The DOI matches its Crossref record; 112 of the 112 references it cites were found in a registry or an index.
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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In the citing paper
“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
In the citing paper
“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]
In the citing paper
“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]
Citations
Cites
A New Method for Measuring Daytime Sleepiness: The Epworth Sleepiness Scale
Johns, M. W. (1991) · Sleep · doi:10.1093/sleep/14.6.540 · Cited by 17,364
The Occurrence of Sleep-Disordered Breathing among Middle-Aged Adults
Young, T., Palta, M., Dempsey, J., Skatrud, J., Weber, S., & Badr, S. (1993) · New England Journal of Medicine · doi:10.1056/nejm199304293281704 · Cited by 10,183
Increased Prevalence of Sleep-Disordered Breathing in Adults
Peppard, P. E., Young, T., Barnet, J. H., Palta, M., Hagen, E. W., & Hla, K. M. (2013) · American Journal of Epidemiology · doi:10.1093/aje/kws342 · Cited by 4,618
Epidemiology of Obstructive Sleep Apnea: A Population Health Perspective
Young, T., Peppard, P. E., & Gottlieb, D. J. (2002) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.2109080 · Cited by 4,244
Self-citationMcNicholas, W. T., Strohl, K. P., White, D. P., Levy, P. A., Schmidt, W., Wheatley, J. R., Redline, S. S., Carley, D. W., Buysse, D. J., Young, T. B., et al. (1999) · PubMed · Cited by 3,665
Kapur, V. K., Auckley, D. H., Chowdhuri, S., Kuhlmann, D. C., Mehra, R., Ramar, K., & Harrod, C. G. (2017) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.6506 · Cited by 3,253
Using the Berlin Questionnaire To Identify Patients at Risk for the Sleep Apnea Syndrome
Netzer, N. C., Stoohs, R. A., Netzer, C. M., Clark, K., & Strohl, K. P. (1999) · Annals of Internal Medicine · doi:10.7326/0003-4819-131-7-199910050-00002 · Cited by 2,973
Prevalence of sleep-disordered breathing in the general population: the HypnoLaus study
Heinzer, R., Vat, S., Marques-Vidal, P., Marti-Soler, H., Andries, D., Tobback, N., Mooser, V, Preisig, M., Malhotra, A., Waeber, G., et al. (2015) · The Lancet Respiratory Medicine · doi:10.1016/s2213-2600(15)00043-0 · Cited by 2,481
The epidemiology of adult obstructive sleep apnea
Punjabi, N. M. (2008) · Proceedings of the American Thoracic Society · doi:10.1513/pats.200709-155mg · Cited by 2,361
Self-citation
Cited by
Sorted by citations
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
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 1,389
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 555
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
“, 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
Self-citation
Metadata
- 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
- 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 (medical) › 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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