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Lung India. 2015 Jul-Aug;32(4):422-34. doi: 10.4103/0970-2113.159677.

Consensus and evidence-based Indian initiative on obstructive sleep apnea guidelines 2014 (first edition).

Author information

1
All India Institute of Medical Sciences, New Delhi, India ; Writing Committee of the Indian Initiative on Obstructive Sleep Apnoea Guidelines Working Group.
2
Writing Committee of the Indian Initiative on Obstructive Sleep Apnoea Guidelines Working Group ; Indian Council of Medical Research, New Delhi, India.
3
Writing Committee of the Indian Initiative on Obstructive Sleep Apnoea Guidelines Working Group ; Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India.
4
Writing Committee of the Indian Initiative on Obstructive Sleep Apnoea Guidelines Working Group ; Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
5
Writing Committee of the Indian Initiative on Obstructive Sleep Apnoea Guidelines Working Group ; Post Graduate Institute of Medical Education and Research, Chandigarh, India.
6
Writing Committee of the Indian Initiative on Obstructive Sleep Apnoea Guidelines Working Group ; Medanta Hospital, Gurgaon, Haryana, India.
7
Writing Committee of the Indian Initiative on Obstructive Sleep Apnoea Guidelines Working Group ; National Allergy Asthma Bronchitis Institute, Kolkata, West Bengal, India.
8
Writing Committee of the Indian Initiative on Obstructive Sleep Apnoea Guidelines Working Group ; Employees' State Insurance Corporation, Post Graduate Institute of Medical Sciences and Research, New Delhi, India.
9
Writing Committee of the Indian Initiative on Obstructive Sleep Apnoea Guidelines Working Group ; Topiwala National Medical College, Mumbai, Maharashtra, India.
10
Writing Committee of the Indian Initiative on Obstructive Sleep Apnoea Guidelines Working Group ; Apollo Hospitals, New Delhi, India.
11
Writing Committee of the Indian Initiative on Obstructive Sleep Apnoea Guidelines Working Group ; Sree Balaji Medical College and Hospital, Bharath University, Chennai, Tamil Nadu, India.
12
Writing Committee of the Indian Initiative on Obstructive Sleep Apnoea Guidelines Working Group ; All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
13
Writing Committee of the Indian Initiative on Obstructive Sleep Apnoea Guidelines Working Group ; School of Life Sciences, Jawaharlal Nehru University, New Delhi, India.
14
Writing Committee of the Indian Initiative on Obstructive Sleep Apnoea Guidelines Working Group ; Apollo Hospitals, Bengaluru, Karnataka, India.
15
Writing Committee of the Indian Initiative on Obstructive Sleep Apnoea Guidelines Working Group ; VP Chest Institute, New Delhi, India.
16
Writing Committee of the Indian Initiative on Obstructive Sleep Apnoea Guidelines Working Group ; Safdarjung Hospital, New Delhi, India.
17
Writing Committee of the Indian Initiative on Obstructive Sleep Apnoea Guidelines Working Group ; Indian Council of Medical Research, Bhopal, Madhya Pradesh, India.
18
Writing Committee of the Indian Initiative on Obstructive Sleep Apnoea Guidelines Working Group ; Apollo Hospitals, Chennai, Tamil Nadu, India.

Abstract

Obstructive sleep apnea (OSA) and obstructive sleep apnea syndrome (OSAS) are subsets of sleep-disordered breathing. Awareness about OSA and its consequences among the general public as well as the majority of primary care physicians across India is poor. This necessitated the development of the Indian initiative on obstructive sleep apnea (INOSA) guidelines under the auspices of Department of Health Research, Ministry of Health and Family Welfare, Government of India. OSA is the occurrence of an average five or more episodes of obstructive respiratory events per hour of sleep with either sleep-related symptoms or co-morbidities or ≥15 such episodes without any sleep-related symptoms or co-morbidities. OSAS is defined as OSA associated with daytime symptoms, most often excessive sleepiness. Patients undergoing routine health check-up with snoring, daytime sleepiness, obesity, hypertension, motor vehicular accidents, and high-risk cases should undergo a comprehensive sleep evaluation. Medical examiners evaluating drivers, air pilots, railway drivers, and heavy machinery workers should be educated about OSA and should comprehensively evaluate applicants for OSA. Those suspected to have OSA on comprehensive sleep evaluation should be referred for a sleep study. Supervised overnight polysomnography is the "gold standard" for evaluation of OSA. Positive airway pressure (PAP) therapy is the mainstay of treatment of OSA. Oral appliances (OA) are indicated for use in patients with mild to moderate OSA who prefer OA to PAP, or who do not respond to PAP or who fail treatment attempts with PAP or behavioral measures. Surgical treatment is recommended in patients who have failed or are intolerant to PAP therapy.

KEYWORDS:

Bariatric surgery; Indian guidelines; continuous positive airway pressure; obstructive sleep apnea; obstructive sleep apnea syndrome; polysomnography; sleep apnea; sleep study; syndrome Z

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