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Obstructive sleep apnea

Obstructive sleep apnea (OSA)—also referred to as obstructive sleep apnea-hypopnea—is a sleep disorder that involves cessation or significant decrease in airflow in the presence of breathing effort.

It is the most common type of sleep-disordered breathing and is characterized by recurrent episodes of upper airway collapse during sleep.

These episodes are associated with recurrent oxyhemoglobin desaturations and arousals from sleep. OSA that is associated with excessive daytime sleepiness is commonly called obstructive sleep apnea syndrome—also referred to as obstructive sleep apnea-hypopnea syndrome.

Obstructive sleep apnea (OSA) is a well recognized and independent vascular risk factor (VRF) 1).


Obstructive sleep apnea is associated with Alzheimer's disease pathology, but this relationship is moderated by APOE ɛ4 and BMI 2).


Abnormal sleep breathing is frequently associated with iNPH. Validation in larger series is required but Román et al. from the Houston Methodist Hospital and Weill Cornell Medical College, Cornell University, New York, suggest including sleep evaluation in patients suspected of iNPH 3).


Vascular dysfunction and insulin resistance (IR) are associated with obstructive sleep apnea (OSA), which is characterized by frequent episodes of nocturnal intermittent hypoxia (IH) 4).


Patients with obstructive sleep apnea are frequently considered unsuitable candidates for awake craniotomy due to anticipated problems with oxygenation, ventilation, and a potentially difficult airway. At present, only a handful of such accounts exist in the literature.

A report describes the novel use of high-flow nasal oxygen therapy for a patient with moderate obstructive sleep apnea who underwent an awake craniotomy under deep sedation. The intraoperative application of high-flow nasal oxygen therapy achieved satisfactory oxygenation, maintained the partial carbon dioxide pressure within a reasonable range even during periods of deep sedation, permitted responsive patient monitoring during mapping, and provided excellent patient and surgeon satisfaction 5).

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3: Lee JH, Kang EJ, Bae WY, Kim JK, Choi JH, Kim CH, Kim SJ, Jo KS, Kim MS, Koh TK. Carotid Arterial Calcium Scoring Using Upper Airway Computed Tomography in Patients with Obstructive Sleep Apnea: Efficacy as a Clinical Predictor of Cerebrocardiovascular Disease. Korean J Radiol. 2019 Apr;20(4):631-640. doi: 10.3348/kjr.2018.0550. PubMed PMID: 30887745; PubMed Central PMCID: PMC6424829.

4: Gagnon K, Baril AA, Montplaisir J, Carrier J, De Beaumont L, D'Aragon C, Chami S, Pelleieux S, Poirier J, Gauthier S, Lafond C, Gagnon JF, Gosselin N. Disconnection Between Self-Reported and Objective Cognitive Impairment in Obstructive Sleep Apnea. J Clin Sleep Med. 2019 Mar 15;15(3):409-415. doi: 10.5664/jcsm.7664. PubMed PMID: 30853044; PubMed Central PMCID: PMC6411171.

5: Zaremba S, Albus L, Schuss P, Vatter H, Klockgether T, Güresir E. Increased risk for subarachnoid hemorrhage in patients with sleep apnea. J Neurol. 2019 Mar 5. doi: 10.1007/s00415-019-09265-5. [Epub ahead of print] PubMed PMID: 30834980.

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obstructive_sleep_apnea.txt · Last modified: 2019/04/15 12:54 by administrador