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218 Obstructive Sleep Apnoea Syndrome
and Cardio Metabolic Risk
Management - The continuum of Benign snoring, UARS and
Conservative OSAS need to be clarified .
The fundamentals of weight loss are still applicable - Early diagnosis and intervention is important in the
and CPAP is still the most widely used treatment for management of OSAS.
OSAS. - OSAS has significant effects on the Cardio-Meta-
Hibbert & Yaggi [35] have advocated patient centred bolic system which can be life threatening.
care in OSAS. OSAS patients are diverse and may - Bariatric surgery is emerging to be an important
have different needs, preferences and values that modality of management for OSAS.
may impact on optimal treatment.
There is some evidence that bed elevation [36] and References
oropharyngeal exercises [37] can have a beneficial 1. Pépin JL, Guillot M, Tamisier R, Lévy P. The upper airway resistance syn-
effect on OSAS. drome. Respiration. 2012;83(6):559-66.
2. Hukins CA. Obstructive sleep apnea - management update. Neuropsychi-
A systematic review & meta-analysis on the useful- atr Dis Treat. 2006 Sep;2(3):309-26.
ness of tongue-retaining devices for OSA [38] was
conducted and it was found that these devices re- 3. Peppard PE, Young T, Barnet JH, Palta M, Hagen EW, Hla KM. In-
creased prevalence of sleep-disordered breathing in adults. Am J
duce apnoea-hypopnoea index by 53%, decrease ox- Epidemiology 2013 May 1;177(9):1006-14.
ygen desaturation index by 56% and decrease the 4. Sia CH , Hong Y, Tan LWL, van Dam RM , Lee CH , Tan A. Awareness
Epworth sleepiness scale by 2.8 points. and knowledge of obstructive sleep apnea among the general population.
Sleep Med. 2017 Aug;36:10-17.
Surgical
5. Singh A, Prasad R, Garg R, Kant S, Hosmane GB, Dubey A, Agarwal A, Ver-
Surgical modeling of the bony and soft tissues of ma RK. A study to estimate prevalence and risk factors of Obstructive
the upper airway is still widely done for OSAS in ap- Sleep Apnoea Syndrome in a semi-urban Indian population. Monaldi Arch
propriate patients. Chest Dis. 2017 May 18;87(1):773.
6. Shafazand S. Guideline: Insufficient evidence exists on screening for ob-
However, it is clear that bariatric surgery has an im- structive sleep apnea in asymptomatic adults. Ann Intern Med. 2017
portant role to play in OSAS . Over 500,000 cases of May 16;166(10):JC50.
bariatric surgery were described by de Raff et al [39] 7. Chung F, Abdullah HR, Liao P. STOP-Bang Questionnaire: A Practical Approach
with OSAS being present in 35%-94% of cases. Del to Screen for Obstructive Sleep Apnea. Chest 2016 Mar;149(3):631-8.
Genio et al [40] clearly showed that sleeve gastrec-
tomy improves OSAS in appropriate patients. 8. Prudon B, Hughes J, West S. A novel postal-based approach to diagnos-
ing obstructive sleep apnoea in a high-risk population. Sleep Med. 2017
Effects of treatment of OSA on Cardiovascular risk May;33:1-5.
9. Chai –Coetzer CL, McEvoy RD. The Debate Should Now Be Over. Simpli-
It is clear that the management of OSAS has a very fied Cardiorespiratory Sleep Tests are a Reliable, Cost-saving Option for Di-
beneficial effect on individual’s lives, there is still a agnosing Obstructive Sleep Apnea. Am J Respir Crit Care Med 2017 Jun 29.
need for clear documentation if it reduces cardiovas- 10. Kheirandish-Gozal L, Gozal D. Pediatric OSA Syndrome Morbidity Biomark-
cular risk. ers: The Hunt Is Finally On! Chest 2017 Feb;151(2):500-506.
Gottlieb [41] (AD 8) suggests that it is too early to 11. Erdim I, Erdur O, Oghan F, Mete F, Celik M. Blood count values and ratios
say if cardiovascular risk is reduced by the treatment for predicting sleep apnea in obese children. Int J Pediatr Otorhinolaryn-
of OSAS. However Schipper et al (AD 15) did a very gol. 2017 Jul;98:85-90.
interesting analysis and concluded that patients with 12. (12) Li K, Wei P, Qin Y, Wei Y. Is C-reactive protein a marker of ob-
OSAS who received CPAP had less cardiovascular structive sleep apnea?: A meta-analysis. Medicine (Baltimore 2017
May;96(19):e6850.
events than those who are not treated.
13. Atan D, Kundi FCS, Özcan KM, Dere H. A New Predictor for Obstructive
Sleep Apnea Syndrome: Monocyte to HDL Ratio. Indian L Otolaryngol
Conclusion Head Neck Surg 2017 Jun;69(2):142-146.
Obstructive sleep apnoea syndrome is common and 14. Koo SK, Kwon SB, Kim YJ, Moon JIS, Kim YJ, Jung SH. Acoustic analysis of
can have serious effects on the cardi-metabolic sys- snoring sounds recorded with a smartphone according to obstruction site
tem of patients leading to significant morbity and in OSAS patients.Eur Arch Otorhinolaryngol. 2017 Mar;274(3):1735-1740.
mortality. 15. Coma-Del-Corral MJ, Alonso-Álvarez ML, Allende M, Cordero J, Ordax
E, Masa F, Terán-Santos J. Reliability of telemedicine in the diagnosis
BULLET POINTS: and treatment of sleep apnea syndrome. Telemed J E Health. 2013
Jan;19(1):7-12
- OSAS is very common, but there is still little aware-
ness of it by the public. 16. Leger D, Elbaz M, Piednoir B, Carron A, Texereau J. Evaluation of the
GCDC 2017

