Diagnosis and Management of Obstructive Sleep Apnea: A Review
Abstract
Importance: Obstructive sleep apnea (OSA) affects 17% of women and 34% of men in the US and has a similar prevalence in other countries. This review provides an update on the diagnosis and treatment of OSA. Observations: The most common presenting symptom of OSA is excessive sleepiness, although this symptom is reported by as few as 15% to 50% of people with OSA in the general population. OSA is associated with a 2- to 3-fold increased risk of cardiovascular and metabolic disease. In many patients, OSA can be diagnosed with home sleep apnea testing, which has a sensitivity of approximately 80%. Effective treatments include weight loss and exercise, positive airway pressure, oral appliances that hold the jaw forward during sleep, and surgical modification of the pharyngeal soft tissues or facial skeleton to enlarge the upper airway. Hypoglossal nerve stimulation is effective in select patients with a body mass index less than 32. There are currently no effective pharmacological therapies. Treatment with positive airway pressure lowers blood pressure, especially in patients with resistant hypertension; however, randomized clinical trials of OSA treatment have not demonstrated significant benefit on rates of cardiovascular or cerebrovascular events. Conclusions and Relevance: OSA is common and the prevalence is increasing with the increased prevalence of obesity. Daytime sleepiness is among the most common symptoms, but many patients with OSA are asymptomatic. Patients with OSA who are asymptomatic, or whose symptoms are minimally bothersome and pose no apparent risk to driving safety, can be treated with behavioral measures, such as weight loss and exercise. Interventions such as positive airway pressure are recommended for those with excessive sleepiness and resistant hypertension. Managing asymptomatic OSA to reduce cardiovascular and cerebrovascular events is not currently supported by high-quality evidence.
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Obstructive sleep apnea affects approximately 25% of adults in the US and similar amounts in other high-income countries, although estimates vary depending on its definition.
“Obstructive sleep apnea (OSA) is a highly prevalent sleep disorder that affects approximately 25% of adults in the US and similar amounts in other high-income countries, although estimates vary depending on its definition (Gottlieb & Punjabi, 2020;Benjafield et al., 2019).”
From Effects of mindfulness meditation and Acceptance and commitment therapy in patients with obstructive sleep apnea with residual excessive sleepiness: A randomized controlled pilot study (2023) · cites this paper as Gottlieb & Punjabi, 2020
Airway dysfunction causes autonomic nervous system dysregulation, sleep fragmentation, insulin resistance, systemic inflammation, oxidative stress, and vascular endothelial dysfunction.
“Airway dysfunction causes autonomic nervous system dysregulation, sleep fragmentation, insulin resistance, systemic inflammation, oxidative stress, and vascular endothelial dysfunction [3].”
From Pregnancy outcomes in infertility patients diagnosed with sleep disordered breathing with wireless wearable sensors (2022) · cites this paper as [3]
SDB may be associated with adverse early pregnancy rates given increases in stress, fatigue, overnight hypoxemia, and systemic inflammation.
“SDB may be associated with adverse early pregnancy rates given increases in stress, fatigue, overnight hypoxemia and systemic inflammation [3].”
From Pregnancy outcomes in infertility patients diagnosed with sleep disordered breathing with wireless wearable sensors (2022) · cites this paper as [3]
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Obstructive Sleep Apnea in Patients Undergoing Bariatric Surgery—A Tertiary Center Experience
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Determinants for adherence to continuous positive airway pressure therapy in obstructive sleep apnea
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Obstructive Sleep Apnea and Oxygen Therapy: A Systematic Review of the Literature and Meta-Analysis
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Positional therapy for obstructive sleep apnoea
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Calibration Model for Apnea-Hypopnea Indices: Impact of Alternative Criteria for Hypopneas
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Self-citationHeadache in sleep apnea syndrome: Epidemiology and pathophysiology
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Sleep and Nocturnal Gastroesophageal Reflux
