The purpose of this review is to outline a practical, useful approach to the overall management of patients with sleep breathing disorder. The spectrum of sleep breathing disorders ranges from nonapneic snoring, to upper airway respiratory syndrome, to more severe apneas causing physiological and clinical abnormalities, Snoring is the most common symptom of sleep apnea, most patients who snore do not have sleep apnea. Nevertheless, many nonapneic snorers present with subjective symptoms similar to those described in patients with sleep apnea, for example, daytime sleepiness, tiredness, difficulty in concentrations, headaches, and reduced work performance. Guilleminault et al termed this constellation of laboratory findings (repetitive arousals and increased upper airway resistance without apneas or hypopneas) and clinical abnormalities (daytime tiredness and sleepiness) the upper airway resistance syndrome (UARS).
Obstructive sleep apnea syndrome (OSAS) is defined by a combination of symptoms and laboratory findings. The symptoms may be excessive daytime sleepiness, choking or gasping during sleep, recurrent awakenings from sleep, unrefreshing sleep, daytime fatigue, and impaired concentration. The overnight sleep study should demonstrate a respiratry disturbance index (RDI) of five or more obstructed breathing events per hour. General treatment guidelines of OSAS are briefly reviewed.
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