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Obstructive Sleep Apnea

Jay F. Piccirillo, MD; Stephen Duntley, MD; Helena Schotland, MD
JAMA. 2000;284(12):1492-1494. doi:10.1001/jama.284.12.1492.
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Obstructive sleep apnea (OSA) syndrome affects an estimated 2% to 4% of the US adult population.1 It is part of a collection of sleep-related breathing disorders, that include snoring, upper airway resistance syndrome,2 and obesity-hypoventilation syndrome.3 The clinical sequelae of untreated OSA syndrome are often severe and include daytime hypersomnolence, cognitive impairment, systemic hypertension, pulmonary hypertension, myocardial infarction, cardiac arrhythmias, and increased risk of motor vehicle crashes.4,5 Unfortunately, the majority of patients with OSA syndrome remain undiagnosed and untreated.6

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Figure. Algorithm for the Management of Patients With Sleep-Related Breathing Disorders
Graphic Jump Location
RDI indicates respiratory disturbance index; UARS, upper airway resistance syndrome; CPAP, continuous positive airway pressure; LAUP, laser-assisted uvulopalatoplasty; PAP, positive airway pressure; and CNS, central nervous system. Asterisk indicates that physician should consider position therapy for all patients with an RDI lower than 5 when in lateral position. Dagger indicates that first-line treatment is influenced by the existence and severity of comorbid ailments and severity of presenting symptoms.

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