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'''For patient information click [[Sleep apnea (patient information)|here]]'''
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{{Sleep apnea}}
{{Infobox_Disease |
{{Infobox_Disease |
   Name          = {{Sleep Apnea}} |
   Name          = Sleep Apnea |
   Image          = Sleep apnea.jpg|
   Image          = Sleep apnea.jpg|
   Caption        = |
   Caption        = |
   Width          = 250px|
   Width          = 250px|
  DiseasesDB    = |
  ICD10          = {{ICD10|G|47|3|g|40}} |
  ICD9          = {{ICD9|780.57}} |
  ICDO          = |
  OMIM          = |
  MedlinePlus    = |
  MeshID        = D012891 |
}}
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{{Sleep apnea}}
{{CMG}}; '''Associate Editor(s)-In-Chief:''' [[Kashish Goel|Kashish Goel, M.D.]]


Keywords: Sleep apnea, obstructive sleep apnea, obesity hypoventilation, cor pulmonale
'''For patient information about sleep apnea click [[Sleep apnea (patient information)|here]]'''
 
'''For patient information about central sleep apnea click [[Central sleep apnea (patient information)|here]]'''


==[[Sleep Apnea Overview |Overview]]==
{{CMG}}; {{AE}} [[Saarah T. Alkhairy, M.D.]]


==Types==
==[[Sleep apnea overview|Overview]]==
There are two different type of sleep apnea. This section will focus on obstructive sleep apnea.
===[[Central Sleep Apnea]]===
===[[Obstructive Sleep Apnea|Obstructive sleep apnea]]===


==Obstructive sleep apnea==
[[Clinical practice guideline]]s by the [[United States Preventive Services Task Force]]<ref name="pmid28118461">US Preventive Services Task Force. Bibbins-Domingo K, Grossman DC, Curry SJ, Davidson KW, Epling JW et al. (2017) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=28118461 Screening for Obstructive Sleep Apnea in Adults: US Preventive Services Task Force Recommendation Statement.] ''JAMA'' 317 (4):407-414. [http://dx.doi.org/10.1001/jama.2016.20325 DOI:10.1001/jama.2016.20325] PMID: [https://pubmed.gov/28118461 28118461]</ref> and the American Academy of Sleep Medicine<ref name="pmid28162150">{{cite journal| author=Kapur VK, Auckley DH, Chowdhuri S, Kuhlmann DC, Mehra R, Ramar K et al.| title=Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline. | journal=J Clin Sleep Med | year= 2017 | volume= 13 | issue= 3 | pages= 479-504 | pmid=28162150 | doi=10.5664/jcsm.6506 | pmc=5337595 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28162150  }} </ref><ref name="pmid29183053">{{cite journal| author=Mokhlesi B, Cifu AS| title=Diagnostic Testing for Obstructive Sleep Apnea in Adults. | journal=JAMA | year= 2017 | volume= 318 | issue= 20 | pages= 2035-2036 | pmid=29183053 | doi=10.1001/jama.2017.16722 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29183053  }} </ref> address screening and diagnosis.


Obstructive sleep apnea (OSA) is not only much more frequent than central sleep apnea, it is a common condition in many parts of the world. If studied carefully in a sleep lab by polysomnography, approximately 1 in 5 American adults has at least mild OSA<ref name="pmid14532320">{{cite journal| author=Shamsuzzaman AS, Gersh BJ, Somers VK| title=Obstructive sleep apnea: implications for cardiac and vascular disease. | journal=JAMA | year= 2003 | volume= 290 | issue= 14 | pages= 1906-14 | pmid=14532320 | doi=10.1001/jama.290.14.1906 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14532320  }} </ref>. Since the muscle tone of the body ordinarily relaxes during sleep, and since, at the level of the throat, the human airway is composed of walls of soft tissue, which can collapse, it is easy to understand why breathing can be obstructed during sleep.  Although many individuals experience episodes of obstructive sleep apnea at some point in life, a much smaller percentage of people are afflicted with chronic severe obstructive sleep apnea.
==[[Sleep apnea historical perspective|Historical Perspective]]==


