FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 334:99-104 January 11, 1996 Number 2 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

	Full Text PDF Purchase this article Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

Our understanding of the nature and consequences of upper-airway obstruction in adults during sleep has evolved considerably over the past two decades. Sleep apnea — defined as repeated episodes of obstructive apnea and hypopnea during sleep, together with daytime sleepiness or altered cardiopulmonary function — is common.¹ Epidemiologic studies estimate that the condition affects 2 to 4 percent of middle-aged adults.² Only a small portion of the cases in this group of adults have been diagnosed; this is related to insufficient awareness of sleep apnea among physicians and the public at large.³

Definitions

The manifestations of upper-airway closure during sleep are . . . [Full Text of this Article]

Pathogenesis

Pathophysiologic Consequences

Diagnosis

Sleep Studies

Treatment

Behavioral Treatment

Medical Treatment

            Positive Airway Pressure

            Oral Appliances

            Medication

Surgical Treatment

            Tracheostomy

            Palatal Surgery

            Maxillofacial Surgery

Source Information

From the Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh School of Medicine, 440 Scaife Hall, 3550 Terrace St., Pittsburgh, PA 15261, where reprint requests should be addressed to Dr. Strollo.

References

This article has been cited by other articles:

• Lancaster, L. H., Mason, W. R., Parnell, J. A., Rice, T. W., Loyd, J. E., Milstone, A. P., Collard, H. R., Malow, B. A. (2009). Obstructive Sleep Apnea Is Common in Idiopathic Pulmonary Fibrosis. Chest 136: 772-778 [Abstract] [Full Text]  
• Lavie, C. J., Milani, R. V., Ventura, H. O. (2009). Obesity and cardiovascular disease: risk factor, paradox, and impact of weight loss.. J Am Coll Cardiol 53: 1925-1932 [Abstract] [Full Text]  
• Waldman, H. B., Hasan, F. M., Perlman, S. (2009). Down Syndrome and Sleep-Disordered Breathing: The Dentist's Role. Journal of the American Dental Association 140: 307-312 [Abstract] [Full Text]  
• Murugan, A., Sharma, G (2008). Obesity and respiratory diseases. Chronic Respiratory Disease 5: 233-242 [Abstract]  
• Ahmad, S., Nagle, A., McCarthy, R. J., Fitzgerald, P. C., Sullivan, J. T., Prystowsky, J. (2008). Postoperative Hypoxemia in Morbidly Obese Patients With and Without Obstructive Sleep Apnea Undergoing Laparoscopic Bariatric Surgery. Anesth. Analg. 107: 138-143 [Abstract] [Full Text]  
• Lanier, B. Q. (2008). Use of Intranasal Corticosteroids in the Management of Congestion and Sleep Disturbance in Pediatric Patients With Allergic Rhinitis. CLIN PEDIATR 47: 435-445 [Abstract]  
• Ybarra, J., Planas, F., Pou, J. M (2008). Aminoterminal pro-brain natriuretic peptide (NT-proBNP) and sleep-disordered breathing in morbidly obese females: a cross-sectional study. Diabetes and Vascular Disease Research 5: 19-24 [Abstract]  
• Sutthiprapaporn, P, Tanimoto, K, Ohtsuka, M, Nagasaki, T, Iida, Y, Katsumata, A (2008). Positional changes of oropharyngeal structures due to gravity in the upright and supine positions. Dentomaxillofac Radiol 37: 130-135 [Abstract] [Full Text]  
• Selmi, C., Montano, N., Furlan, R., Keen, C. L., Gershwin, M. E. (2007). Inflammation and Oxidative Stress in Obstructive Sleep Apnea Syndrome. Exp. Biol. Med. 232: 1409-1413 [Abstract] [Full Text]  
• Parati, G., Lombardi, C., Narkiewicz, K. (2007). Sleep apnea: epidemiology, pathophysiology, and relation to cardiovascular risk. Am. J. Physiol. Regul. Integr. Comp. Physiol. 293: R1671-R1683 [Abstract] [Full Text]  
