Lege Artis Medicinae

[An update on obstructive sleep apnea]

METES Ágnes1, HIRSCHBERG Andor2

JULY 27, 1994

Lege Artis Medicinae - 1994;4(07)

[Obstructive sleep apnea, which occurs in approximately 2% of the adult population, is the more common of the two major forms of sleep apnea. The conse quences and dangers of excessive daytime sleepiness are emphasized along with the other well-known characteristics of sleep apnea syndrome. Both the decreased upper airway muscle tone during sleep and the negative pressure due to breathing through the obstructed airways may cause upper air ways to collapse. The history has a very important role in the clinical assessment, while the role of the physical examination is limited. An exact and reliable diagnosis may be arrived at through laboratory evaluation, e. g. polysomnography (PSG), Multiple Sleep Latency Test (MSLT), or radiologic examinations. Among conservative treatments, reduction of the body weight is usually effective in mild to moderate cases. In severe apneas, nasal continuous positive airway pressure (nCPAP) is the current treatment of choice. The efficacy of surgical intervention is still controversial. According to most authors, uvulopalatopharyngoplasty (UPPP) has a 50% success rate. Most recently good results have been obtained with maxillo-facial surgery in a variety of selected patients. ]

AFFILIATIONS

  1. Depatrments of Otolaryngology and Respiratory, Mount Sinai Hospital, University of Toronto, Toronto
  2. Semmelweis Orvostudományi Egyetem, Fül-Orr-Gége és Fej-Nyaksebészeti Klinika, Budapest

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