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Health Consequences of Obstructive Sleep Apnea

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Management of Obstructive Sleep Apnea

Abstract

Obstructive sleep apnea (OSA) adversely impacts virtually all organ systems. Neurocognitive consequences include impairments in daytime alertness, attention/vigilance, long-term visual and verbal memory, visuospatial/constructional abilities, and executive function while neuropsychological ones include depression, somatic syndromes, anxiety, and attention deficit/hyperactivity disorder. Cardiovascular consequences of OSA include CHF, systemic hypertension, ischemic heart disease, atrial fibrillation, ventricular arrhythmia, and stroke. Respiratory consequences include poor symptom control in asthma, worse pulmonary function in chronic obstructive pulmonary disease (COPD), increased frequency of exacerbation in both asthma and COPD, increased prevalence and recurrence of pulmonary embolism, and a higher prevalence pulmonary hypertension. Endocrine consequences include diabetes mellitus, metabolic syndrome, and sexual dysfunction in men and women. Gastrointestinal consequences include gastroesophageal reflux disease and nonalcoholic fatty liver disease. Obstetric consequences include pregnancy-related hypertensive disorders and gestational diabetes, as well as maternal cardiovascular, pulmonary, and surgical complications. Perinatal consequences include low birth weight, preterm birth, NICU admission, and hyperbilirubinemia. Perioperative consequences include postoperative ICU transfer, respiratory complications, cardiovascular events, and neurologic complications. Accident-related consequences include motor vehicle crashes and work-related injuries. Oncologic consequences include increased cancer incidence including breast and colorectal cancer. Mortality-related consequences include higher death rates overall and from cardiovascular, noncardiovascular, and COPD-related causes. Nocturnal respiratory dysfunction (i.e., hypoxemia-reoxygenation and hypercapnia), poor sleep quality (i.e., increased arousals, poor sleep efficiency, and altered sleep architecture), and intrathoracic pressure variations result in oxidative stress, inflammation, sympathetic activation, endothelial dysfunction, neurohormonal changes, thrombophilia, and hemodynamic changes, which are the mechanisms for these adverse clinical outcomes.

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Espiritu, J.R.D. (2021). Health Consequences of Obstructive Sleep Apnea. In: Kim, K.B., Movahed, R., Malhotra, R.K., Stanley, J.J. (eds) Management of Obstructive Sleep Apnea. Springer, Cham. https://doi.org/10.1007/978-3-030-54146-0_3

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