Title: Unraveling the Complexities of Obstructive Sleep Apnea Syndrome: A Comprehensive

Literature Review

In the realm of medical research, few conditions demand as much attention and understanding as
Obstructive Sleep Apnea Syndrome (OSAS). This prevalent disorder, characterized by repetitive
partial or complete obstruction of the upper airway during sleep, poses significant challenges for both
patients and healthcare providers. To navigate through the labyrinth of knowledge surrounding
OSAS, a thorough literature review becomes indispensable.

Crafting a comprehensive literature review on OSAS is no easy feat. It requires meticulous

exploration of peer-reviewed articles, clinical studies, and academic papers spanning various
disciplines such as sleep medicine, pulmonology, neurology, and otolaryngology. The complexity of
OSAS, intertwined with its multifaceted etiology, clinical manifestations, diagnostic modalities, and
treatment options, adds layers of intricacy to the review process.

Researchers undertaking the task of synthesizing existing literature on OSAS must grapple with the
vast array of data sources and divergent perspectives within the scientific community. Furthermore,
they must critically evaluate the quality and relevance of each study to ensure the integrity and
validity of their review findings.

In light of these challenges, individuals seeking a comprehensive understanding of OSAS may find
themselves overwhelmed by the sheer volume and complexity of available literature. This is where
expert assistance can prove invaluable.

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receive a meticulously researched and impeccably written analysis of OSAS literature. Whether you
are a student, researcher, or healthcare professional, our services are designed to streamline your
academic or clinical pursuits and facilitate a deeper understanding of this enigmatic sleep disorder.

In conclusion, writing a literature review on Obstructive Sleep Apnea Syndrome is a formidable task
that requires expertise, diligence, and attention to detail. For those seeking clarity amidst the
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OSAS.
The potential role of nursing in paediatric OSA has been explored in a limited number of studies.
Surgery with complete removal of the lesion is the most adequate treatment. Journal of
Cardiovascular Development and Disease (JCDD). We use cookies on our website to ensure you get
the best experience. In: C Guilleminault, W Dement (ed) Sleep apnea syndromes. Care for paediatric
OSA may require a different level of specialisation and skill compared to adult nursing care.
Obstructive sleep apnea: who should be tested, and how. Int J Pediatr Otorhinolaryngol
32(Suppl):S59 Article. The use of strategies to enhance adherence to PAP therapy and to promote
remote management of patients with OSA are gathering interest, including pharmacological
therapies, telemedicine approaches to care provision and supplemental oxygen use. Additionally,
paediatric patients with OSA may require a different approach to education and care than adults.
Portable Monitoring Task Force of the American Academy of Sleep Medicine. Paediatric with OSA
have a different clinical picture from adults. Well the question is that which child with snoring has
sleep apnea. But all children with snoring do Not have sleep apnea. Using the inclusion and exclusion
criteria, two reviewers independently examined the titles and abstracts of the references, and any
disagreements between them were resolved by consensus. In addition, in each of them,
anthropometric parameters such as weight, height, body mass index (BMI), waist and neck
circumference were measured. All overnight cardiorespiratory monitors had a valid recording time of
at least 4 hours. University of Michigan Center for Human Growth and Development, Ann Arbor,
MI 149 (endash). Note that from the first issue of 2016, this journal uses article numbers instead of
page numbers. Additionally, the included studies primarily focused on PAP therapy, whereas non-
PAP therapies were largely excluded. 10. Implications From a research perspective, studies are
needed to improve the standardisation of methods used to diagnose OSA in practice through direct
comparisons of tools used in different practice settings and a thorough evaluation of their value.
Nursing Professionals’ Role in the Comprehensive Management of Obstructive Sleep Apnoea: A
Literature Review. Appl. Sci. 2023, 13, 3516. International Journal of Translational Medicine (IJTM).