Normal sleep/wakefulness in adults has distinct stages  numbered 1 to 4, REM sleep, and wake. The deeper stages (3 to 4) are required for the physically restorative effects of sleep and in pre-adolescents are the focus of release for human growth hormone.  Stages 2 and REM, which combined are 70% of an average person's total sleep time, are more associated with mental recovery and maintenance.  During REM sleep in particular, muscle tone of the throat and neck, as well as the vast majority of all skeletal muscles, is almost completely attenuated, allowing the tongue and soft palate/oropharynx to relax, and in the case of sleep apnea, to impede the flow of air to a degree ranging from light [[snoring]] to complete collapse. In the cases where airflow is reduced to a degree where blood oxygen levels fall, or the physical exertion to breathe is too great, neurological mechanisms trigger a sudden interruption of sleep, called a neurological arousal.  These arousals may or may not result in complete awakening, but can have a significant negative effect on the restorative quality of sleep.  In significant cases of obstructive sleep apnea, one consequence is sleep deprivation due to the repetitive disruption and recovery of sleep activity.  This sleep interruption in stages 3 and 4 (also collectively called slow-wave sleep), can interfere with normal growth patterns, healing, and immune response, especially in children and young adults.
==[[Sleep apnea classification|Classification]]==


Many people experience elements of obstructive sleep apnea for only a short period of time. This can be the result of an upper respiratory infection that causes nasal congestion, along with swelling of the throat, or tonsillitis that temporarily produces very enlarged tonsils. The [[Epstein-Barr virus]], for example, is known to be able to dramatically increase the size of lymphoid tissue during acute infection, and obstructive sleep apnea is fairly common in acute cases of severe [[infectious mononucleosis]]. Temporary spells of obstructive sleep apnea syndrome may also occur in individuals who are under the influence of a drug (such as alcohol) that may relax their body tone excessively and interfere with normal arousal from sleep mechanisms.
==[[Sleep apnea epidemiology|Epidemiology]]==
==[[Sleep apnea risk factors|Risk factors]]==
==[[Sleep apnea pathophysiology|Pathophysiology]]==
==[[Sleep apnea pathophysiology|Pathophysiology]]==
==[[Sleep apnea natural history|Natural History, Complications and Prognosis]]==
 
==[[Sleep apnea causes|Causes]]==
==[[Sleep apnea causes|Causes]]==
== Diagnosis ==  
 
:[[Sleep apnea history and symptoms| History and Symptoms]] | [[Sleep apnea physical examination | Physical Examination]] | [[Sleep apnea laboratory studies | Lab Studies]] | [[Sleep apnea electrocardiogram|Electrocardiogram]] | [[Sleep apnea polysomnography|Polysomnography]] | [[Sleep apnea home oximetry|Home Oximetry]] | [[Sleep apnea other imaging findings|Other imaging findings]]
==[[Sleep apnea differential diagnosis|Differentiating Sleep Apnea From Other Diseases]]==
 
==[[Sleep apnea epidemiology and demographics|Epidemiology and Demographics]]==
 
==[[Sleep apnea risk factors|Risk Factors]]==
 
==[[Sleep apnea screening|Screening]]==
 
==[[Sleep apnea natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
 
==Diagnosis==
 
[[Sleep apnea diagnostic criteria|Diagnostic Criteria]] | [[Sleep apnea history and symptoms|History and Symptoms]] | [[Sleep apnea physical examination|Physical Examination]] | [[Sleep apnea laboratory findings|Laboratory Findings]] | [[Sleep apnea CT|CT]] | [[Sleep apnea MRI|MRI]] | [[Sleep apnea echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[Sleep apnea other imaging findings|Other Imaging Findings]] | [[Sleep apnea other diagnostic studies|Other Diagnostic Studies]]