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Efficacy of pharmacotherapy for OSA in adults: A systematic review and network meta-analysis
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Tonsillectomy with Uvulopalatopharyngoplasty in Obstructive Sleep Apnea
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The prevalence of obstructive sleep apnea in patients with atrial fibrillation
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Portable Sleep Monitoring for Diagnosing Sleep Apnea in Hospitalized Patients With Heart Failure
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Self-citationPositional therapy for obstructive sleep apnoea
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on behalf of the TESLA-investigator group, He, B., Al-Sherif, M., Nido, M., Tas, R. N., Beach, M., Schwarz, E. I., Cheng, M. C. F., Ishak, A., Lee, K. N., et al. (2019) · Journal of Thoracic Disease · doi:10.21037/jtd.2019.05.04 · Cited by 21 · see citing works
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Benefits and Risks of Bariatric Surgery in Adults: A Review
Arterburn, D. E., Telem, D. A., Kushner, R. F., & Courcoulas, A. P. (2020) · JAMA · doi:10.1001/jama.2020.12567 · Cited by 1,251 · see citing works
Diretrizes Brasileiras de Hipertensão Arterial – 2020
Barroso, W. K. S., Rodrigues, C. I. S., Bortolotto, L. A., Gomes, M. A. M., Brandão, A. A., Feitosa, A. D. M., Machado, C. A., Poli‐de‐Figueiredo, C. E., Amodeo, C., Mion, D., et al. (2021) · Arquivos Brasileiros de Cardiologia · doi:10.36660/abc.20201238 · Cited by 1,305 · see citing works
Pathophysiological mechanisms and therapeutic approaches in obstructive sleep apnea syndrome
Lv, R., Liu, X., Zhang, Y., Dong, N., Wang, X., He, Y., Yue, H., & Yin, Q. (2023) · Signal Transduction and Targeted Therapy · doi:10.1038/s41392-023-01496-3 · Cited by 521 · see citing works
Metrics of sleep apnea severity: beyond the apnea-hypopnea index
Malhotra, A., Ayappa, I., Ayas, N., Collop, N., Kirsch, D., Mcardle, N., Mehra, R., Pack, A. I., Punjabi, N., White, D. P., et al. (2021) · SLEEP · doi:10.1093/sleep/zsab030 · Cited by 489 · see citing works
“, assessment of the autonomic nervous system or EEG) and [3] individual response to therapy (e.”
BackgroundSelf-citationInternational Consensus Statement on Obstructive Sleep Apnea
Chang, J. L., Goldberg, A. N., Alt, J. A., Mohammed, A., Ashbrook, L., Auckley, D., Ayappa, I., Bakhtiar, H., Barrera, J. E., Bartley, B. L., et al. (2023) · International Forum of Allergy & Rhinology · doi:10.1002/alr.23079 · Cited by 350 · see citing works
Self-citationObstructive sleep apnoea heterogeneity and cardiovascular disease
Redline, S. S., Azarbarzin, A., & Peker, Y. (2023) · Nature Reviews Cardiology · doi:10.1038/s41569-023-00846-6 · Cited by 346 · see citing works
de Zambotti, M., Goldstein, C. A., Cook, J. D., Menghini, L., Altini, M., Cheng, P., & Robillard, R. (2023) · SLEEP · doi:10.1093/sleep/zsad325 · Cited by 262 · see citing works
“Given the relevance of OSA for daytime function, management of certain chronic conditions, and risk of incident disease (particularly cardiovascular) [91], the lack of high-quality evidence regarding the ability of consumer-grade wearables to detect OSA prevents their use as a diagnostic tool.”
The Sleep Apnea–Specific Pulse-Rate Response Predicts Cardiovascular Morbidity and Mortality
Azarbarzin, A., Sands, S. A., Younes, M. K., Taranto‐Montemurro, L., Sofer, T., Vena, D., Alex, R. M., Kim, S., Gottlieb, D. J., White, D. P., et al. (2021) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.202010-3900oc · Cited by 208 · see citing works
“demonstrate a reduction in CVD events or mortality (4, 6, 7), posing a significant challenge to therapeutic decision-making in individuals with OSA (8).”
BackgroundSelf-citationThe association between sleep and depressive symptoms in US adults: data from the NHANES (2007–2014)
Li, C., Shaomei, S., & Wannian, L. (2022) · Epidemiology and Psychiatric Sciences · doi:10.1017/s2045796022000452 · Cited by 178 · see citing works
CPAP Therapy Termination Rates by OSA Phenotype: A French Nationwide Database Analysis
Pépin, J., Bailly, S., Rinder, P., Adler, D., Szeftel, D., Malhotra, A., Cistulli, P. A., Benjafield, A., Lavergne, F., Josseran, A., et al. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10050936 · Cited by 171 · see citing works
“Furthermore, the fact that CPAP has not had any significant effects on the cardiovascular event rate in randomized clinical trials to date [10,11,23] means that the benefits of this treatment approach in unselected patient groups may be difficult to justify [29].”