• Authors/Task Force Members:, , Mancia, G., De Backer, G., Dominiczak, A., Cifkova, R., Fagard, R., Germano, G., Grassi, G., Heagerty, A. M., Kjeldsen, S. E., Laurent, S., Narkiewicz, K., Ruilope, L., Rynkiewicz, A., Schmieder, R. E., Struijker Boudier, H. A.J., Zanchetti, A., ESC Committee for Practice Guidelines (CPG):, , Vahanian, A., Camm, J., De Caterina, R., Dean, V., Dickstein, K., Filippatos, G., Funck-Brentano, C., Hellemans, I., Kristensen, S. D., McGregor, K., Sechtem, U., Silber, S., Tendera, M., Widimsky, P., Zamorano, J. L., ESH Scientific Council:, , Kjeldsen, S. E., Erdine, S., Narkiewicz, K., Kiowski, W., Agabiti-Rosei, E., Ambrosioni, E., Cifkova, R., Dominiczak, A., Fagard, R., Heagerty, A. M., Laurent, S., Lindholm, L. H., Mancia, G., Manolis, A., Nilsson, P. M., Redon, J., Schmieder, R. E., Struijker-Boudier, H. A.J., Viigimaa, M., Document Reviewers:, , Filippatos, G., Adamopoulos, S., Agabiti-Rosei, E., Ambrosioni, E., Bertomeu, V., Clement, D., Erdine, S., Farsang, C., Gaita, D., Kiowski, W., Lip, G., Mallion, J.-M., Manolis, A. J., Nilsson, P. M., O'Brien, E., Ponikowski, P., Redon, J., Ruschitzka, F., Tamargo, J., van Zwieten, P., Viigimaa, M., Waeber, B., Williams, B., Zamorano, J. L. (2007). 2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J 0: ehm236v1-75 [Full Text]  
• Suhl, J. (2007). The Neuropharmacology of Sleep Disorders: Better Sleeping Through Chemistry?. Journal of Pharmacy Practice 20: 181-191 [Abstract]  
• Nici, L., Donner, C., Wouters, E., Zuwallack, R., Ambrosino, N., Bourbeau, J., Carone, M., Celli, B., Engelen, M., Fahy, B., Garvey, C., Goldstein, R., Gosselink, R., Lareau, S., MacIntyre, N., Maltais, F., Morgan, M., O'Donnell, D., Prefault, C., Reardon, J., Rochester, C., Schols, A., Singh, S., Troosters, T., on behalf of the ATS/ERS Pulmonary Rehabilitation, (2006). American thoracic society/european respiratory society statement on pulmonary rehabilitation.. Am. J. Respir. Crit. Care Med. 173: 1390-1413 [Full Text]  
• Poirier, P., Giles, T. D., Bray, G. A., Hong, Y., Stern, J. S., Pi-Sunyer, F. X., Eckel, R. H. (2006). Obesity and cardiovascular disease: pathophysiology, evaluation, and effect of weight loss.. Arterioscler. Thromb. Vasc. Bio. 26: 968-976 [Abstract] [Full Text]  
• Poirier, P., Giles, T. D., Bray, G. A., Hong, Y., Stern, J. S., Pi-Sunyer, F. X., Eckel, R. H. (2006). Obesity and Cardiovascular Disease: Pathophysiology, Evaluation, and Effect of Weight Loss: An Update of the 1997 American Heart Association Scientific Statement on Obesity and Heart Disease From the Obesity Committee of the Council on Nutrition, Physical Activity, and Metabolism. Circulation 113: 898-918 [Abstract] [Full Text]  
• Cormican, L J, Williams, A (2005). Sleep disordered breathing and its treatment in congestive heart failure. Heart 91: 1265-1270 [Abstract] [Full Text]  
• Greenfeld, M., Tauman, R., Sivan, Y. (2004). The Yield of Esophageal pH Monitoring During Polysomnography in Infants with Sleep-Disordered Breathing. CLIN PEDIATR 43: 653-658 [Abstract]  
• Atwood, C. W. Jr, McCrory, D., Garcia, J. G. N., Abman, S. H., Ahearn, G. S. (2004). Pulmonary Artery Hypertension and Sleep-Disordered Breathing: ACCP Evidence-Based Clinical Practice Guidelines. Chest 126: 72S-77S [Abstract] [Full Text]  
• Sanner, B.M., Kollhosser, P., Buechner, N., Zidek, W., Tepel, M. (2004). Influence of treatment on leptin levels in patients with obstructive sleep apnoea. Eur Respir J 23: 601-604 [Abstract] [Full Text]  
• Harsch, I. A., Schahin, S. P., Radespiel-Troger, M., Weintz, O., Jahreiss, H., Fuchs, F. S., Wiest, G. H., Hahn, E. G., Lohmann, T., Konturek, P. C., Ficker, J. H. (2004). Continuous Positive Airway Pressure Treatment Rapidly Improves Insulin Sensitivity in Patients with Obstructive Sleep Apnea Syndrome. Am. J. Respir. Crit. Care Med. 169: 156-162 [Abstract] [Full Text]  