==Treatment==
==Treatment==
:[[Sleep apnea medical treatment| Medical Treatment]] | [[Sleep apnea surgical treatment| Surgical Treatment]] | [[Sleep apnea other treatment| Other Treatments]]
[[Sleep apnea medical therapy|Medical Therapy]] | [[Sleep apnea surgery|Surgery]] | [[Sleep apnea primary prevention|Primary Prevention]] | [[Sleep apnea secondary prevention|Secondary Prevention]] | [[Sleep apnea cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Sleep apnea future or investigational therapies|Future or Investigational Therapies]]


==See also==
==Case Studies==
*[[Marfan syndrome]]


==References==
{{reflist|2}}   


{{Diseases of the nervous system}}
{{Diseases of the nervous system}}
{{SleepSeries2}}
{{SleepSeries2}}
{{SIB}}


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[[de:Schlafapnoe-Syndrom]]
[[et:Uneapnoe]]
[[el:Άπνοια ύπνου]]
[[es:Síndrome de apnea-hipopnea durante el sueño]]
[[es:Síndrome de apnea-hipopnea durante el sueño]]
[[fr:Apnée du sommeil]]
[[fr:Apnée du sommeil]]
[[id:Sleep apnea]]
 
[[it:Apnea nel sonno]]
[[ml:കൂര്‍ക്കം വലി]]
[[nl:Slaapapneu]]
[[ja:睡眠時無呼吸症候群]]
[[ja:睡眠時無呼吸症候群]]
[[no:Søvnapné]]
 
[[nn:Søvnapné]]
[[pt:Apnéia do sono]]
[[pt:Apnéia do sono]]
[[fi:Uniapnea]]
 
[[sv:Sömnapné]]
[[zh:睡眠呼吸暂停]]
[[zh:睡眠呼吸暂停]]


[[tr:Uyku Apnesi]]
[[tr:Uyku Apnesi]]
{{WH}}
{{WS}}


[[Category:Sleep disorders]]
[[Category:Medical conditions related to obesity]]
[[Category:Pulmonology]]
[[Category:Pulmonology]]
[[Category:Cardiology]]
[[Category:Cardiology]]
[[Category:Signs and symptoms]]
[[Category:Cardiology]]
[[Category:Primary care]]
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Latest revision as of 00:12, 30 July 2020

Sleep Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Sleep apnea from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Criteria

History and Symptoms

Physical Examination

Laboratory Findings

Polysomnography

Home Oximetry

CT

MRI

Ultrasound

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

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Sleep Apnea

For patient information about sleep apnea click here

For patient information about central sleep apnea click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Saarah T. Alkhairy, M.D.

Overview

Clinical practice guidelines by the United States Preventive Services Task Force[1] and the American Academy of Sleep Medicine[2][3] address screening and diagnosis.

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Sleep Apnea From Other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Criteria | History and Symptoms | Physical Examination | Laboratory Findings | CT | MRI | Echocardiography or Ultrasound | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Template:Diseases of the nervous system Template:SleepSeries2 Template:WH Template:WS

  1. ↑ US Preventive Services Task Force. Bibbins-Domingo K, Grossman DC, Curry SJ, Davidson KW, Epling JW et al. (2017) Screening for Obstructive Sleep Apnea in Adults: US Preventive Services Task Force Recommendation Statement. JAMA 317 (4):407-414. DOI:10.1001/jama.2016.20325 PMID: 28118461
  2. ↑ Kapur VK, Auckley DH, Chowdhuri S, Kuhlmann DC, Mehra R, Ramar K; et al. (2017). "Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline". J Clin Sleep Med. 13 (3): 479–504. doi:10.5664/jcsm.6506. PMC 5337595. PMID 28162150.
  3. ↑ Mokhlesi B, Cifu AS (2017). "Diagnostic Testing for Obstructive Sleep Apnea in Adults". JAMA. 318 (20): 2035–2036. doi:10.1001/jama.2017.16722. PMID 29183053.
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