OSAS lies along a continuum of sleep-disordered breathing (SDB). This snoring can be associated
with intermittent gasps, short pauses, bed wetting and abnormal sleep postures (like sleeping with
neck hyperextended) There can be associated day time symptoms like morning headaches, excessive
day time sleepiness and some children might become hyperactive. See our Other Publications
MDedge: Keeping You Informed. Thought you might appreciate this item(s) I saw in Current
Opinion in Pulmonary Medicine. OSA is characterized by recurrent episodes of partial or complete
collapse of the upper airway during sleep followed by hypoxia and sympathetic activation. Patients
with Parkinson disease are at risk for both OSA and hypotension, making them generally an
exception to the association of OSA with hypertension. 3 The home overnight OSA test often
consists of a pulse oximeter worn for 8 hours at night, taped to a finger. 4 This simple, inexpensive
test for OSA detects episodes of apnea or hypopnea that result in arterial desaturation. The time
domain indices analyzed in this study include: the standard deviation of all R-R intervals (SDNN);
the square root of the mean square differences of the adjacent R-R intervals (RMSSD); the
percentage of adjacent R-R intervals that differ from each other by more than 50 ms (pNN50). To
manage references, to look for duplicates, and eliminate them, EndNote 9.2 was used as a citation
management tool.
The education was delivered by a sleep physician and specialist nurse from the sleep unit who were
responsible for managing PAP therapy treatment for the patients in this study who were assigned to
the sleep unit group. J Clin Sleep Med. 2009;5:263-276. 5. Qaseem A, Dallas P, Owens DK, et al.
The patient’s daytime performance becomes insidiously more impaired, until the patient eventually
decompensates and presents to the healthcare system, either volitionally or as a result of one of the
complications of sleep apnea. ATRAMI (Autonomic Tone and Reflexes After Myocardial Infarction)
Investigators. The use of strategies to enhance adherence to PAP therapy and to promote remote
management of patients with OSA are gathering interest, including pharmacological therapies,
telemedicine approaches to care provision and supplemental oxygen use. Mayo Clin Proc.
2016;91:469-476. 7. Flemons WW, Whitelaw WA, Brant R, et al. This study maps current research
on this topic based on scholarly publications, including qualitative and quantitative studies. The HF
component reflects the activity of the parasympathetic nervous system, while the LF component is
generally associated with sympathetic activity. It is likely that nurses will screen the patients as they
are the first point of contact within the healthcare system. The evidence base that underlies nurse-led
interventions should also be improved. All overnight cardiorespiratory monitors had a valid
recording time of at least 4 hours. To manage references, to look for duplicates, and eliminate them,
EndNote 9.2 was used as a citation management tool. Am J Respir Crit Care Med 162(4 Pt 1):1407
Article. Clinical guideline for the evaluation, management and long-term care of obstructive sleep
apnea in adults. University of Michigan Center for Human Growth and Development, Ann Arbor,
MI 149 (endash). Additionally, paediatric patients with OSA may require a different approach to
education and care than adults. Inclusion was restricted to English language publications published
from January 2015. Additionally, the included studies primarily focused on PAP therapy, whereas
non-PAP therapies were largely excluded. 10. Implications From a research perspective, studies are
needed to improve the standardisation of methods used to diagnose OSA in practice through direct
comparisons of tools used in different practice settings and a thorough evaluation of their value. The
symptoms and treatment of OSA in paediatric and adult patients are unique. HSAT devices have
increased risk of technical failures due to a lack of real-time monitoring and have inherent limitations
resulting from the inability of most devices to define sleep versus wake. A multicentre, noninferiority,
randomised, controlled trial with two open parallel arms and a cost-effectiveness analysis was
conducted in Spain in which 20 primary care centres corresponding to six tertiary hospitals
sequentially screened patients for suspected OSA. What is known about the effectiveness of nurse-
led interventions, as well as cost effectiveness of obstructive sleep apnoea management in primary
care settings? 3. Regarding primary care management, the patients were overseen by primary care
physicians and nurses who attended a 6-h education programme on obstructive sleep apnoea. Further,
patients reported improved sleepiness and quality of life. It is imperative that OSA-related risk
factors and complications are identified for effective management in clinical practice. Additionally,
300 studies were disregarded because they failed to present results particular to the role of nursing in
OSA management. In order for patients to benefit from this transition, nurses must be supported and
trained in OSA management and follow-up. The AASM manual for the scoring of sleep and
associated events: rules, terminology and technical specifications, 1st edn. Decreased sleep time in
the elderly is a precipitating factor in amyloid retention. Use of this website is subject to the website
terms of use and privacy policy.
