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Sleep Apnea

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Handbook of Outpatient Medicine

Abstract

Sleep apnea/sleep-disordered breathing (SDB) is an under recognized condition in the primary care clinic. Patients with multiple comorbid conditions and coexisting sleep apnea can lead to increasing cardiovascular mortality and morbidity. Diagnosing respiratory sleep disorders via clinical signs and symptoms can be challenging; however, use of advanced diagnostic techniques can reliably help with a diagnosis. There are many approaches to treatment of sleep apnea, but compliance with treatment is always a limitation.

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References

  1. Colten HR, Altevogt BM, editors. Sleep disorders and sleep deprivation: an unmet public health problem. The National Academies Collection: Reports funded by National Institutes of Health. Washington, DC. 2006.

    Google Scholar 

  2. American Academy of Sleep Medicine. International classification of sleep disorders. 3rd ed. Darien, IL: American Academy of Sleep Medicine; 2014.

    Google Scholar 

  3. Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med. 1993;328(17):1230–5.

    Article  CAS  PubMed  Google Scholar 

  4. McEvoy RD, Antic NA, Heeley E, Luo Y, Ou Q, Zhang X, et al. CPAP for prevention of cardiovascular events in obstructive sleep apnea. N Engl J Med. 2016;375(10):919–31.

    Article  PubMed  Google Scholar 

  5. Senthilvel E, Auckley D, Dasarathy J. Evaluation of sleep disorders in the primary care setting: history taking compared to questionnaires. J Clin Sleep Med. 2011;7(1):41–8.

    PubMed  PubMed Central  Google Scholar 

  6. Johns MW. Reliability and factor analysis of the Epworth sleepiness scale. Sleep. 1992;15(4):376–81.

    Article  CAS  PubMed  Google Scholar 

  7. Neelapu BC, Kharbanda OP, Sardana HK, Balachandran R, Sardana V, Kapoor P, et al. Craniofacial and upper airway morphology in adult obstructive sleep apnea patients: A systematic review and meta-analysis of cephalometric studies. Sleep Med Rev. 2016;

    Google Scholar 

  8. Chai-Coetzer CL, Antic NA, McEvoy RD. Ambulatory models of care for obstructive sleep apnoea: Diagnosis and management. Respirology. 2013;18(4):605–15.

    Article  PubMed  Google Scholar 

  9. Grover M, Mookadam M, Armas D, Bozarth C, Castleberry T, Gannon M, et al. Identifying patients at risk for obstructive sleep apnea in a primary care practice. J Am Board Fam Med. 2011;24(2):152–60.

    Article  PubMed  Google Scholar 

  10. Redline S, Yenokyan G, Gottlieb DJ, Shahar E, O'Connor GT, Resnick HE, et al. Obstructive sleep apnea-hypopnea and incident stroke: the sleep heart health study. Am J Respir Crit Care Med. 2010;182(2):269–77.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Ren R, Li Y, Zhang J, Zhou J, Sun Y, Tan L, et al. Obstructive sleep apnea with objective daytime sleepiness is associated with hypertension. Hypertension. 2016;68(5):1264–70.

    Article  CAS  PubMed  Google Scholar 

  12. Calik MW. Treatments for obstructive sleep apnea. J Clin Outcomes Manag. 2016;23(4):181–92.

    PubMed  PubMed Central  Google Scholar 

  13. Dieltjens M, Vanderveken OM, Heyning PH, Braem MJ. Current opinions and clinical practice in the titration of oral appliances in the treatment of sleep-disordered breathing. Sleep Med Rev. 2012;16(2):177–85.

    Article  PubMed  Google Scholar 

  14. Strollo PJ Jr, Soose RJ, Maurer JT, de Vries N, Cornelius J, Froymovich O, et al. Upper-airway stimulation for obstructive sleep apnea. N Engl J Med. 2014;370(2):139–49.

    Article  CAS  PubMed  Google Scholar 

  15. Sukhal S, Khalid M, Tulaimat A. Effect of wakefulness-promoting agents on sleepiness in patients with sleep apnea treated with CPAP: a meta-analysis. J Clin Sleep Med. 2015;11(10):1179–86.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Lee JJ, Sahu N, Rogers R, Soose RJ. Severe obstructive sleep apnea treated with combination hypoglossal nerve stimulation and oral appliance therapy.. Journal of Dental. Sleep Med. 2015;2(4):185–6.

    Google Scholar 

  17. Tefft BC, Safety AFFT. Prevalence of motor vehicle crashes involving drowsy drivers, United States, 2009—2013. Washington, DC: AAA Foundation for Traffic Safety; 2014.

    Google Scholar 

  18. Eckert DJ, Jordan AS, Merchia P, Malhotra A. Central sleep apnea: Pathophysiology and treatment. Chest. 2007;131(2):595–607.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Javaheri S. Sleep disorders in systolic heart failure: a prospective study of 100 male patients. The final report. Int J Cardiol. 2006;106(1):21–8.

    Article  PubMed  Google Scholar 

  20. Pepin JL, Borel JC, Janssens JP. Obesity hypoventilation syndrome: an underdiagnosed and undertreated condition. Am J Respir Crit Care Med. 2012;186(12):1205–7.

    Article  PubMed  Google Scholar 

  21. Van Ryswyk E, Antic NA. Opioids and sleep-disordered breathing. Chest. 2016;150(4):934–44.

    Article  PubMed  Google Scholar 

  22. Barateau L, Lopez R, Dauvilliers Y. Management of narcolepsy. Curr Treat Options Neurol. 2016;18(10):43.

    Article  PubMed  Google Scholar 

  23. Liira J, Verbeek JH, Costa G, Driscoll TR, Sallinen M, Isotalo LK, et al. Pharmacological interventions for sleepiness and sleep disturbances caused by shift work. Cochrane Database Syst Rev. 2014;8:CD009776.

    Google Scholar 

  24. Wijemanne S, Jankovic J. Restless legs syndrome: clinical presentation diagnosis and treatment. Sleep Med. 2015;16(6):678–90.

    Article  PubMed  Google Scholar 

  25. Hukins CA. Obstructive sleep apnea - management update. Neuropsychiatr Dis Treat. 2006;2(3):309–26.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Grimm W, Koehler U. Cardiac arrhythmias and sleep-disordered breathing in patients with heart failure. Int J Mol Sci. 2014;15(10):18693–705.

    Article  PubMed  PubMed Central  Google Scholar 

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Correspondence to Jhansi Nalamati MD, FAASM, FACP, FCCP .

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Nalamati, J., Damania, D. (2018). Sleep Apnea. In: Sydney, E., Weinstein, E., Rucker, L. (eds) Handbook of Outpatient Medicine. Springer, Cham. https://doi.org/10.1007/978-3-319-68379-9_14

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  • DOI: https://doi.org/10.1007/978-3-319-68379-9_14

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-68378-2

  • Online ISBN: 978-3-319-68379-9

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