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January 24/31, 2017

Screening for Obstructive Sleep Apnea: Implications for the Sleep Health of the Population

Author Affiliations
  • 1Sleep Health Institute and Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
  • 2Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
JAMA. 2017;317(4):368-370. doi:10.1001/jama.2016.18630

Obstructive sleep apnea (OSA) is highly prevalent, affecting 34% of men and 17% of women.1 Individuals with OSA experience recurrent cardiometabolic stress when repetitively attempting to breathe against an occluded airway during sleep, leading to nightly episodes of hypoxia, sleep disruption, and surges of the sympathetic nervous system. These physiological perturbations often cause blood pressure and heart rate elevations, endothelial dysfunction, and insulin resistance—mechanisms implicated in the pathogenesis of cardiovascular disease (CVD), diabetes, and neurologic disease.2 When untreated, OSA is associated with an increased risk for incident hypertension, CVD, stroke, and mortality,3 as well as increased sleepiness, motor vehicle crashes, and mood disorders and reduced quality of life.4,5 Given its association with CVD, OSA has been proposed as a novel intervention target for reducing morbidity and mortality rates. The quest, however, to improve health by treating OSA requires rigorous research that evaluates the role of OSA interventions in large groups of patients followed up for long periods. Advancing this research agenda requires validated tools for screening appropriate populations and the availability of interventions that effectively treat OSA.

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