Title: Navigating the Complexity of Obstructive Sleep Apnea: A Literature Review

Welcome to our comprehensive literature review on Obstructive Sleep Apnea (OSA). As you delve
into this intricate topic, you'll quickly realize the challenges associated with synthesizing vast
amounts of research. From understanding the underlying pathophysiology to exploring the latest
treatment modalities, conducting a literature review on OSA requires diligence, expertise, and time.

At the heart of the matter lies the complexity of OSA itself. With its multifactorial etiology and
diverse manifestations, OSA demands a nuanced approach to literature review. Researchers and
clinicians alike must sift through a myriad of studies spanning various disciplines including sleep
medicine, respiratory physiology, neurology, and more.

Moreover, the landscape of OSA research is constantly evolving. New findings emerge, challenging
previously established paradigms and introducing novel perspectives. Keeping abreast of these
developments necessitates continuous engagement with the literature, making the task of conducting
a literature review on OSA both daunting and rewarding.

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In conclusion, conducting a literature review on Obstructive Sleep Apnea presents formidable

challenges, yet it is a crucial endeavor in advancing our understanding and management of this
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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. OSA also has been detected in more than 50% of patients with heart
failure with preserved systolic function. Some people have episodes of sleep apnea that have
characteristics of. People with OSA may also experience impaired attention, memory, and an
increased risk of making errors. 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. Identifying patients at risk for obstructive sleep apnea in a primary care practice.
Paediatric OSA nurses play a crucial role in identifying these symptoms, educating patients and their
families regarding OSA, and providing comprehensive care to patients. Association of nocturnal
arrhythmias with sleep-disordered breathing: the Sleep Heart Health Study. Researchers suggest that
this increased risk could be at least partially related to shared anatomical features, similar lifestyles,
or a common environment. Editor’s Choice articles are based on recommendations by the scientific
editors of MDPI journals from around the world. 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.
Methodology As a result of the fragmented and scattered nature of the literature, a systematic
review and meta-analysis was not feasible. The results showed that Islam illustrates that the three
elements of the KSOC are interrelated with one another. Management plan to reduce risks in
perioperative care of patients with presumed obstructive sleep apnea syndrome. A nn Intern Med.
2014;161:210-220. 6. Grover M, Mookadam M, Chang Y-H, et al. Gout, Urate, and Crystal
Deposition Disease (GUCDD). Previous Article in Journal Special Issue on Current Trends and
Future Directions in Voice Acoustics Measurement. This review supports the findings of other
studies published prior to 2015. View this table: View inline View popup TABLE 1 The STOP-Bang
questionnaire for obstructive sleep apnea WHICH TEST TO ORDER. Writers and editors caught
stealing content or improperly citing sources are immediately terminated, and we will work to rectify
the situation with the original publisher(s). Estimation of the clinically diagnosed proportion of sleep
apnea syndrome in middle-aged men and women. Clinical guidelines for the use of unattended
portable monitors in the diagnosis of obstructive sleep apnea in adult patients. 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. Tell us about your sleep by
taking this brief quiz. Sleep-disordered breathing, glucose intolerance, and insulin resistance: The
Sleep Heart Health Study. The following key search terms were used in the search: obstructive sleep
apnoea, OSA, nurses, nurses’ roles, primary care, primary setting, management, intervention, and
sleep units. Young T, Evans L, Finn L, Palta M Estimation of the clinically diagnosed proportion of
sleep apnea syndrome in middle-aged men and women. Obstructive sleep apnea-hypopnea and
incident stroke: the Sleep Heart Health Study. Be sure to talk to a doctor before using sedatives.
Home sleep apnea testing may be appropriate for people with a high likelihood of moderate to severe
OSA.
Somers VK, White DP, Amin R, et al American Heart Association Council for High Blood Pressure
Research Professional Education Committee, Council on Clinical Cardiology American Heart
Association Stroke Council American Heart Association Council on Cardiovascular Nursing
American College of Cardiology Foundation. Please note that many of the page functionalities won't
work as expected without javascript enabled. Journal of Theoretical and Applied Electronic
Commerce Research (JTAER). Methodology: The present study was performed to test the stability
of microspheres formulation. The use of PAP therapy for OSA continues to be a standard of care,
which can be delivered in a community setting. The experience of these nurse-led telephone
consultations was subsequently evaluated by parents between June 2016 and April 2017. Strategies
for improving the quality of verbal patient and family education: A review of the literature and
creation of the EDUCATE model. Additionally, 300 studies were disregarded because they failed to
present results particular to the role of nursing in OSA management. The first page of the PDF of
this article appears above. These include peer-reviewed journals, government reports, academic and
medical associations, and interviews with credentialed medical experts and practitioners. Many
complications of OSA are caused by a sleeper’s unsuccessful attempts to inhale when their airway is
closed or obstructed. Journal of Pharmaceutical and BioTech Industry (JPBI). The use of screening
tools can reduce OSA-related mortality and morbidity rates. However, some people with OSA never
develop noticeable symptoms, or they might attribute these signs to another cause. There are two
major types of SDB: obstructive sleep apnea (OSA) and central sleep apnea (CSA). Young T, Evans
L, Finn L, Palta M Estimation of the clinically diagnosed proportion of sleep apnea syndrome in
middle-aged men and women. The value of primary care services in management of OSA is noted in
the included studies. 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. Adverse respiratory events after general anesthesia in patients at high risk of
obstructive sleep apnea syndrome. In order to be human-readable, please install an RSS reader. OSA