• Schwartz, J. R. L., Hirshkowitz, M., Erman, M. K., Schmidt-Nowara, W. (2003). Modafinil as Adjunct Therapy for Daytime Sleepiness in Obstructive Sleep Apnea: A 12-Week, Open-Label Study. Chest 124: 2192-2199 [Abstract] [Full Text]  
• Harsch, I.A., Konturek, P.C., Koebnick, C., Kuehnlein, P.P., Fuchs, F.S., Pour Schahin, S., Wiest, G.H., Hahn, E.G., Lohmann, T., Ficker, J.H. (2003). Leptin and ghrelin levels in patients with obstructive sleep apnoea: effect of CPAP treatment. Eur Respir J 22: 251-257 [Abstract] [Full Text]  
• Watson, N. F., Kapur, V. (2003). Esophageal Foreign Bodies Causing Obstructive Sleep Apnea in a Patient With Sturge-Weber Syndrome. Chest 124: 400-403 [Abstract] [Full Text]  
• Sabers, C., Plevak, D. J., Schroeder, D. R., Warner, D. O. (2003). The Diagnosis of Obstructive Sleep Apnea as a Risk Factor for Unanticipated Admissions in Outpatient Surgery. Anesth. Analg. 96: 1328-1335 [Abstract] [Full Text]  
• Siyam, M. A., Benhamou, D. (2003). Intubation in Morbidly Obese Patients. Anesth. Analg. 96: 913-913 [Full Text]  
• Sin, D. D., Mayers, I., Man, G. C.W., Ghahary, A., Pawluk, L. (2002). Can Continuous Positive Airway Pressure Therapy Improve the General Health Status of Patients With Obstructive Sleep Apnea?: A Clinical Effectiveness Study. Chest 122: 1679-1685 [Abstract] [Full Text]  
• Sin, D. D., Jones, R. L., Man, S. F. P. (2002). Obesity Is a Risk Factor for Dyspnea but Not for Airflow Obstruction. Arch Intern Med 162: 1477-1481 [Abstract] [Full Text]  
• Otake, K, Delaive, K, Walld, R, Manfreda, J, Kryger, M H (2002). Cardiovascular medication use in patients with undiagnosed obstructive sleep apnoea. Thorax 57: 417-422 [Abstract] [Full Text]  
• Lacasse, Y., Godbout, C., Series, F. (2002). Health-related quality of life in obstructive sleep apnoea. Eur Respir J 19: 499-503 [Abstract] [Full Text]  
• Yan, A. T., Bradley, T. D., Liu, P. P. (2001). The Role of Continuous Positive Airway Pressure in the Treatment of Congestive Heart Failure. Chest 120: 1675-1685 [Abstract] [Full Text]  
• PACK, A. I., BLACK, J. E., SCHWARTZ, J. R. L., MATHESON, J. K. (2001). Modafinil as Adjunct Therapy for Daytime Sleepiness in Obstructive Sleep Apnea. Am. J. Respir. Crit. Care Med. 164: 1675-1681 [Abstract] [Full Text]  
• Ziegler, M. G., Mills, P. J., Loredo, J. S., Ancoli-Israel, S., Dimsdale, J. E. (2001). Effect of Continuous Positive Airway Pressure and Placebo Treatment on Sympathetic Nervous Activity in Patients With Obstructive Sleep Apnea. Chest 120: 887-893 [Abstract] [Full Text]  
• Crystal, R. G. (2001). Research Opportunities and Advances in Lung Disease. JAMA 285: 612-618 [Abstract] [Full Text]  
• Kowallik, P., Jacobi, I., Jirmann, A., Meesmann, M., Schmidt, M., Wirtz, H. (2001). Breath-to-Breath Variability Correlates With Apnea-Hypopnea Index in Obstructive Sleep Apnea. Chest 119: 451-459 [Abstract] [Full Text]  
• Malow, B.A., Edwards, J., Marzec, M., Sagher, O., Fromes, G. (2000). Effects of vagus nerve stimulation on respiration during sleep: A pilot study. Neurology 55: 1450-1454 [Abstract] [Full Text]  
• Malow, B. A., Levy, K., Maturen, K., Bowes, R. (2000). Obstructive sleep apnea is common in medically refractory epilepsy patients. Neurology 55: 1002-1007 [Abstract] [Full Text]  
• Blankfield, R. P., Hudgel, D. W., Tapolyai, A. A., Zyzanski, S. J. (2000). Bilateral Leg Edema, Obesity, Pulmonary Hypertension, and Obstructive Sleep Apnea. Arch Intern Med 160: 2357-2362 [Abstract] [Full Text]  
• FRIEDLANDER, A. H., WALKER, L. A., FRIEDLANDER, I. K., FELSENFELD, A. L. (2000). DIAGNOSING AND COMANAGING PATIENTS WITH OBSTRUCTIVE SLEEP APNEA SYNDROME. Journal of the American Dental Association 131: 1178-1184 [Abstract] [Full Text]  
