Obstructive sleep apnea syndrome, part 1: Identifying the problem

April 1, 2006

Abstract: Obstructive sleep apnea-hypopnea syndrome (OSAHS) is a common, yet often overlooked, form of symptomatic sleep-disordered breathing. OSAHS is a cause for concern for several reasons, one of which is its association with cardiovascular disease. Risk factors include obesity, hypertension, and upper airway malformations. Diagnostic clues include habitual snoring, witnessed apneas, choking arousals, excessive daytime sleepiness, and large neck circumference. Polysomnography is the definitive diagnostic test; it pro- vides objective documentation of apnea and hypopnea. Since OSAHS may contribute to adverse postsurgical events, consideration of this syndrome should be part of the preoperative assessment of patients. (J Respir Dis. 2006;27(4):144-152)

Sleep-disordered breathing refers to a group of clinical syndromes with the common characteristic of altered ventilation during sleep.1 There is overlap between central and obstructive disordered breathing syndromes. For example, mixed apneas and conversion of obstructive apnea to central apnea with application of positive airway pressure suggest a shared pathophysiologic basis.2

Obstructive sleep apnea-hypopnea syndrome (OSAHS) is a form of sleep-disordered breathing that has emerged as a major health issue. The neurobehavioral and cardiovascular consequences of OSAHS underscore the importance of prompt recognition.

In this article, the first of 2 parts, we will provide some background information about OSAHS. We will then offer a practical plan for the clinical evaluation. In the second part of this article, to be published in a future issue of The Journal of Respiratory Diseases,