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Obstructive sleep apnea: current perspectives
Open accessAbstract
The prevalence of obstructive sleep apnea (OSA) continues to rise. So too do the health, safety, and economic consequences. On an individual level, the causes and consequences of OSA can vary substantially between patients. In recent years, four key contributors to OSA pathogenesis or "phenotypes" have been characterized. These include a narrow, crowded, or collapsible upper airway "anatomical compromise" and "non-anatomical" contributors such as ineffective pharyngeal dilator muscle function during sleep, a low threshold for arousal to airway narrowing during sleep, and unstable control of breathing (high loop gain). Each of these phenotypes is a target for therapy. This review summarizes the latest knowledge on the different contributors to OSA with a focus on measurement techniques including emerging clinical tools designed to facilitate translation of new cause-driven targeted approaches to treat OSA. The potential for some of the specific pathophysiological causes of OSA to drive some of the key symptoms and consequences of OSA is also highlighted.
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“Alternatively, insomnia disorder may be associated with a reduced respiratory arousal threshold, which may predispose patients to prematurely awaken to respiratory events [16,105].”
From Co-morbid insomnia and sleep apnea (COMISA): Prevalence, consequences, methodological considerations, and recent randomized controlled trials (2019) · cites this paper as [16]
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“OSA is thought to result from a combination of anatomical (e.g., a narrow pharyngeal airway), and non-anatomical factors (e.g., impaired upper airway muscle function, low arousal threshold, and unstable control of breathing) [16].”
From Co-morbid insomnia and sleep apnea (COMISA): Prevalence, consequences, methodological considerations, and recent randomized controlled trials (2019) · cites this paper as [16]
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Metadata
- Authors
- Osman, A. M., Carter, S. G., Carberry, J. C., & Eckert, D. J.
- Affiliations
- UNSW Sydney (AU)
- Corresponding author
- Eckert, Danny J
- Venue
- Nature and Science of Sleep
- Publisher
- Informa UK Limited
- Published
- 2018-01
- Volume
- Volume 10
- Pages
- 21-34
- ISSN
- 1179-1608 (ISSN-L)
- PMC
- PMC5789079
- OpenAlex
- W2784442221
- Cited by
- 441
- References
- 186
- Citations by year
- 2026: 37 · 2025: 56 · 2024: 49 · 2023: 56 · 2022: 64 · 2021: 76 · 2020: 49 · 2019: 44 · 2018: 9
- FWCI
- 5.85
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Nature and Science of Sleep (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- UNSWorks (University of New South Wales, Sydney, Australia) (submittedVersion, cc-by-nc-nd)
- Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
- Topics
- Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Neuroscience of respiration and sleep
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- obstructive sleep apnea, OSA pathogenesis, OSA phenotypes, upper airway anatomy, arousal threshold, loop gain, targeted therapy
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