pulmonary disorders
Obstructive Sleep Apnea (OSA)
Key Points
Obesity, anatomic abnormalities in the upper airway passages, family history, certain disorders (eg, hypothyroidism, stroke), and use of alcohol or sedatives increase the risk of obstructive sleep apnea (OSA). Patients typically snore, have restless and unrefreshing sleep, and often feel daytime sleepiness and fatigue. Most people who snore do not have OSA. Disorders that occur more commonly in patients with OSA include hypertension, stroke, diabetes, gastroesophageal reflux disease, nonalcoholic steatohepatitis, nocturnal angina, heart failure, and atrial fibrillation or other arrhythmias. Confirm the diagnosis by polysomnography or, if uncomplicated OSA, home sleep testing. Control modifiable risk factors and treat most patients with continuous positive airway pressure and/or oral appliances designed to open the airway. Consider surgery for abnormalities causing airway encroachment or if the disorder is intractable. 