Sleep Apnea and Snoring

Perioperative and Anesthesia Management

1 Introduction Obstructive sleep apnea/hypopnea syndrome (OSAHS) is a growing health care concern with many potentially detrimental consequences and important anesthetic implications. A rise in obesity among the population of the United States corresponds with an upswing in the prevalence…

Rationale and Indications for Surgical Treatment

1 Background and Rationale for Surgical Therapy The rationale for and the objectives of surgical treatment for obstructive sleep apnea (OSA) are fundamentally analogous to those of medical management: to improve sleep-related symptoms and quality-of-life measures and to reduce cardiovascular…

Oral Appliances for OSA

1 Introduction Intraoral mandibular advancement devices (MADs) have become an acceptable and common treatment for the signs and symptoms of obstructive sleep apnea (OSA) in the United States. Oral appliances can be employed as a first-line modality for OSA and…

Analysis of CPAP Failures

1 Introduction Arguably, the goal of treatment of obstructive sleep apnea (OSA) is (1) elimination or improvement of symptoms, (2) normalization or improvement of sleep study parameters, and (3) cardiovascular risk reduction in the longer term. The latter is especially…

CPAP, APAP, and BiPAP

1 Introduction Positive airway pressure (PAP) therapy is the standard modality for treating moderate and severe obstructive sleep apnea (OSA) in adults. It was first described by Colin Sullivan, an Australian pulmonologist, in 1981. There are several theories as to…

Obstructive Sleep Apnea: Decision Making and Treatment Planning

1 Introduction Numerous treatment options for obstructive sleep apnea (OSA) presently exist. These treatments range from noninvasive behavioral modifications to nightly use of continuous positive airway pressure (CPAP) devices to numerous pharyngeal expansion procedures that either alter airway anatomy or…

Drug-Induced Sleep Endoscopy (DISE)

1 Introduction Drug-induced sleep endoscopy (DISE) was introduced by Croft and Pringle in 1991 and over time has increased in popularity and is applied worldwide. The evaluation requires pharmacologic induction of sedation and flexible fiber-optic endoscopy to visualize upper airway…