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Obstructive sleep apnea (OSA) is a common disease that is often under-diagnosed and under-treated in all ages. This is due to differences in morphology, diversity in clinical phenotypes, and differences in diagnosis and treatment of OSA in children and adults, even among individuals of the same age. This narrative review seeks to describe the current concepts and relevant approaches towards personalized management of patients with OSA, according to pathophysiology, cluster analysis of clinical characteristics, adequate combined therapy, and the consideration of patients’ expectations.

Using electronic health records data from the All of Us Research Program, we show that higher daily step counts in data collected over several years of Fitbit fitness tracker use were associated with lower risk of common, chronic diseases, including diabetes, hypertension, gastroesophageal reflux disease, depression, obesity and sleep apnea.

After controlling for demographics, sleep, and health covariates, each 10-year increment in age estimate error (AEE) was associated with increased all-cause mortality rate of 29% (95% confidence interval: 20–39%). An increase from -10 to +10?years in AEE translates to an estimated decreased life expectancy of 8.7?years (95% confidence interval: 6.1–11.4?years). Greater AEE was mostly reflected in increased sleep fragmentation, suggesting this is an important biomarker of future health independent of sleep apnea.

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In this series of phenotypic association analyses including data from 24 877 individuals, the overall prevalence of NDD CNVs in the biobank was found to be 2.5%. NDD CNV carriers were enriched for congenital disorders and major depressive disorder, and the presence of NDD CNVs was found to be associated with several medical outcomes, including hypertension, obesity, and obesity-related phenotypes, specifically obstructive sleep apnea and increased body mass index.

The goal of this study was to identify and validate digital oximetry biomarkers (OBMs) for creating a reference toolbox for continuous oximetry time series analysis. We review the sleep medicine literature to identify clinically relevant OBMs. We implement these biomarkers and demonstrate their clinical value within the context of obstructive sleep apnea diagnosis.

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Also known as Vascular Contributions to Cognitive Impairment and Dementia Vascular dementia, the second most common form of dementia, is caused by conditions that damage the blood vessels in the brain or interfere with proper blood flow and oxygen delivery to the brain. Overview Vascular dementia is the second most common form of dementia, after Alzheimer?s disease, affecting almost a third of people over age 70. Dementia causes a decline in brain function, or cognitive abilities, beyond what is expected from the normal aging process. Dementia causes problems with memory, thinking, behavior, language skills, and decision making. Vascular dementia is caused by conditions that damage the blood vessels in the brain, depriving the brain of oxygen. This oxygen shortage inhibits the brain?s ability to work as well as it should. For example, stroke blocks blood flow to the brain, decreasing oxygen. However, high blood pressure, high cholesterol, and smoking also increase the risk of vascular dementia. Vascular dementia in patients can occur alone or with Alzheimer?s disease. To diagnose cognitive impairment and dementia, your doctor will ask about problems you may have carrying out daily activities. Your doctor will give you brief memory or thinking tests and may ask to speak with a relative or friend who knows you well. To determine whether vascular dementia is the cause of any cognitive impairment or dementia that you may have, your doctor will consider your medical history and your lifestyle (such as your eating patterns, physical activity level, sleep health, and whether you are or have been a smoker), and order imaging tests. Diagnosis can take time. This is because it is often difficult to tell whether symptoms are a result of problems with the blood vessels, as is the case with vascular dementia, or whether they are from Alzheimer?s disease. If your doctor diagnoses you with vascular dementia, your treatment plan may include taking medicine or using medical devices to manage other conditions, such as high blood pressure, atherosclerosis, or sleep apnea, that may cause your vascular dementia to worsen. Your doctor may also recommend that you adopt heart-healthy lifestyle changes, such as heart-healthy eating, which includes limiting alcohol, getting regular physical activity, aiming for a healthy weight; quitting smoking; and managing stress.

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Also known as Continuous Positive Airway Pressure CPAP is a treatment that uses mild air pressure to keep your breathing airways open. Overview It involves using a CPAP machine that includes a mask or other device that fits over your nose or your nose and mouth, straps to position the mask, a tube that connects the mask to the machine?s motor, and a motor that blows air into the tube. CPAP is used to treat sleep-related breathing disorders including sleep apnea. It also may be used to treat preterm infants who have underdeveloped lungs. If your doctor prescribes CPAP over other treatment options for your sleep apnea, your insurance will work with a medical device company to provide you with a CPAP machine and the disposable mask and tube. Your doctor will set up your machine with certain pressure settings. After using your machine for a while, your doctor and possibly your insurance company will want to check the data card from your machine to confirm that you are using your CPAP device and to see if the machine and its pressure settings are working to reduce or eliminate apnea events while you sleep. For the treatment to work, you should use your CPAP machine every time you sleep at home, while traveling, and during naps. Getting used to using your CPAP machine can take time and requires patience. Your doctor may need to adjust your pressure settings for you. You may have to work with your sleep doctor to find the most comfortable mask that works best for you, to try the humidifier chamber in your machine, or to use a different CPAP machine that allows multiple or auto-adjusting pressure settings. Some patients notice immediate improvements after starting CPAP treatment, such as better sleep quality, reduction or elimination of snoring, and less daytime sleepiness. Equally important are the long-term benefits that you cannot notice, such as helping to prevent or control high blood pressure, lowering your risk for stroke, and improving memory and other cognitive function. Side effects of CPAP treatment may include congestion, runny nose, dry mouth, or nosebleeds. If you experience stomach discomfort or bloating, you should stop using your CPAP machine and contact your doctor immediately. Some masks can cause irritation. Your doctor can help you find ways to relieve these symptoms and adjust to using your CPAP machine. It is important that you clean your mask and tube every day and refill your medical device prescription at the right time to replace the mask and tube to ensure the treatment continues to work.