BackgroundCarneiro‐Barrera, A., Amaro‐Gahete, F. J., Guillén‐Riquelme, A., Jurado‐Fasoli, L., Sáez-Roca, G., Martín-Carrasco, C., Buela‐Casal, G., & Ruiz, J. R. (2022) · JAMA Network Open · doi:10.1001/jamanetworkopen.2022.8212 · Cited by 153 · see citing works
Kuna, S. T., Reboussin, D. M., Strotmeyer, E. S., Millman, R. P., Zammit, G., Walkup, M. P., Wadden, T. A., Wing, R. R., Pi-Sunyer, F. X., Spira, A. P., et al. (2021) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201912-2511oc · Cited by 151 · see citing works
“Obesity is a major risk factor for obstructive sleep apnea (OSA) (1, 2).”
BackgroundInteractions of Obstructive Sleep Apnea With the Pathophysiology of Cardiovascular Disease, Part 1
Javaheri, S., Javaheri, S., Somers, V. K., Gozal, D., Mokhlesi, B., Mehra, R., McNicholas, W. T., Zee, P. C., Campos‐Rodríguez, F., Martínez‐García, M. Á., et al. (2024) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2024.02.059 · Cited by 157 · see citing works
Sleep apnoea and ischaemic stroke: current knowledge and future directions
Baillieul, S., Dekkers, M., Brill, A.-K., Schmidt, M. H., Detante, O., Pépin, J., Tamisier, R., & Bassetti, C. L. A. (2021) · The Lancet Neurology · doi:10.1016/s1474-4422(21)00321-5 · Cited by 140 · see citing works
The Role of Sleep in Cardiovascular Disease
Jaspan, V. N., Greenberg, G. S., Parihar, S., Park, C. M., Somers, V. K., Shapiro, M. D., Lavie, C. J., Virani, S. S., & Slipczuk, L. N. (2024) · Current Atherosclerosis Reports · doi:10.1007/s11883-024-01207-5 · Cited by 140 · see citing works
Traaen, G. M., Aakerøy, L., Hunt, T.-E., Øverland, B., Bendz, C., Sande, L. Ø., Aakhus, S., Fagerland, M. W., Steinshamn, S., Anfinsen, O., et al. (2021) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.202011-4133oc · Cited by 121 · see citing works
Salari, N., Far, A. H., Mohammadi, M., Ghasemi, H., Khazaie, H., Daneshkhah, A., & Ahmadi, A. (2021) · Expert Systems with Applications · doi:10.1016/j.eswa.2021.115950 · Cited by 112 · see citing works
“Accordingly, PSG examines sleep and respiration parameters using electroencephalogram, electrocardiogram (ECG 4 ), electroechogram, electromyogram, pulse oximetry, airflow measurement. and respiratory effort (Rundo & Downey, 2019; Gottlieb & Punjabi, 2020; Rundo & Downey, 2019).”
Singh, B., Ahmed, M., Staiano, A. E., Gough, C., Petersen, J., Vandelanotte, C., Kracht, C., Huong, C., Yin, Z., Vasiloglou, M. F., et al. (2024) · npj Digital Medicine · doi:10.1038/s41746-024-01172-y · Cited by 115 · see citing works
Endotypic Mechanisms of Successful Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea
de Beeck, S. O., Wellman, A., Dieltjens, M., Strohl, K. P., Willemen, M., de Heyning, P. V., Verbraecken, J. A., Vanderveken, O. M., & Sands, S. A. (2020) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.202006-2176oc · Cited by 113 · see citing works
Deep learning for obstructive sleep apnea diagnosis based on single channel oximetry
Levy, J., Álvarez, D., Campo, F. D., & Behar, J. A. (2023) · Nature Communications · doi:10.1038/s41467-023-40604-3 · Cited by 102 · see citing works
Schweitzer, P. K., Taranto‐Montemurro, L., Ojile, J. M., Thein, S., Drake, C. L., Rosenberg, R. P., Corser, B. C., Abaluck, B., Sangal, R. B., & Maynard, J. (2023) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.202306-1036oc · Cited by 104 · see citing works
“The ef fi cacy of alternative treatment options such as oral appliances, upper airway surgeries, and hypoglossal nerve stimulation is patient-dependent and challenging to predict (8, 9).”
BackgroundSleep apnoea and ischaemic stroke: current knowledge and future directions.
Baillieul, S., Dekkers, M. P. J., Brill, A., Schmidt, M. H., Detante, O., Pépin, J., Tamisier, R., & Bassetti, C. L. (2022) · doi:10.48350/163559 · Cited by 100 · see citing works
A Survey on Recent Advances in Machine Learning Based Sleep Apnea Detection Systems
Ramachandran, A., & Karuppiah, A. (2021) · Healthcare · doi:10.3390/healthcare9070914 · Cited by 98 · see citing works
“ECG analyzes the rhythm of heartbeats and blood flow to the heart muscles and is measured using an ECG machine or a single lead ECG. SPO2 indicates the measure of oxygen in the blood.”
