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Nat Rev Dis Primers. 2015 Jun 25;1:15015. doi: 10.1038/nrdp.2015.15.

Obstructive sleep apnoea syndrome.

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Grenoble University Hospital, Department of Physiology, Sleep Laboratory, BP 53, 38041 Grenoble, Cedex 9, France.
Hypoxia-Pathophysiology Laboratory (HP2), University Grenoble Alpes, Grenoble, France.
Department of Pulmonology, University Hospital of Zurich, Zurich, Switzerland.
Pulmonary and Sleep Disorders Unit, University College Dublin, Dublin, Ireland.
Respiratory Department, Arnau de Vilanova and Santa Maria University Hospital, Leida, Spain.
Respiratory Research Group, CIBERES, Madrid, Spain.
Adelaide Institute for Sleep Health, Adelaide, Australia.
Division of Cardiovascular Diseases, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
The Rappaport Faculty of Medicine, Unit of Anatomy and Cell Biology, Technion - Israel Institute of Technology, Haifa, Israel.


Obstructive sleep apnoea syndrome (OSAS) is a common clinical condition in which the throat narrows or collapses repeatedly during sleep, causing obstructive sleep apnoea events. The syndrome is particularly prevalent in middle-aged and older adults. The mechanism by which the upper airway collapses is not fully understood but is multifactorial and includes obesity, craniofacial changes, alteration in upper airway muscle function, pharyngeal neuropathy and fluid shift towards the neck. The direct consequences of the collapse are intermittent hypoxia and hypercapnia, recurrent arousals and increase in respiratory efforts, leading to secondary sympathetic activation, oxidative stress and systemic inflammation. Excessive daytime sleepiness is a burden for the majority of patients. OSAS is also associated with cardiovascular co-morbidities, including hypertension, arrhythmias, stroke, coronary heart disease, atherosclerosis and overall increased cardiovascular mortality, as well as metabolic dysfunction. Whether treating sleep apnoea can fully reverse its chronic consequences remains to be established in adequately designed studies. Continuous positive airway pressure (CPAP) is the primary treatment modality in patients with severe OSAS, whereas oral appliances are also widely used in mild to moderate forms. Finally, combining different treatment modalities such as CPAP and weight control is beneficial, but need to be evaluated in randomized controlled trials. For an illustrated summary of this Primer, visit:

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