Am J Respir Crit Care Med 162(4 Pt 1):1407 Article. Critical analysis can assist researchers in
focusing their attention on articles relevant to the research issue and substantiating their assertions
with reliable evidence. Nursing Professionals’ Role in the Comprehensive Management of
Obstructive Sleep Apnoea: A Literature Review. Appl. Sci. 2023, 13, 3516. Fifty-one consecutive
patients treated by maxillofacial surgery. This article is an open access article distributed under the
terms and conditions of the Creative Commons Attribution (CC BY) license ( ). Likelihood ratios
for a sleep apnea clinical prediction rule. International Journal of Environmental Research and Public
Health (IJERPH). J Am Board Fam Med. 2011;24:138-145. 4. Epstein LJ, Kristo D, Strollo PJ, Jr., et
al; Adult Obstructive Sleep Apnea Task Force of the American Academy of Sleep Medicine. In: C
Guilleminault, W Dement (ed) Sleep apnea syndromes. Effectiveness of portable monitoring devices
for diagnosing obstructive sleep apnea: update of a systematic review. All articles published by
MDPI are made immediately available worldwide under an open access license. No special. A nn
Intern Med. 2014;161:210-220. 6. Grover M, Mookadam M, Chang Y-H, et al. The statistical tests
used were, when appropriate, Student's t and Mann-Withney respectively. However, the demand for
specialised sleep units has been increasing as well as the wait lists for consultations for these
services. Accordingly, this might have implications for OSA diagnosis based on the AHI. American
Academy of Sleep Medicine, Westchester, IL. Poorer sleep quality and shorter sleep duration have
been associated with a higher amyloid burden. Sleep apnea is a condition where the breathing
airways (as shown in the figure) close partially or completely during sleep. In view of the co-
morbidities and potential public health implications as well as the economic burden of untreated
OSA in the long term, it is imperative to identify and manage patients with OSA. Thought you might
appreciate this item(s) I saw in Current Opinion in Pulmonary Medicine. Overall, in OSA it is
possible to consider a conceptual model based on repeated acute insults (i.e. continuous
hemodynamic, hypoxemic and autonomic variations) that lead, over time, to a structural and
electrical cardiac remodeling capable of constituting a potentially arrhythmogenic substrate (Figure
1). The primary symptom of sleep apnea is snoring during sleep. Clinical guidelines for the use of
unattended portable monitors in the diagnosis of obstructive sleep apnea in adult patients. The
patient’s daytime performance becomes insidiously more impaired, until the patient eventually
decompensates and presents to the healthcare system, either volitionally or as a result of one of the
complications of sleep apnea. J Clin Sleep Med. 2007;3:582-588. 9. Myers KA, Mrkobrada M, Simel
DL. METHODS Subjects We performed secondary analyses on data obtained from our SACS
validation cohort. 6 In brief, these were patients suspected of having OSA based on the presence of
signs, symptoms, or associated risk factors. J Am Board Fam Med. 2011;24:152-160. 3. Mold JW,
Quattlebaum C, Schinnerer E, et al. The peripheral type arises from the periosteum and is rarely seen
in the mandible. It is necessary, however, to raise concerns regarding the global shortage of nurses as
well as whether nurses are prepared to cope with the growing number of patients. 11. Limitations
The review process recognised that there was a relative paucity of literature on the effectiveness of
nurses in delivering OSA care in the community, including studies comparing nurse-led care with
other approaches. Feature papers are submitted upon individual invitation or recommendation by the
scientific editors and must receive.
There have been very few reported cases of osteomas located on the ramus of mandible. Nursing
Professionals’ Role in the Comprehensive Management of Obstructive Sleep Apnoea: A Literature
Review. The evidence base that underlies nurse-led interventions should also be improved.