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Also known as Pickwickian Syndrome What Is Obesity hypoventilation (HI-po-ven-tih-LA-shun) syndrome (OHS) is a breathing disorder that affects some obese people. In OHS, poor breathing results in too much carbon dioxide (hypoventilation) and too little oxygen in the blood (hypoxemia). OHS sometimes is called Pickwickian syndrome. Overview To understand OHS, it helps to understand how the lungs work. When you breathe, air passes through your nose and mouth into your windpipe. The air then travels to your lungs' air sacs. These sacs are called alveoli (al-VEE-uhl-eye). Small blood vessels called capillaries (KAP-ih-lare-ees) run through the walls of the air sacs. When air reaches the air sacs, oxygen passes through the air sac walls into the blood in the capillaries. At the same time, carbon dioxide moves from the capillaries into the air sacs. This process is called gas exchange. In people who have OHS, poor breathing prevents proper gas exchange. As a result, the level of carbon dioxide in the blood rises. Also, the level of oxygen in the blood drops. These changes can lead to serious health problems, such as leg edema (e-DE-mah), pulmonary hypertension (PULL-mun-ary HI-per-TEN-shun), cor pulmonale (pul-meh-NAL-e), and secondary erythrocytosis (eh-RITH-ro-si-TOE-sis). If left untreated, OHS can even be fatal. The cause of OHS isn't fully known. Researchers think that several factors may work together to cause the disorder. Many people who have OHS also have obstructive sleep apnea. Obstructive sleep apnea is a common disorder in which the airway collapses or is blocked during sleep. This causes pauses in breathing or shallow breaths while you sleep. Obstructive sleep apnea disrupts your sleep and causes you to feel very tired during the day. (For more information, go to the Health Topics Sleep Apnea article.) Outlook Doctors treat OHS in a number of ways. One way is with positive airway pressure (PAP) machines, which are used during sleep. PAP therapy uses mild air pressure to keep your airways open. Your doctor might recommend CPAP (continuous positive airway pressure) or BiPAP (bilevel positive airway pressure). If your doctor prescribes PAP therapy, you'll work with someone from a home equipment provider to select a CPAP or BiPAP machine. The home equipment provider will help you select a machine based on your prescription and the features that meet your needs. Other treatments for OHS include ventilator (VEN-til-a-tor) support and medicines. (A ventilator is a machine that supports breathing.) OHS occurs with obesity, so your doctor will likely recommend weight loss as part of your treatment plan. Successful weight loss often involves setting goals and making lifestyle changes, such as following a healthy diet and being physically active. OHS can lead to other serious health problems, so following your treatment plan is important. Your health care team, home equipment provider, and family can help you manage your treatment.

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Also known as Polysomnography Sleep studies are painless, noninvasive tests that measure how well you sleep and how your body responds to sleep problems. Overview The more common sleep studies monitor and record data about your body during a full night of sleep. Other types of sleep studies include multiple sleep latency and daytime maintenance of wakefulness tests. Multiple sleep latency tests measure how quickly you fall asleep during a series of daytime naps and use sensors to record your brain activity and eye movements. A daytime maintenance of wakefulness test measures your ability to stay awake and alert. Sleep studies can help your doctor diagnose sleep-related breathing disorders such as sleep apnea, sleep-related seizure disorders, sleep-related movement disorders, and sleep disorders that cause extreme daytime tiredness such as narcolepsy. Doctors also may use sleep studies to help diagnose or rule out restless legs syndrome. Your doctor will determine whether you must have your sleep study at a sleep center or if you can do it at home with a portable diagnostic device. If your sleep study will be done at a sleep center, you will sleep in a bed at the sleep center for the duration of the study. Removable sensors will be placed on your scalp, face, eyelids, chest, limbs, and a finger. These sensors record your brain waves, heart rate, breathing effort and rate, oxygen levels, and muscle movements before, during, and after sleep. There is a small risk of irritation from the sensors, but this will go away after they are removed. Your doctor will review your sleep study test results and develop a treatment plan for any diagnosed sleep disorder. Untreated sleep disorders can raise your risk for heart failure, high blood pressure, stroke, diabetes, and depression. Sleep disorders also have been linked to an increased risk for injury and car accidents.

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Sleep apnea is a common condition in the United States. It can occur when the upper airway becomes blocked repeatedly during sleep, reducing or completely stopping airflow. This is known as obstructive sleep apnea. If the brain does not send the signals needed to breathe, the condition may be called central sleep apnea. Healthcare providers use sleep studies to diagnose sleep apnea. They record the number of episodes of slow or stopped breathing and the number of central sleep apnea events detected in an hour. They also determine whether oxygen levels in the blood are lower during these events. Breathing devices such as continuous positive air pressure (CPAP) machines and lifestyle changes are common sleep apnea treatments. Undiagnosed or untreated sleep apnea can lead to serious complications such as heart attack, glaucoma, diabetes, cancer, and cognitive and behavioral disorders. Explore this Health Topic to learn more about sleep apnea, our role in research and clinical trials to improve health, and where to find more information.

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