Long term management of obstructive sleep apnea and its comorbidities
Marin-Oto M (1), Vicente EE (2,3), Marin JM (4,3).
(1) Department of Respiratory Medicine, Clinica Universitaria de Navarra, University of Navarra, Pamplona, Spain.
(2) Otorhinolaryngology Service, Hospital Universitario Miguel Servet, Zaragoza, Spain.
(4) Traslational Respiratory Research Unit, IISAragon, Zaragoza and CIBER Enfermedades Respiratorias, Instituto Salud Carlos III, Madrid, Spain.
(3) Respiratory Service, Hospital Universitario Miguel Servet, and Department of Medicine, University of Zaragoza, Avda. Isabel la Católica, 1-3, 50009 Zaragoza, Spain.
Obstructive sleep apnea (OSA) is a worldwide highly prevalent disease associated with systemic consequences, including excessive sleepiness, impairment of neurocognitive function and daytime performance, including driving ability.
The long-term sequelae of OSA include and increase risk for cardiovascular, cerebrovascular and metabolic syndrome disorders that ultimately lead to premature death if untreated.
To ensure optimal long-term outcomes, the assessment and management of OSA should be personalized with the involvement of the appropriate specialist.
Most studies have demonstrated inmediate improvement in daytime somnolence and quality of life with CPAP and other therapies, but the effect of long-term treatment on mortality is still under debate.
Currently, the long-term management of OSA should be based on a) identifying physiological or structural abnormalities that are treatable at the time of patient evaluation and b) comprehensive lifestyle interventions, especially weight-loss interventions, which are associated with improvements in OSA severity, cardiometabolic comorbidities, and quality of life.
In long-term management, attention should be paid to the clinical changes related to a potential reoccurrence of OSA symptoms and it is also necessary to monitor throughout the follow up how the main associated comorbidities evolve.
CITATION Multidiscip Respir Med. 2019 Jul 4;14:21. doi: 10.1186/s40248-019-0186-3. eCollection 2019