Epidemiology and pathophysiology are part of the presentation. The definition of a large neck as
larger than 40 cm must obviously be more sensitive for predicting OSA, and the definition of greater
than 17 inches more specific. Additionally, nurses can provide patient education and coordinate with
other health care providers. The experience of these nurse-led telephone consultations was
subsequently evaluated by parents between June 2016 and April 2017. Use of this website is subject
to the website terms of use and privacy policy. Hypoxemia and poor sleep quality because of OSA
increase the risk of cognitive decline in the elderly. Download citation.RIS.ENW.BIB DOI:
Published: 03 May 2017. Further studies are needed to identify the potential role of nursing in the
comprehensive management of paediatric OSA and to explore cost-effective alternatives, including
other clinical settings such as primary care units. Diagnosis of obstructive sleep apnea in adults: a
clinical practice guideline from the American College of Physicians. Parents were contacted by
telephone for six weeks post-operatively by a nurse specialist. Our internal OSA practice guidelines
recommend referral for sleep medicine consultation when oximetry results are
abnormal—specifically, an oxygen desaturation index (ODI) of ?5, a mean saturation less than 89%,
and a minimum saturation of 75% or less. Nevertheless, the questionnaires may provide useful input
in identifying individuals who are suffering from OSA until nursing educational programmes are
further developed to integrate OSA as a chronic disease into primary care. Comorbidities secondary
to SDB (particularly cardio and cerebrovascular) are emphasized. Sleep apnea also leads to
disturbances in the blood levels of oxygen and carbon dioxide (waste gas). The first page of the PDF
of this article appears above. A reversible uvulopalatal flap for snoring and sleep apnea syndrome:
surgical technique. Journal of Cardiovascular Development and Disease (JCDD). The management of
OSA typically revolves around positive airway pressure (PAP) therapy; the use of continuous positive
airway pressure (CPAP) is considered the gold standard treatment. As a result of the literature
review, it appears that nurses play a variety of roles in the diagnosis, assessment, management, and
follow-up of patients with OSA. ODI was defined as the number of 4% drops in saturation from
baseline divided by the number of hours of recording time. The symptoms and treatment of OSA in
paediatric and adult patients are unique. It is, however, possible to use PAP therapy during an HSAT
under certain circumstances. Sleep apnea.. Accessed September 14, 2018. 2. Grover M, Mookadam
M, Armas D, et al. Additionally, 300 studies were disregarded because they failed to present results
particular to the role of nursing in OSA management. This study maps current research on this topic
based on scholarly publications, including qualitative and quantitative studies. Nursing care for
children with OSA may require creative and interactive methods for educating them on the
importance of treatment adherence as well as involving family members more heavily than in care for
adults. Int J Pediatr Otorhinolaryngol 32(Suppl):S59 Article.
Editors select a small number of articles recently published in the journal that they believe will be
particularly. Herein, we report an unusual case of giant osteoma of the mandible depressing the
lateral pharyngeal wall, interfering with normal respiration during the night. Google Scholar More in
this TOC Section Departments. Paediatric OSA nurses play a crucial role in identifying these
symptoms, educating patients and their families regarding OSA, and providing comprehensive care
to patients. Patients could also consult with the primary care physician or nurse who performed the
follow-up visits via telephone if necessary. Following the removal of duplicates, 345 articles were
selected for screening. Parents were contacted by telephone for six weeks post-operatively by a nurse
specialist. Identifying patients at risk for obstructive sleep apnea in a primary care practice. Many
patients suspected of having OSA will be assigned to intermediate risk (SACS 6-14), and their PTP
of OSA remains at 40% to 45%, the pre-test level most commonly encountered in suspected OSA.
This leads to a poor sleep quality (also called as a fragmented sleep). Furthermore, the patients were
asked to complete relevant research questionnaires. Overall, in OSA it is possible to consider a
conceptual model based on repeated acute insults (i.e. continuous hemodynamic, hypoxemic and
autonomic variations) that lead, over time, to a structural and electrical cardiac remodeling capable of
constituting a potentially arrhythmogenic substrate (Figure 1). Its incidence is rare in the jaws and
mandible is more affected than the maxilla. Further studies are needed to identify the potential role
of nursing in the comprehensive management of paediatric OSA and to explore cost-effective
alternatives, including other clinical settings such as primary care units. Practice parameters for the
use of portable monitoring devices in the investigation of suspected obstructive sleep apnea in adults.
