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Obstructive Sleep Apnea

Clinical Presentation

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Primary Care Sleep Medicine

Part of the book series: Current Clinical Practice ((CCP))

Abstract

Obstructive sleep apnea (OSA) is associated with a decreased quality of life (1) and increased morbidity, particularly an increased risk for driving accidents because of falling asleep or inattention (2) and cardiovascular disease (3). However, before sleep apnea can be diagnosed, it must be considered as a possible diagnosis. Clinical presentation and recognition is crucial in considering OSA as an explanation for a group of symptoms and clinical findings. How do patients present when they have OSA? Whom do they go to for evaluation? Are there differences between genders and races? These questions will be addressed in this chapter.

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References

  1. Jenkinson C, Davies R, Mullins R, et al. (1999) Comparison of therapeutic and subtherapeutic nasal continuous positive airway pressure for obstructive sleep apnoea: a randomized prospective parallel trial. Lancet 353:2100–2105.

    Article  PubMed  CAS  Google Scholar 

  2. George C (2004) Sleep. 5: Driving and automobile crashes in patients with the apnoea/hypopnoea syndrome. Thorax 59:804–807.

    Article  PubMed  CAS  Google Scholar 

  3. Peker Y, Hedner J, Norum J, et al. (2002) Increased incidence of cardiovascular disease in middleaged men with obstructive sleep apnea: a 7-year follow-up. Am J Respir Crit Care Med 166:159–165.

    Article  PubMed  Google Scholar 

  4. Young T, Palta M, Dempsey J, et al. (1993) The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 328:1230–1235.

    Article  PubMed  CAS  Google Scholar 

  5. Young T, Peppard PE, Gottlieb DJ (2002) Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med 165:1217–1239.

    Article  PubMed  Google Scholar 

  6. Tishler PV, Larkin EK, Schluchter MD, et al. (2003) Incidence of sleep-disordered breathing in an urban adult population: the relative importance of risk factors in the development of sleep-disordered breathing. JAMA 289:2230–2237.

    Article  PubMed  Google Scholar 

  7. Bixler EO, Vgontzas AN, Lin H-M, et al. (2001) Prevalence of sleep-disordered breathing in women, effects of gender. Am J Respir Crit Care Med 163:608–613.

    PubMed  CAS  Google Scholar 

  8. Bixler EO, Vgontzad AN, Ten Have T, et al. (1998) Effects of age on sleep apnea in men. I: prevalence and severity. Am J Respir Crit Care Med 157:144–148.

    PubMed  CAS  Google Scholar 

  9. Ohayon M, Guilleminault C, Priest R, et al. (1997) Snoring and breathing pauses during sleep: telephone interview survey of a United Kingdom population sample. BMJ 314:860–863.

    PubMed  CAS  Google Scholar 

  10. Grunstein R, Senlof K, Hedner J, et al. (1995) Impact of self-reported sleep-breathing disturbances on psychosocial performance in the Swedish obese subjects (SOS) study. Sleep 18:635–643.

    PubMed  CAS  Google Scholar 

  11. Redline S, Kump K, Tishler PV, et al. (1994) Gender differences in sleep-disordered breathing in a community-based sample. Am J Respir Crit Care Med 149:722–726.

    PubMed  CAS  Google Scholar 

  12. Viner S, Szalai J, Hoffstein V (1991) Are history and physical examination a good screening test for sleep apnea? Ann Intern Med 115:356–359.

    PubMed  CAS  Google Scholar 

  13. Johns M (1991) A new method for measuring daytime sleepiness: the Epworth Sleepiness Scale. Sleep 14:540–545.

    PubMed  CAS  Google Scholar 

  14. Johns M (1992) Reliability and factor analysis of the Epworth Sleepiness Scale. Sleep 15:376–381.

    PubMed  CAS  Google Scholar 

  15. Benbadis S, Mascha E, Perry M, et al. (1999) Association between the Epworth Sleepiness Scale and the Multiple Sleep Latency Test in a clinical population. Ann Intern Med 130:289–292.