BackgroundMethodObesity and Endothelial Function
Kajikawa, M., & Higashi, Y. (2022) · Biomedicines · doi:10.3390/biomedicines10071745 · Cited by 93 · see citing works
“It is well known that obesity is a risk factor for the development of obstructive sleep apnea syndrome (OSAS), which is characterized by repeated episodes of obstruction of the respiratory passages during sleep that results in intermittent hypoxia and sleep fragmentation [83].”
BackgroundMalhotra, A., Bednařík, J., Chakladar, S., Dunn, J. P., Weaver, T. E., Grunstein, R. R., Fietze, I., Redline, S. S., Azarbarzin, A., Sands, S. A., et al. (2024) · Contemporary Clinical Trials · doi:10.1016/j.cct.2024.107516 · Cited by 104 · see citing works
Wang, X., Fan, J., Guo, R., Hao, W., Gong, W., Yan, Y., Zheng, W., Ai, H., Que, B., Hu, D., et al. (2022) · European Respiratory Journal · doi:10.1183/13993003.01110-2022 · Cited by 90 · see citing works
“OSA is associated with oxidative stress, sympathetic activation, inflammatory responses and endothelial dysfunction that could induce or exacerbate cardiovascular comorbidities [2, 3], including acute coronary syndrome (ACS) [4].”
The Effects of Obstructive Sleep Apnea on the Cardiovascular System: A Comprehensive Review
Dicaro, M. V., Lei, K., Yee, B., & Tak, T. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13113223 · Cited by 99 · see citing works
Obstructive Sleep Apnea and Cardiometabolic Disease: Obesity, Hypertension, and Diabetes
Tasali, E., Pamidi, S., Covassin, N., & Somers, V. K. (2025) · Circulation Research · doi:10.1161/circresaha.125.325676 · Cited by 100 · see citing works
A flexible catheter-based sensor array for upper airway soft tissues pressure monitoring
Shang, J., Ma, X., Zou, P., Huang, C., Lao, Z., Wang, J., Jiang, T., Fu, Y., Li, J., Zhang, S., et al. (2025) · Nature Communications · doi:10.1038/s41467-024-55088-y · Cited by 83 · see citing works
“While polysomnography (PSG) is the gold standard for OSA diagnosis, capturing various sleep-related physiological parameters, it falls short in obstruction localization 1,13 .”
InfluentialDiet Composition and Objectively Assessed Sleep Quality: A Narrative Review
Wilson, K. K., St‐Onge, M., & Tasali, E. (2022) · Journal of the Academy of Nutrition and Dietetics · doi:10.1016/j.jand.2022.01.007 · Cited by 86 · see citing works
Incremental health care utilization and expenditures for sleep disorders in the United States
Huyett, P. A., & Bhattacharyya, N. (2021) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.9392 · Cited by 80 · see citing works
An Update on Obstructive Sleep Apnea Syndrome—A Literature Review
Platon, A. L., Stelea, C. G., Boișteanu, O., Pătrășcanu, E., Zetu, I. N., Rosu, S. N., Trifan, V., & Palade, D. O. (2023) · Medicina · doi:10.3390/medicina59081459 · Cited by 86 · see citing works
“Behavioral therapy is recommended for asymptomatic patients or for those who have no apparent risk to driving safely [31].”
BackgroundZhou, T., Chen, S., Mao, J., Zhu, P., Yu, X., & Lin, R. (2024) · Lipids in Health and Disease · doi:10.1186/s12944-024-02081-5 · Cited by 73 · see citing works
“Its primary symptom is excessive daytime drowsiness [1, 2].”
BackgroundProgress in the treatment of knee osteoarthritis with high tibial osteotomy: a systematic review
He, M., Zhong, X.-H., Li, Z., Shen, K., & Zeng, W. (2021) · Systematic Reviews · doi:10.1186/s13643-021-01601-z · Cited by 71 · see citing works
Sleep Apnea, Obesity, and Diabetes — an Intertwined Trio
Kurnool, S., McCowen, K. C., Bernstein, N., & Malhotra, A. (2023) · Current Diabetes Reports · doi:10.1007/s11892-023-01510-6 · Cited by 66 · see citing works
“However, despite general acknowledgement that diet, exercise, and sleep are the three pillars of health [14, 15], most OSA remains undiagnosed and untreated [16, 17].”