Clinical guidelines for the use of unattended portable monitors in the diagnosis of obstructive sleep
apnea in adult patients. Kent A contemporary review of obstructive sleep apnea Ralls, Frank a,b;
Cutchen, Lisa a,b. This review excluded studies that had been published before 2015, were not in
English, or were abstracts, conference papers, editorial studies, commentaries, or grey literature. Am
J Respir Crit Care Med 162(4 Pt 1):1407 Article. The primary symptom of sleep apnea is snoring
during sleep. Additionally, the secondary outcomes were Epworth Sleep Scale (ESS) score,
EuroQoL, patient satisfaction, BMI, blood pressure and cost-effectiveness. What are the conditions
which predispose a child to have sleep apnea. The statistical tests used were, when appropriate,
Student's t and Mann-Withney respectively. A further consideration has been that all levels of
medical care must be involved. In addition, further research is required to determine the most
effective approaches to improving PAP therapy adherence as well as to supporting PAP therapy
withdrawal in patients with OSA. American Academy of Sleep Medicine, Westchester, IL. This
review supports the findings of other studies published prior to 2015. The guiding quality questions
were used as a guide to inform decisions about the risk of various systematic biases. Home
respiratory polygraphy (HRP) is a simplified, portable monitor that measures air flow, respiratory
efforts, pulse oximetry, and body position. A noteworthy contribution of this study is the use of a
prescribed clinical algorithm in primary care practices that did not require extensive training of
primary care nurses.
Sleep apnea.. Accessed September 14, 2018. 2. Grover M, Mookadam M, Armas D, et al. The
guiding quality questions were used as a guide to inform decisions about the risk of various
systematic biases. In a study conducted by the Spanish Sleep Network, PAP therapy adherence was
similar between primary care and sleep units, and primary care settings demonstrated consistent
overall effectiveness of care. Tropical Medicine and Infectious Disease (TropicalMed). Conclusion:
Nurses can play a critical role in obstructive sleep apnoea. This leads to a poor sleep quality (also
called as a fragmented sleep). Is it beneficial to also document episodes of apnea or hypopnea that
do not result in arterial desaturation. In: Y Oomura, S Tarui, S Inoue, T Shimazu (ed) Progress in
Obesity Research. Identifying patients at risk for obstructive sleep apnea in a primary care practice.
Strategies for improving the quality of verbal patient and family education: A review of the literature
and creation of the EDUCATE model. In: C Guilleminault, W Dement (ed) Sleep apnea syndromes.
Thought you might appreciate this item(s) I saw in Current Opinion in Pulmonary Medicine. Using
the inclusion and exclusion criteria, two reviewers independently examined the titles and abstracts of
the references, and any disagreements between them were resolved by consensus. International data
suggests that around 1-5 out of a hundred would have sleep apnea. A new search of relevant articles
was conducted in February 2023, and as a result two new articles were added to the review, as a
result, the total of included articles is 12. Journal of Otorhinolaryngology, Hearing and Balance
Medicine (JOHBM). There are many ways in which nurses can contribute, including screening,
assessment, diagnosis, promotion of therapy adherence, and following up with patients, including
monitoring for any side effects associated with the CPAP machine, such as irritation of the face. In
the second paragraph of the text, large neck circumference is defined as greater than 17 inches in
men, which would include collar sizes above 17. Inclusion was restricted to English language
publications published from January 2015. In: C Guilleminault, W Dement (ed) Sleep apnea
syndromes. The statistical tests used were, when appropriate, Student's t and Mann-Withney
respectively. The inclusion criteria were peer-reviewed studies, including quantitative and qualitative
studies, as well as mixed methods studies, studies focused on individuals with OSA of any age
group and studies which displayed the nursing contribution to the management of obstructive sleep
apnoea in primary care or in sleep units. The objective of our study was to report the case of a patient
with OSA treated in Dento-Facial Orthopedics. J Am Board Fam Med. 2011;24:152-160. 3. Mold
JW, Quattlebaum C, Schinnerer E, et al. A nn Intern Med. 2014;161:210-220. 6. Grover M,
Mookadam M, Chang Y-H, et al. Are these episodes important clinically, other than for prognosis in
patients who may go on to develop apneic episodes severe enough to cause desaturation. The
potential role of nursing in paediatric OSA has been explored in a limited number of studies. We
reported our experience in diagnosis, treatment and follow-up of this uncommon disease. In June
2021, the five databases yielded a total of 566 articles. Gout, Urate, and Crystal Deposition Disease
(GUCDD).
