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Obstructive Sleep Apnea Syndrome (OSAS)

A Possible Cause of Loud Snoring & Excessive Daytime Sleepiness

What is OSAS?

Obstructive sleep apnea syndrome (OSAS) is a sleep-related breathing disorder, featured by repetitive pauses in breathing during sleep which results in blood oxygen reduction. The pauses (apneas) in breathing last longer than 10 seconds and occur at least 5 times per hour.

Obstructive sleep apnea syndrome is a worldwide phenomenon which is present in approximately 12-14% of the adult population. OSAS prevalence multiplies the risk of both cardiovascular and cerebrovascular mortality.

OSAS Risk Factors

  1. Obesity
  2. Male gender
  3. Middle age
  4. Smoking
  5. Excessive alcohol consumption

Middle-aged, overweight men with central fat distribution, short, thick neck and pharyngeal abnormalities are at the highest risk.

OSAS Symptoms

  1. Extreme snoring
  2. Drowning nightmares
  3. Daytime sleepiness
  4. Morning headaches
  5. Mental deficits
  6. Erectile dysfunction

Relationship between OSAS & Hypertension

The prevalence of obstructive sleep apnea is higher in patients with cardiac disorders. A growing amount of evidence suggests that OSAS is the most common type of secondary hypertension; however, as many patients are not aware of their heavy snoring and nocturnal arousals, an estimated 70-90% of cases remain undiagnosed.

Quick Facts

  1. Up to 70-80% of OSAS patients are hypertensive.
  2. OSAS is shown to be present in as much as 60% of therapy-resistant hypertension cases.
  3. Approximately 40% of hypertensive patients have obstructive sleep apnea.

In such cases the hypertension is typically diastolic; nighttime blood pressure dipping is decreased or missing; the standard deviation of nighttime blood pressure from the average nighttime value is usually seriously elevated.

Risks of Untreated OSAS

Untreated severe obstructive sleep apnea syndrome lowers cumulative survival of patients by 30% in 5 years and by 40% in 7 years from diagnosis.

  1. Obstructive sleep apnea syndrome independently elevates the risk of cardiovascular mortality by a factor of 10 to 23 times to normal.
  2. Obstructive sleep apnea syndrome causes a 7 to 10 times growth in cerebrovascular mortality and a 15-to 20-time growth in the risk of sleep-related traffic and work accidents.
  3. Obstructive sleep apnea syndrome is a major contributing factor in a large part of early mental deficit symptoms.

apneABP - When Sleep Labs May Not Be Available

Diagnostic protocols require patients with suspected obstructive sleep apnea syndrome to be referred to fully equipped sleep labs which may not be readily available either in a convenient time range or in a nearby institute. Therefore, an effective and easily available screening method is really important.

Meditech apneABP combined Holter ABPM, pulse oximeter and actigraph may provide a convenient and affordable pre-screening method for sleep apnea in primary care.