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Sleep Apnea, Obstructive

Thomas J. Hansen, MD, FAAFP Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Obstructive sleep apnea (OSA) is defined as repetitive episodes of cessation of airflow (apnea) through the nose and mouth during sleep due to obstruction at the level of the pharynx...

DIAGNOSIS

HISTORY

  • Elicit a complete history of daytime and nighttime symptoms. Symptoms can be insidious and may have been present for years.

  • Daytime symptoms

    • EDS or fatigue (cardinal symptom) (1)

      • Mild sy...

TREATMENT

  • Lifestyle modification is the most frequently recommended treatment for mild to moderate OSA. This includes weight loss, exercise, and avoidance of alcohol, smoking, and sedatives, especiall...

ONGOING CARE

Lifelong compliance with weight loss or CPAP is necessary for successful OSA treatment. 

DIET

Overweight and obese patients should be encouraged to lose weight, and all patients must avoid ...

REFERENCES

1
Myers KA, Mrkobrada M, Simel DL. Does this patient have obstructive sleep apnea? The rational clinical examination systematic review. JAMA.  2013;310(7):731–741. [View Abstract on Ovi...

ADDITIONAL READING

  • Barbé F, Durán-Cantolla J, Sánchez-de-la-Torre M, et al; for Spanish Sleep and Breathing Network. Effect of continuous positive airway pressure on the incidence of hypertension and ...

CODES

ICD10

G47.33 Obstructive sleep apnea (adult) (pediatric) 

ICD9

327.23 Obstructive sleep apnea (adult)(pediatric) 

SNOMED

  • 78275009 Obstructive sleep apnea syndrome (disorder)

  • 1101000119103 Obstructive ...

CLINICAL PEARLS

  • OSA is characterized by repetitive episodes of apnea often terminating in a snort/gasp.

  • Laboratory PSG is the key to diagnosis.

  • CPAP is the most effective form of treatment for both mild...

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