Nursing care for children with OSA may require creative and interactive methods for educating them
on the importance of treatment adherence as well as involving family members more heavily than in
care for adults. Clinical guidelines for the use of unattended portable monitors in the diagnosis of
obstructive sleep apnea in adult patients. The potential role of nursing in paediatric OSA has been
explored in a limited number of studies. It is a difficult question to answer since No signs and
symptoms would give us a good clue. The gold standard test for diagnosing OSA is an in-lab sleep
study or PSG. Considering the chronicity of this disease, its prevalence and long-term consequences,
it is imperative to manage it. Strategies for improving the quality of verbal patient and family
education: A review of the literature and creation of the EDUCATE model. All articles published by
MDPI are made immediately available worldwide under an open access license. No special. The
patient’s daytime performance becomes insidiously more impaired, until the patient eventually
decompensates and presents to the healthcare system, either volitionally or as a result of one of the
complications of sleep apnea. The primary symptom of sleep apnea is snoring during sleep. It will be
necessary for nurses to receive training in the proper use of screening tools to ensure an accurate and
timely diagnosis and referral of individuals suffering from sleep apnoea. The uniqueness of this case
is related to snoring and sleep apnoea symptoms. In fact, he presented to our Department because
daytime sleepiness hindered his work, and not for the evident facial swelling. Of the 45 articles
which were retrieved fully, only 10 met all the inclusion and exclusion criteria ( Figure 1 ). Others
are children with neuromuscular disorders, craniofacial syndromes, pierre robin syndrome, Down’s
syndrome etc. OSA is characterized by recurrent episodes of partial or complete collapse of the
upper airway during sleep followed by hypoxia and sympathetic activation. In primary health care,
nurses appear to be best positioned to provide effective patient follow-up and education, using
diverse techniques such as telemedicine to facilitate patient assessment and prevent treatment
escalation. In view of the co-morbidities and potential public health implications as well as the
economic burden of untreated OSA in the long term, it is imperative to identify and manage patients
with OSA. Identification by primary care clinicians of patients with obstructive sleep apnea: a
practice-based research network (PBRN) study. Journal of Cardiovascular Development and Disease
(JCDD). The first page of the PDF of this article appears above. International Journal of
Environmental Research and Public Health (IJERPH). Nursing Professionals’ Role in the
Comprehensive Management of Obstructive Sleep Apnoea: A Literature Review. The patients with
OSA were randomly assigned to either the specialised sleep unit or primary care units for follow-up
over the course of six months. Nursing-led care is often supported by clinical trials rather than actual
practice in patients with OSA, and it is therefore necessary to conduct further research on nurse-led
care strategies in practice as well as using other research methodologies, such as qualitative studies.
Overall, in OSA it is possible to consider a conceptual model based on repeated acute insults (i.e.
continuous hemodynamic, hypoxemic and autonomic variations) that lead, over time, to a structural
and electrical cardiac remodeling capable of constituting a potentially arrhythmogenic substrate
(Figure 1). Accordingly, this might have implications for OSA diagnosis based on the AHI. Care for
paediatric OSA may require a different level of specialisation and skill compared to adult nursing
care. A 5-year follow-up study on the relationship between obstructive sleep apnea and Parkinson
disease. HRV is the variation of the time intervals between adjacent heart beats and is considered a
measure of neurocardiac function that reflects, in fact, heart-brain interactions and the dynamics of
the autonomic nervous system. They are usually asymptomatic and can be discovered in routine
clinical and radiographic examination.