Effects of Obstructive Sleep Apnea and CPAP on Cognitive Function
Seda, G., Matwiyoff, G. N., & Parrish, S. (2021) · Current Neurology and Neuroscience Reports · doi:10.1007/s11910-021-01123-0 · Cited by 63 · see citing works
Research routes on improved sleep bruxism metrics: Toward a standardised approach
Lavigne, G. J., Kato, T., Babiloni, A. H., Huynh, N. T., Fabbro, C. D., Svensson, P. J., Aarab, G., Ahlberg, J., Baba, K., Carra, M. C., et al. (2021) · Journal of Sleep Research · doi:10.1111/jsr.13320 · Cited by 61 · see citing works
Liu, S., Shen, J., Li, Y., Wang, J., Wang, J., Xu, J., Wang, Q., & Chen, R. (2021) · Frontiers in Neurology · doi:10.3389/fneur.2021.643855 · Cited by 58 · see citing works
Kanclerska, J., Wieckiewicz, M. A., Nowacki, D., Szymańska–Chabowska, A., Poręba, R., Mazur, G. J., & Martynowicz, H. (2023) · Dental and Medical Problems · doi:10.17219/dmp/172243 · Cited by 65 · see citing works
Cao, Y., Song, Y., Ning, P., Zhang, L., Wu, S., Quan, J., & Li, Q. (2020) · BMC Pulmonary Medicine · doi:10.1186/s12890-020-01253-0 · Cited by 55 · see citing works
Effects of Exercise on Patients with Obstructive Sleep Apnea: A Systematic Review and Meta-Analysis
Peng, J., Yuan, Y., Zhao, Y., & Ren, H. C. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph191710845 · Cited by 55 · see citing works
“It is also related to gender and weight; it is almost several times higher in men than in women [3] and in obese people compared to people of normal weight [2,4].”
BackgroundHao, S., Zhu, X., Liu, Z., Wu, X., Li, S., Jiang, P., & Jiang, L. (2021) · Respiratory Research · doi:10.1186/s12931-021-01655-6 · Cited by 55 · see citing works
“OSA is associated with a wide array of morbidities and mortalities including metabolic syndrome, cardiovascular and cognitive disorders [2].”
BackgroundMulti-night measurement for diagnosis and simplified monitoring of obstructive sleep apnoea
Lechat, B., Scott, H., Manners, J., Adams, R., Proctor, S., Mukherjee, S., CATCHESIDE, P. G., Eckert, D. J., Vakulin, A., & Reynolds, A. C. (2023) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2023.101843 · Cited by 58 · see citing works
Du, D., Zhang, G., Xu, D., Liu, L., Hu, X., Chen, L., Li, X., Shen, Y., & Wen, F. (2023) · Sleep Medicine · doi:10.1016/j.sleep.2023.10.034 · Cited by 54 · see citing works
The causal relationships between obstructive sleep apnea and elevated CRP and TNF-α protein levels
Yi, M., Zhao, W., Tan, Y. L., Fei, Q., Liu, K., Chen, Z., & Zhang, Y. (2022) · Annals of Medicine · doi:10.1080/07853890.2022.2081873 · Cited by 53 · see citing works
“disarrangement to physiological homoeostasis [3].”
Highlights of mechanisms and treatment of obesity-related hypertension
Shams, E., Kamalumpundi, V., Peterson, J., Gismondi, R. A., Oigman, W., & Correia, M. (2022) · Journal of Human Hypertension · doi:10.1038/s41371-021-00644-y · Cited by 57 · see citing works
Endocrine disorders in obstructive sleep apnoea syndrome: A bidirectional relationship
Akset, M., Poppe, K. G., Kleynen, P., Bold, I., & Bruyneel, M. (2022) · Clinical Endocrinology · doi:10.1111/cen.14685 · Cited by 54 · see citing works
“Obesity is one of the strongest sleep apnoea risk factors, with an odds ratio (OR) of disease occurrence of 4–10 compared with normal weight individuals.(4) Epidemiologic studies have shown that the prevalence of OSA among individuals aged 30–49 years with a normal body mass index (BMI) < 25 kg/m2 is 1.”
BackgroundCampos, A. I., Ingold, N., Huang, Y., Mitchell, B. L., Kho, P. F., Han, X., García‐Marín, L. M., Ong, J., Agee, M., Aslibekyan, S., et al. (2022) · SLEEP · doi:10.1093/sleep/zsac308 · Cited by 51 · see citing works
Revolutionizing Sleep Health: The Emergence and Impact of Personalized Sleep Medicine
Garbarino, S., & Bragazzi, N. L. (2024) · Journal of Personalized Medicine · doi:10.3390/jpm14060598 · Cited by 49 · see citing works
“From a gender perspective, this pathology affects 17% and 34% of women and men, respectively, and excessive daytime sleepiness is its most common presenting symptom, although it is reported by as few as 15–50% of people with OSA in the general population [73–76].”
