OBSTRUCTIVE SLEEP APNEA: PATHOPHYSIOLOGY, CLINICAL CONSEQUENCES, AND CONTEMPORARY MANAGEMENT
Renukuntla Spandana*, Syeda Nishat Fathima
Department of Pharmacology, Jayamukhi College of Pharmacy, Narsampet, Warangal-506332, Telangana, India
Email ID: spandanarajrenukuntla@gmail.com Contact No: 7416257396
ABSTRACT:
Obstructive sleep apnea is a common sleep-related breathing disorder characterised by recurrent episodes of partial or complete upper airway obstruction during sleep, resulting in intermittent hypoxaemia, hypercapnia, and sleep fragmentation. These disturbances lead to excessive daytime sleepiness, impaired neurocognitive function, reduced quality of life, and increased risk of cardiovascular, metabolic, and cerebrovascular disease. Despite its substantial global burden, OSA remains markedly underdiagnosed. This Review summarises current evidence on the epidemiology, aetiology, pathophysiology, diagnosis, and management of OSA in adult and paediatric populations. OSA arises from a complex interaction between anatomical airway vulnerability, impaired neuromuscular control, ventilatory instability, obesity, ageing, and genetic susceptibility. Recurrent upper airway collapses trigger sympathetic activation, endothelial dysfunction, oxidative stress, and systemic inflammation, providing mechanistic links to cardiometabolic morbidity. Diagnosis relies on clinical assessment supported by objective sleep testing, with in-laboratory polysomnography as the diagnostic gold standard. Management is individualised and includes lifestyle modification, positive airway pressure therapy, oral appliances, surgical interventions, and emerging neurostimulation approaches. Continuous positive airway pressure remains the first-line treatment for moderate to severe disease, offering substantial symptomatic benefit despite ongoing challenges with adherence.
KEYWORDS: Obstructive sleep apnea; Sleep-disordered breathing; Intermittent hypoxia; Apnea–hypopnea index; Polysomnography; Continuous positive airway pressure
DOI link – https://doi.org/10.69758/GIMRJ/2512S01V13P014
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