Clinical Outcomes in OSA—SLEEP GOAL—a More Holistic Approach

Abstract

Purpose of Review

Obstructive sleep apnea (OSA) is a systemic disease that is due to a narrow upper airway that collapses and obstructs during sleep, which results in frequent nocturnal hypoxemia, sympathetic overdrive, tachycardia, nocturnal hypertension, and oxidative metabolic stress. Symptoms include unrefreshed sleep, daytime tiredness, loss of memory, irritability, lack of concentration, poor work productivity, poor quality of life (QOL), mood swings, and even depression. This upper airway disorder can lead to systemic diseases such as hypertension, cardiovascular events, myocardial infarct, and fatal arrhythmias.

Recent Findings

The standard diagnostic test for OSA is commonly assumed to be the overnight polysomnography (PSG); however, it is widely known that there is discordance between the levels of AHI (apnea–hypopnea index) used to denote outcomes/success of therapy and real-world clinical outcomes such as QOL, patient perception of disease, cardiovascular measures, and/or survival.

Summary

Hence, the use of a single parameter AHI is inadequate and unrealistic; sleep specialists need more holistic and less biased parameters to assess treatment outcomes. Some of these parameters include snoring level, sleep satency, execution time, Epworth Sleepiness Scale, blood pressure, gross weight (BMI), oxygen duration below 90%, AHI, and QOL scores.

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