BackgroundObstructive Sleep Apnea, Circadian Clock Disruption, and Metabolic Consequences
Malicki, M., Karuga, F. F., Szmyd, B. M., Sochal, M., & Gabryelska, A. (2022) · Metabolites · doi:10.3390/metabo13010060 · Cited by 49 · see citing works
“Several studies have discussed the link between OSA and circadian clock disruption [192].”
Approach the Patient With Obstructive Sleep Apnea and Obesity
Meyer, E. J., & Wittert, G. (2023) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgad572 · Cited by 54 · see citing works
New frontiers in pharmacologic obstructive sleep apnea treatment: A narrative review
Schütz, S. G., Dunn, A., Braley, T. J., Pitt, B., & Shelgikar, A. V. (2021) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2021.101473 · Cited by 47 · see citing works
Obstructive sleep apnea and road traffic accidents: a Danish nationwide cohort study
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Impact of obesity on pulmonary function: current understanding and knowledge gaps
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“such as dyspnea [2] and exercise intolerance [3] and is an important contributor to many cardiopulmonary diseases including asthma [4,5], chronic obstructive pulmonary disease (COPD) [6,7], sleepdisordered breathing [8,9], heart failure [10], and coronary artery disease [11].”
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Causal analysis between altered levels of interleukins and obstructive sleep apnea
Yi, M., Zhao, W., Fei, Q., Tan, Y., Liu, K., Chen, Z., & Zhang, Y. (2022) · Frontiers in Immunology · doi:10.3389/fimmu.2022.888644 · Cited by 45 · see citing works
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Explainable machine learning for sleep apnea prediction
Troncoso-García, A. R., Martínez-Ballesteros, M., Alvarez, F. M., & Troncoso, A. (2022) · Procedia Computer Science · doi:10.1016/j.procs.2022.09.351 · Cited by 43 · see citing works
Association of lifestyle with sleep health in general population in China: a cross-sectional study
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Zhang, H.-J., Zhou, L., Zhou, Y.-H., Wang, L.-L., Jiang, W.-L., Liu, L., Yue, S., Zheng, P.-D., & Liu, H.-G. (2021) · Life Science · doi:10.1016/j.lfs.2021.119963 · Cited by 41 · see citing works
McCall, C. A., & Watson, N. F. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11020415 · Cited by 42 · see citing works
“Surgical options for treating OSA also include modification of the upper airway soft tissue, including the palate, tongue base, and lateral pharyngeal walls [98].”
BackgroundEvaluation and Management of Secondary Hypertension
Sarathy, H., Salman, L. A., Lee, C. S., & Cohen, J. B. (2022) · Medical Clinics of North America · doi:10.1016/j.mcna.2021.11.004 · Cited by 48 · see citing works
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Defining obstructive sleep apnoea syndrome: a failure of semantic rules
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“OSAS runs in families and is probably due to heritable craniofacial and dental structures, control of breathing, and fat deposition propensity [12].”
BackgroundInfluentialAutomatically detecting apnea-hypopnea snoring signal based on VGG19 + LSTM
Ding, L., Peng, J., Song, L., & Zhang, X. (2022) · Biomedical Signal Processing and Control · doi:10.1016/j.bspc.2022.104351 · Cited by 41 · see citing works
Gaspar, L. S., Hesse, J., Yalçın, M., Santos, B., Carvalhas-Almeida, C., Ferreira, M., Moita, J. J., Relógio, A., Cavadas, C., & Álvaro, A. R. (2021) · EBioMedicine · doi:10.1016/j.ebiom.2021.103248 · Cited by 40 · see citing works
“However, the low compliance of some patients to CPAP treatment, together with the controversial effects of CPAP treatment on OSA symptoms and comorbidities, questions the efficacy of this palliative strategy [13,14].”
