Obstructive sleep apnea (OSA) is defined clinically as the repeated collapse of the upper airway throughout the night, leading to a challenging sleep disorder. Bed partners will notice various telltale noises such as snoring, gasping for air, or snorting sounds that likewise interrupts their sleep hygiene. Not surprisingly, patients tend to feel sleepy throughout the work day.
OSA is usually diagnosed with the help of polysomnography. Patients must meet certain criteria, depending on whether they are asymptomatic or symptomatic: 15+ apneaic or 5+ apneaic events, respectively. In either case, 75% of the apneaic events must be obstructive in respiratory effort.
In addition to decompensated pulmonary function, OSA has been linked to other specific bodily functions found in the cardiovascular, cerebrovascular, and gastrointestinal systems. The alternation between incidents of hypoxia and reoxygenation is the main culprit.
In regards to the cardiovascular system, OSA is linked not only to the onset of heart failure, but also the progression of it. Furthermore, it is known to worsen obesity, diabetes, and the metabolic syndrome.
In regards to the cerebrovascular system, OSA is known to precipitate neurocognitive decline. Some of the symptoms include memory problems, concentration difficulty, morning headaches, and depression.
An important consideration for clinicians is that upper airway tends to narrow at the retropalatal and retroglossal levels as sedation progresses. For this reason, OSA will make the patient particular vulnerable during sedation. Special care must be taken to increase clinician and patient awareness of the precarious needs of this sleep disorder.
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