encouraged to lose weight and bariatric surgery can be considered in patients with bmi over 40. a multidisciplinary approach and the implementation of educational programs will significantly improve the management of the disease.
the diagnosis and treatment of obstructive sleep apnea is discussed in the context of recent diagnostic and therapeutic advances. osa is also common in smokers, individuals with family history of osa and in postmenopausal females. osa can be associated with lack of attention, loss of productivity, and accidents at work or on the road. nasal cpap was first described in 198114 and has since become the first line of therapy for osa.
positional therapy is the avoidance of sleeping in a supine position to counter the gravitational effect of supine sleep on the tongue and narrowing of the airway. in general a tracheostomy is considered the gold standard treatment of osa but has social implications and is undesired by most patients. although not as efficacious as cpap, there are acceptable alternative therapies for the treatment of mild osa and more severe osa in patients that cannot tolerate or adhere to cpap. clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults.
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listen to osa-g on spotify. artist 4 monthly listeners. open app. osa-g. 4 monthly listeners. follow. popular. 1. scorpion. 2. who gonna ride. 3. obstructive sleep apnoea (osa) is a common disorder characterized by repetitive episodes of nocturnal breathing cessation due to upper airway collapse. mcardle n, devereux g, heidarnejad h, engleman hm, mackay tw, douglas nj. long-term use of cpap therapy for sleep apnea/hypopnea syndrome., .
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