Obstructive sleep apnea and incidence of malignant tumors: a meta-analysis
Cheng, L., Guo, H., Zhang, Z., Yao, Y., & Yao, Q. (2021) · Sleep Medicine · doi:10.1016/j.sleep.2021.05.029 · Cited by 40 · see citing works
Poncin, W., Correvon, N., Tam, J., Borel, J., Berger, M., Liistro, G., Mwenge, B., Heinzer, R. C., & Contal, O. (2022) · Journal of Oral Rehabilitation · doi:10.1111/joor.13369 · Cited by 39 · see citing works
Papaetis, G. S. (2023) · Archives of Medical Science - Atherosclerotic Diseases · doi:10.5114/amsad/161170 · Cited by 40 · see citing works
Obstructive Sleep Apnea and Cardiovascular Disease: Where Do We Stand?
Peker, Y. (2023) · The Anatolian Journal of Cardiology · doi:10.14744/anatoljcardiol.2023.3307 · Cited by 39 · see citing works
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“OSA leads to frequent hypoxemia, hypercapnia, and sleep architecture disorders [1].”
BackgroundObesity and the increased risk for COVID-19: mechanisms and nutritional management
Morais, A. H. D. A., Passos, T. S., Vale, S. H. D. L., da Silva-Maia, J. K., & Maciel, B. L. L. (2020) · Nutrition Research Reviews · doi:10.1017/s095442242000027x · Cited by 39 · see citing works
Dharmakulaseelan, L., & Boulos, M. I. (2024) · CHEST Journal · doi:10.1016/j.chest.2024.04.028 · Cited by 44 · see citing works
“65 This approach is potentially promising for patients with stroke, given that patients with stroke with OSA tend to have lower BMIs (compared with patients with OSA in the general population).”
BackgroundSleep apnea is a common and dangerous cardiovascular risk factor
Henning, R. J., & Anderson, W. M. (2024) · Current Problems in Cardiology · doi:10.1016/j.cpcardiol.2024.102838 · Cited by 38 · see citing works
Atherogenic Index of Plasma in Obstructive Sleep Apnoea
Bikov, A., Mészáros, M., Kunos, L., Negru, A. G., Frent, S., & Mihaicuta, S. D. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10030417 · Cited by 39 · see citing works
“Obstructive sleep apnoea is a common disease and a significant risk factor for cardiovascular disease [29].”
BackgroundSleep Disorders in Adults with Down Syndrome
Giménez, S., Altuna, M., Blessing, E., Osorio, R. M., & Fortea, J. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10143012 · Cited by 39 · see citing works
“Obstructive sleep apnea (OSA) is the most frequent sleep breathing disorder, characterized by recurrent events of partial (hypopnea) or complete (apnea) upper airway obstruction with disruption of normal oxygenation, ventilation, and sleep patterns (Figure 4) [35].”
BackgroundInfluentialZhang, Y., Elgart, M., Kurniansyah, N., Spitzer, B., Wang, H., Kim, D., Shah, N. A., Daviglus, M. L., Zee, P. C., Cai, J., et al. (2022) · EBioMedicine · doi:10.1016/j.ebiom.2022.104288 · Cited by 35 · see citing works
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Natural sleep endoscopy in obstructive sleep apnea: A systematic review
den Bossche, K. V., de Perck, E. V., Kazemeini, E., Willemen, M., de Heyning, P. V., Verbraecken, J. A., de Beeck, S. O., & Vanderveken, O. M. (2021) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2021.101534 · Cited by 37 · see citing works
Association of healthy lifestyle with risk of obstructive sleep apnea: a cross-sectional study
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“OSA ascertainment OSA was determined by the Berlin Questionnaire (BQ), a tool developed for assessing OSA risk in the primary care settings with the sensitivity of 77% and the specificity of 44% among the general population [21].”
BackgroundMethodManagement of obstructive sleep apnea in Europe – A 10-year follow-up
Fietze, I., Laharnar, N., Bargiotas, P., Başoğlu, Ö. K., Đogaš, Z., Drummond, M., Fanfulla, F., Gíslason, Þ., Gouveris, H. T., Grote, L., et al. (2022) · Sleep Medicine · doi:10.1016/j.sleep.2022.06.001 · Cited by 37 · see citing works
Torres‐Castro, R., Solís‐Navarro, L., Homero Puppo, G., Alcaraz-Serrano, V., Vasconcello‐Castillo, L., Vilaró, J., & Vera‐Uribe, R. (2022) · Clocks & Sleep · doi:10.3390/clockssleep4020020 · Cited by 34 · see citing works
Association of sleep apnea and depressive symptoms among US adults: a cross-sectional study
Li, M., Zou, X., Lu, H., Li, F., Xin, Y., Zhang, W., Li, B., & Wang, Y. (2023) · BMC Public Health · doi:10.1186/s12889-023-15358-8 · Cited by 38 · see citing works
Is obstructive sleep apnea a circadian rhythm disorder?
