Overview of Obstructive Sleep Apnea
Experts discuss the widespread underdiagnosis of obstructive sleep apnea (OSA), emphasizing its significant impact on quality of life and comorbid conditions, the critical role of primary care in early detection, the importance of family input in recognizing symptoms, and the need for proactive, multidisciplinary strategies to ensure timely diagnosis and effective management.
OSA is a highly prevalent but frequently underdiagnosed condition that significantly impacts patients' quality of life and long-term health outcomes. Despite affecting nearly 1 billion adults between the ages of 30 and 69 globally, many individuals remain undiagnosed and untreated for years. OSA is closely associated with numerous comorbid conditions such as hypertension, diabetes, obesity, cardiovascular disease, stroke, and depression. Beyond the physical risks, OSA contributes to chronic fatigue, reduced cognitive function, increased accident risk, and overall diminished life expectancy. As such, early recognition and intervention are essential.
In primary care settings, clinicians play a pivotal role in identifying at-risk individuals. Patients with high body mass index, uncontrolled hypertension despite multiple medications, type 2 diabetes, and psychiatric conditions such as depression should be carefully evaluated. Additionally, symptoms such as persistent fatigue, loud snoring, nocturnal awakenings, and frequent nighttime urination may signal OSA. Importantly, many of these signs are often reported by a bed partner rather than the patient, highlighting the value of collateral information during the assessment process. Family involvement can be key, especially when patients are unaware of their symptoms.
Despite the challenges of diagnosis, tools such as sleep questionnaires and home sleep studies can assist primary care providers in initiating the evaluation process. Prompt diagnosis and treatment—commonly with continuous positive airway pressure —can lead to significant improvements in both comorbid disease management and overall quality of life. Increasing awareness among clinicians and patients, integrating family perspectives, and considering OSA in the differential diagnosis of fatigue or resistant hypertension are all critical steps toward addressing this widespread and impactful condition. As more data highlight the broad health consequences of untreated OSA, a proactive and holistic approach in primary care is more important than ever.
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