Obstructive Sleep Apnea: A Syndrome from Childhood to Old-Age

Obstructive sleep apnea (OSA) is estimated to occur in 26% of adults and 2% to 7% of children. OSA is characterized by a partial or complete cessation of airflow in the upper airway. Classically, the main risk factors include obesity, age, and gender, although those outside the “overweight, middle-aged man” phenotype can certainly be at risk for the development of OSA, particularly when predisposing anatomic abnormalities are encountered. Common symptoms include excessive daytime sleepiness, snoring, witnessed apneas, choking or gasping, and unrefreshing sleep. OSA has also been linked to many systemic pathology including pulmonary and cardiovascular disease, neurocognitive and neuropsychiatric impairments, metabolic dysregulation, and ophthalmologic disorders. Due to this potential for influencing multi-system disease, accurate diagnosis and treatment is essential. Treatment methods are continuously developing and improving, but the traditional, gold standard treatment is positive airway pressure (PAP) treatment. There are several modalities within this category including continuous PAP and bilevel PAP. Other treatment alternatives which can improve OSA include upper airway surgery, orthodontic therapy, mandibular advancement devices, and weight loss. Novel treatments that target upper airway muscle tone include hypoglossal nerve stimulation and myofunctional exercises. The goal of this article was to summarize key aspects of patient presentation, potential comorbidities, and therapeutic options for multidisciplinary clinicians who play an integral role in the management of this syndrome from childhood to old-age. © 2015, The Author(s).