Sleep medicine reviews
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Sleep medicine reviews · Feb 2014
Meta Analysis Comparative StudyComparison of positional therapy versus continuous positive airway pressure in patients with positional obstructive sleep apnea: a meta-analysis of randomized trials.
Obstructive sleep apnea (OSA), caused by the obstruction of the upper airway, is the most common type of sleep apnea. Continuous positive airway pressure (CPAP) and positional therapy have been shown to be effective to improve positional OSA. ⋯ CPAP is superior to positional therapy in reducing the severity of sleep apnea and increasing the oxygen saturation level in patients with positional OSA.
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Sleep medicine reviews · Feb 2014
ReviewSupine position related obstructive sleep apnea in adults: pathogenesis and treatment.
The most striking feature of obstructive respiratory events is that they are at their most severe and frequent in the supine sleeping position: indeed, more than half of all obstructive sleep apnea (OSA) patients can be classified as supine related OSA. Existing evidence points to supine related OSA being attributable to unfavorable airway geometry, reduced lung volume, and an inability of airway dilator muscles to adequately compensate as the airway collapses. The role of arousal threshold and ventilatory control instability in the supine position has however yet to be defined. ⋯ The treatment of supine related OSA remains largely ignored in major clinical guidelines. Supine OSA is the dominant phenotype of the OSA syndrome. This review explains why the supine position so favors upper airway collapse and presents the available data on the management of patients with supine related OSA.
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Sleep medicine reviews · Feb 2014
ReviewUntreated obstructive sleep apnea and the risk for serious long-term adverse outcomes: a systematic review.
Reports on the association between obstructive sleep apnea (OSA) and risk of death, cardiovascular (CV) events, diabetes and depression have been inconsistent. ⋯ Evidence exists in men for a relationship between OSA and all-cause mortality and a composite CV outcome. Associations between OSA and other outcomes remain uncertain. Among OSA-specific markers, only AHI was a consistent predictor. Other consistent predictors were traditional CV risk factors. Research is required to identify effect modifiers and the predictive ability of various AHI threshold values and hypopnea definitions. An enhanced set of OSA-specific predictors will allow better risk stratification to guide OSA treatment.