What is sleep disordered breathing (SDB) and obstructive sleep apnea (OSA)?
Sleep disordered breathing (SDB) is an umbrella term describing a spectrum of sleep-related breathing disorders and respiratory abnormalities, encompassing primary snoring, upper airway resistance syndrome (UARS), obstructive sleep apnea (OSA), and obstructive hypoventilation syndrome (OHS) (Park et al., Mayo Clin Proc 86:549–54, 2011). Primary snoring is the mildest form of SDB resulting from narrowed pharyngeal airway, which makes turbulent air flow causing vibration of soft-tissues, principally the soft palate and uvula. Although snoring is not relevant to hypoxia and sleep fragmentation, the sound of snoring is a key symptom of obstructive sleep apnea becoming a medical concern. On the other hand, OSA is the largest subset of SDB, which is characterized by repeated episodes airflow reduction (hypopnea) or cessation (apnea) during sleep. According to the third edition of the international classification of sleep disorders (ICSD-3), the diagnosis of OSA requires either sign/symptoms or related medical comorbidities. OSA is diagnosed when at least five obstructive respiratory events per hour are detected coupled with related symptoms or comorbidities, or when more than 15 apnea and hypopnea per hour are present in the absence of symptoms (Epstein et al., J Clin Sleep Med 5:263–276, 2009). The condition is significantly underdiagnosed, due to the lack of awareness and an insidious presentation.
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