Šmon, J., Kočar, E., Pintar, T., Dolenc‐Grošelj, L., & Rozman, D. (2023) · Journal of Sleep Research · doi:10.1111/jsr.13875 · Cited by 33 · see citing works
“2023;32:e13875. wileyonlinelibrary.com/journal/jsr 1 of 20 https://doi.org/10.1111/jsr.13875 Due to its strong association with cardiovascular and metabolic disease, obstructive sleep apnea represents a substantial threat to public health (Garvey et al., 2015; Gottlieb & Punjabi, 2020).”
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“Pending the ADVENT-HF study results,(18) symptomatic patients are eligible for CPAP treatment.(38) As a consequence, only 9/22 G2 patients were not ‘CPAP treated’, and for the eight patients with SV intake at the 3 month P evaluation, the median AHI difference between initial and final assessment was 12.”
MethodGaspar, L. S., Santos-Carvalho, A., Santos, B., Carvalhas-Almeida, C., Barros-Viegas, A. T., Oliveiros, B., Donato, H., Santos, C., Moita, J. J., Cavadas, C., et al. (2022) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2022.101659 · Cited by 34 · see citing works
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“Body weight excess is a well-established respiratory disease risk factor, especially for sleep apnea [30], and the reported correlation between obesity and severe cases of COVID-19 infection is therefore unsurprising.”
Obstructive sleep apnoea in obesity: A review
Tai, J. E., Phillips, C. L., Yee, B. J., & Grunstein, R. R. (2024) · Clinical Obesity · doi:10.1111/cob.12651 · Cited by 33 · see citing works
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Clinical and Research Solutions to Manage Obstructive Sleep Apnea: A Review
Xia, F., & Sawan, M. (2021) · Sensors · doi:10.3390/s21051784 · Cited by 34 · see citing works
“AHI defines the number of apneas and hypopneas per hour while asleep [28].”
BackgroundModification of Endotypic Traits in OSA by the Carbonic Anhydrase Inhibitor Sulthiame
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MicroRNAs to guide medical decision-making in obstructive sleep apnea: A review
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“An initial evaluation might best include: “ Do you snore, ” which may be the most diagnostically sensitive question when assessing the risk of snoring disorders, including OSA [34].”
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The impact of obstructive sleep apnea on nonalcoholic fatty liver disease
Tang, H., Lv, F., Zhang, P., Liu, J., & Mao, J. (2023) · Frontiers in Endocrinology · doi:10.3389/fendo.2023.1254459 · Cited by 35 · see citing works
“Uvulopalatopharyngoplasty, which entails resection of the uvula and soft palate, is the most researched procedure (112).”
Cohen, O., Kundel, V., Barbé, F., Peker, Y., McEvoy, R. D., Sánchez‐de‐la‐Torre, M., Gottlieb, D. J., Bradley, T. D., Suárez‐Fariñas, M., Zinchuk, A. V., et al. (2024) · Annals of the American Thoracic Society · doi:10.1513/annalsats.202409-981st · Cited by 33 · see citing works
Self-citation
- Authors
- Gottlieb, D. J., & Punjabi, N. M.
- Affiliations
- Brigham and Women's Hospital (US)
- Johns Hopkins University (US)
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2020-04-14
- Volume
- 323
- Issue
- 14
- Pages
- 1389
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W3015537361
- Semantic Scholar
- 0172e9c7f7ea58bd5623bd24ef5636cfe5f6c7df
- Cited by
- 1,482
- References
- 112
- Citations by year
- 2026: 266 · 2025: 330 · 2024: 287 · 2023: 230 · 2022: 225 · 2021: 109 · 2020: 32 · 2016: 1 · 2013: 1
- FWCI
- 19.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JAMA (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Heart, Lung, and Blood Institute (R01HL146709, R01HL137234)
- National Institute of Nursing Research (R01NR018335)
- National Institute of Diabetes and Digestive and Kidney Diseases (U34DK120051)
- Topics
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Neuroscience of respiration and sleep
- Keywords
- obstructive sleep apnea, sleep apnea diagnosis, home sleep apnea testing, positive airway pressure, oral appliances, hypoglossal nerve stimulation, weight loss, physical activity, obesity, daytime sleepiness, resistant hypertension, cardiovascular risk, cerebrovascular risk, pharyngeal surgery, pharmacotherapy
- MeSH terms
- Female, Humans, Male, Prognosis, Risk Factors, Weight Loss, Health Behavior, Exercise, Mandibular Advancement, Sleep Apnea, Obstructive, Continuous Positive Airway Pressure
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