Obstructive sleep apnoea syndrome related morbidities and their treatment: A matter of mandate

Author : Kuldeep Patial, Vishwajeet Rohil, Sunil Kumar Ratra, Bharti Patial, Rajendra Kumar Behera

Obstructive sleep apnoea syndrome is the most prevalent form of sleep disorder breathing characterized by persistent pauses of breathing during sleep time. The disorder is manifested by upper airway obstruction and excessive day time somnolence which directly affect the quality of life of the patients. Reports from previous studies revealed that occurrence rate of obstructive sleep apnoea syndrome is approx 13.7% among habitual snorers and 3.6% among non-habitual snorers which is equivalent to other major diseases and contributes to morbidity and mortality in developed as well as in developing countries, like India. The disorder is in association with metabolic syndrome and many serious cardiovascular conditions are stimuli of various inflammatory pathways in disease progression. The primary pathophysiologic abnormality in sleep disorder breathing is insulin resistance. Recurrent hypoxic function contributes to delay in hepatic function. The occurrence of oxidative stress with sleep disorder breathing also emerged as a public health issue. It has been reported that, severe obstructive sleep disorder patients have higher levels of plasma leptin than patients with mild and there occurs a positive correlation which is independent of age and BMI, between the plasma leptin levels and the severity of disease. Consequently hyperleptinemia may be considered a predictive marker of obstructive sleep disorder. The first line treatment of diagnosed obstructive sleep disorder syndrome includes nasal continuous positive airway pressure. Apart other treatments include surgical procedures, mandibular advancement splint and drugs which treat daytime somnolence. Recent study shows that oral intake of anti-oxidants not only reduces oxidative stress but also improves sleep disorder breathing and excessive day time somnolence. In this review, an exhaustive scan is done from past till up to date which are in concern of the morbidities along with their therapeutic measures associated with obstructive sleep disorder syndrome.

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