    PubMed  CAS  Google Scholar 

  16. Punjabi N, Bandeen-Roche K, Young T (2003) Predictors of objective sleep tendency in the general population. Sleep 26:678–683.

    PubMed  Google Scholar 

  17. Fisk J, Ritvo P, Ross L, et al. (1994) Measuring the functional impact of fatigue: initial validation of the fatigue impact scale. Clin Infect Dis 18:S79–S83.

    PubMed  Google Scholar 

  18. Littner M, Kushida C, Wise M, et al. (2005) Practice parameters for clinical use of the Multiple Sleep Latency Test and the Maintenance of Wakefulness Test. Sleep 28:113–121.

    PubMed  Google Scholar 

  19. van Kralingen K, de Kanter W, de Groot G, et al. (1998) Assessment of sleep complaints and sleepdisordered breathing in a consecutive series of obese patients. Respiration 66:312–316.

    Article  Google Scholar 

  20. Laaban J-P, Cassuto D, Orvoen-Frija E, et al. (1998) Cardiorespiratory consequences of sleep apnoea syndrome in patients with massive obesity. Eur Respir J 11:20–27.

    Article  PubMed  CAS  Google Scholar 

  21. Hajduk I, Jasani R, Strollo P, et al. (2001) Nocturia in sleep disordered breathing. Sleep Med 1:263–267.

    Article  Google Scholar 

  22. Hajduk I, Strollo P, Jasani R, et al. (2002) Prevalence and predictors of nocturia in obstructive sleep apnea-hypopnea syndrome (osahs): a retrospective study. Sleep 26:61–64.

    Google Scholar 

  23. Akashiba T, Otsuka K, Yoshizawa T, et al. (1991) Effects of nasal continuous positive airway pressure (NCPAP) on nocturnal renal function in obstructive sleep apnea syndrome (OSAS). Jpn J Thor Dis 29:573–577.

    CAS  Google Scholar 

  24. Collop N, Adkins D, Phillips B (2004) Gender differences in sleep and sleep-disordered breathing. Clin Chest Med 25:257–268.

    Article  PubMed  Google Scholar 

  25. Kapsimalis F, Kryger M (2002) Gender and obstructive sleep apnea syndrome, part 1: clinical features. Sleep 25:409–416.

    Google Scholar 

  26. Schlosshan D, Elliot M (2005) Sleep 3: Clinical presentation and diagnosis of the obstructive sleep apnoea hypopnoea syndrome. Thorax 59:347–352.

    Article  Google Scholar 

  27. Sherpertycky M, Banno K, Kryger M (2005) Differences between men and women in the clinical presentation of patients diagnosed with obstructive sleep apnea syndrome. Sleep 28:309–314.

    Google Scholar 

  28. Young T, Hutton R, Finn L, et al. (1996) The gender bias in sleep apnea diagnosis: are women missed because they have different symptoms. Arch Intern Med 156:2445–2451.

    Article  PubMed  CAS  Google Scholar 

  29. Scharf S, Seiden L, DeMore J, et al. (2004) Racial differences in clinical presentation of patients with sleep-disordered breathing. Sleep Breath 8:173–183.

    Article  PubMed  Google Scholar 

  30. Kramer N, Cook T, Carlisle C, et al. (1999) The role of the primary care physician in recognizing obstructive sleep apnea. Arch Intern Med 159:965–968.

    Article  PubMed  CAS  Google Scholar 

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© 2007 Humana Press Inc., Totowa, NJ

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Atwood, C.W. (2007). Obstructive Sleep Apnea. In: Pagel, J.F., Pandi-Perumal, S.R. (eds) Primary Care Sleep Medicine. Current Clinical Practice. Humana Press. https://doi.org/10.1007/978-1-59745-421-6_8

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  • DOI: https://doi.org/10.1007/978-1-59745-421-6_8

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-992-5

  • Online ISBN: 978-1-59745-421-6

  • eBook Packages: MedicineMedicine (R0)

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