• SCHELLENBERG, J. B., MAISLIN, G., SCHWAB, R. J. (2000). Physical Findings and the Risk for Obstructive Sleep Apnea . The Importance of Oropharyngeal Structures. Am. J. Respir. Crit. Care Med. 162: 740-748 [Abstract] [Full Text]  
• Margolis, M. L. (2000). Brahms' Lullaby Revisited : Did the Composer Have Obstructive Sleep Apnea?. Chest 118: 210-213 [Full Text]  
• Epstein, M. D., Chicoine, S. A., Hanumara, R. C. (2000). Detection of Upper Airway Resistance Syndrome Using a Nasal Cannula/Pressure Transducer. Chest 117: 1073-1077 [Abstract] [Full Text]  
• HENKE, K. G., FRANTZ, D. E., KUNA, S. T. (2000). An Oral Elastic Mandibular Advancement Device for Obstructive Sleep Apnea. Am. J. Respir. Crit. Care Med. 161: 420-425 [Abstract] [Full Text]  
• (1999). Tension Pneumocranium, a Rare Complication of Transsphenoidal Pituitary Surgery: Mayo Clinic Experience 1976-1998. J. Clin. Endocrinol. Metab. 84: 4731-4734 [Abstract] [Full Text]  
• Stone, J. G., Cozine, K. A., Wald, A. (1999). Nocturnal Oxygenation During Patient-Controlled Analgesia. Anesth. Analg. 89: 104-104 [Abstract] [Full Text]  
• van Houwelingen, K.G., van Uffelen, R., van Vliet, A.C.M. (1999). The sleep apnoea syndromes. Eur Heart J 20: 858-866  
• Teran-Santos, J., Jimenez-Gomez, A., Cordero-Guevara, J., The Cooperative Group Burgos-Santander, (1999). The Association between Sleep Apnea and the Risk of Traffic Accidents. NEJM 340: 847-851 [Abstract] [Full Text]  
• Suratt, P. M., Findley, L. J. (1999). Driving with Sleep Apnea. NEJM 340: 881-883 [Full Text]  
• Narkiewicz, K., van de Borne, P. J. H., Pesek, C. A., Dyken, M. E., Montano, N., Somers, V. K. (1999). Selective Potentiation of Peripheral Chemoreflex Sensitivity in Obstructive Sleep Apnea. Circulation 99: 1183-1189 [Abstract] [Full Text]  
• Narkiewicz, K., van de Borne, P. J. H., Cooley, R. L., Dyken, M. E., Somers, V. K. (1998). Sympathetic Activity in Obese Subjects With and Without Obstructive Sleep Apnea. Circulation 98: 772-776 [Abstract] [Full Text]  
• Neven, A K., Middelkoop, H A M, Kemp, B, Kamphuisen, H A C, Springer, M P (1998). The prevalence of clinically significant sleep apnoea syndrome in the Netherlands. Thorax 53: 638-642 [Abstract] [Full Text]  
• Ficker, J H, Wiest, G H, Lehnert, G, Wiest, B, Hahn, E G (1998). Evaluation of an auto-CPAP device for treatment of obstructive sleep apnoea. Thorax 53: 643-648 [Abstract] [Full Text]  
• Lyznicki, J. M., Doege, T. C., Davis, R. M., Williams, M. A., for the Council on Scientific Affairs, American Me, (1998). Sleepiness, Driving, and Motor Vehicle Crashes. JAMA 279: 1908-1913 [Abstract] [Full Text]  
• Nkere, U. U., Hall, M.C.S., Corris, P.A. (1998). Sleep apnoea/hypopnoea syndrome: a potential cause of graft failure following heart transplantation. Eur. J. Cardiothorac. Surg. 13: 203-205 [Abstract] [Full Text]  
• Kushida, C. A., Efron, B., Guilleminault, C. (1997). A Predictive Morphometric Model for the Obstructive Sleep Apnea Syndrome. ANN INTERN MED 127: 581-587 [Abstract] [Full Text]  
• Claman, D. M., Votteri, B. A. (1997). EFFECTS OF ESOPHAGEAL PRESSURE MONITORING ON SLEEP ARCHITECTURE. Am. J. Respir. Crit. Care Med. 157: 1697-1698 [Full Text]  
• Wright, J., Johns, R., Watt, I., Melville, A., Sheldon, T. (1997). Health effects of obstructive sleep apnoea and the effectiveness of continuous positive airways pressure: a systematic review of the research evidence. BMJ 314: 851-851 [Abstract] [Full Text]  
• Sobieraj, J., Schembre, D. B., Boynton, K. K., Fishman, A. P., Hoffman, R. M., Upson, D., Dhurandhar, N. V., Atkinson, R. L., Williamson, D. F., Abenhaim, L., Rich, S., Benichou, J., Begaud, B., The International Primary Pulmonary Hypertension S, (1997). Appetite-Suppressant Drugs and Primary Pulmonary Hypertension. NEJM 336: 510-513 [Full Text]  
• Kupfer, D. J., Reynolds, C. F. (1997). Management of Insomnia. NEJM 336: 341-346 [Full Text]