can also increase the likelihood of developing complications from diabetes. 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. Connecting with other people with OSA through
websites and support groups may be a helpful first step in finding accurate information and social
support. A more comprehensive sleep history should be taken as soon as possible after a positive
OSA screening or when the physician determines that further evaluation is necessary. E-health
technology can be used by nurses to monitor and motivate patients with OSA through virtual
educational programmes, visits, and remote monitoring; however, more research needs to be
conducted to find out whether e-health technologies are cost-effective, whether patient education
via e-health tools is effective, and whether patients accept receiving education and monitoring via e-
health tools. The evidence base that underlies nurse-led interventions should also be improved. The
result of this investigation is the conclusion that unlawfulness is only one and expresses a
contradiction with the whole legal order. J Clin Sleep Med. 2009;5:263-276. 5. Qaseem A, Dallas P,
Owens DK, et al. Download Free PDF View PDF Free PDF Circumstances excluding punishability
Robert Kabat 2018 214 SUMMARY Circumstances excluding punishability 1. Symptoms of OSA
may be present both at nighttime and during the day.
The patients were followed up in person by a primary care physician or a primary care nurse to
review patients’ progress, provide support for the PAP device setup, advice regarding managing
PAP-related adverse effects and encouragement to comply with PAP therapy and adhere to its use,
education and lifestyle modification. Methodology: The present study was performed to test the
stability of microspheres formulation. Does this patient have obstructive sleep apnea?: The rational
clinical examination systematic review. JAMA. 2013;310(7):731-741. Tell us about your sleep by
taking this brief quiz. The following tips can help people learn to live with OSA. It is clear that
nurses play an essential role in supporting adherence to PAP therapy, and more should be done to
support nurses in this role by providing evidence-based strategies and facilitating primary care staff
engagement with patients in the primary care settings. The promising formulations were selected for
in-vitro stability studies. The first part of the night is used to diagnose OSA. International Journal of
Translational Medicine (IJTM). European Journal of Investigation in Health, Psychology and
Education (EJIHPE). Additionally, it was found that nursing-led interventions, particularly
educational strategies, could improve adherence to PAP therapy in particular, highlighting the
important role that nurses can play both in specialist and primary care settings to educate patients.
Inaccurate or unverifiable information will be removed prior to publication. Positive airway pressure
(PAP) therapy is the gold standard for treatment of OSA. Colleen G. Lance, MD, reviews and
presents case scenarios about the efficacy of PAP therapy, features of continuous PAP therapy, and
innovative strategies to improve adherence to therapy. Does this patient have obstructive sleep
apnea?: The rational clinical examination systematic review. JAMA. 2013;310(7):731-741.
Additionally, the secondary outcomes were Epworth Sleep Scale (ESS) score, EuroQoL, patient
satisfaction, BMI, blood pressure and cost-effectiveness. Based on the results, primary care
management of patients with OSA was not associated with poorer outcomes than sleep unit
management and was shown to be more cost-effective than sleep unit specialist management. The
study's findings reveal a relationship between basic need satisfaction of teachers and researcherly
disposition. Identifying patients at risk for obstructive sleep apnea in a primary care practice. The
Sleep Foundation editorial team is dedicated to providing content that meets the highest standards
for accuracy and objectivity. Punjabi NM, Shahar E, Redline S, Gottlieb DJ, Givelber R, Resnick
HE, Sleep Heart Health Study Investigators. To maintain the precise numbers obtained from each
database, the references were exported to the software. Main focus is on two of them that, in both
historical and international comparison, are not in all circumstances conceived as so-called
justification (circumstance excluding unlawful- ness), but also as a reason for excluding subjective
criminal liability (excuse). 2. The concepts of criminality, criminal liability and anti-legality in their
various con- cepts, which can be found in the theory of criminal law, are first analyzed. Despite the
difference in the actual cause of each type, in both cases, people with untreated sleep apnea stop
breathing repeatedly during their sleep. Journal of Pharmaceutical and BioTech Industry (JPBI).
However, the management approach should be based upon the principle that individuals with
different characteristics will be treated differently. Nursing interventions such as patient education
have been demonstrated to be highly effective in promoting adherence to PAP therapy in both sleep
units and primary care settings. The patients were reviewed by a nurse in person to evaluate their
progress. Use of this website is subject to the website terms of use and privacy policy. 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. It is, however, possible to use PAP therapy during an HSAT
under certain circumstances.
Obstructive Sleep Apnea (OSA) occurs when the upper airway becomes blocked, leading to brief
pauses in breathing during sleep. Having OSA increases the chances of developing nonalcoholic
fatty liver disease by two to three times. Dr. Mehra also reviews central sleep apnea and discusses 2
newer therapies for it: adaptive servoventilation and phrenic nerve stimulation. Clinical guidelines
for the use of unattended portable monitors in the diagnosis of obstructive sleep apnea in adult
patients. Nursing Professionals’ Role in the Comprehensive Management of Obstructive Sleep
Apnoea: A Literature Review. Acknowledgments The authors would like to thank Joel Somerville
for his efforts in proofreading this manuscript. Use of this website is subject to the website terms of
use and privacy policy. Although many medications have been studied for managing OSA, none
have been found to be as effective as PAP therapy and other treatments. 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. The OSA management in specialised
sleep units is commonplace. Obstructive sleep apnea: who should be tested, and how. When you buy
through our links, we may earn a commission. The link between OSA and the heart is presented by
Reena Mehra, MD, MS, with an overview of the physiology of sleep-heart interactions and the
association of OSA and cardiovascular health. Symptoms include tossing and turning during sleep,
snoring, daytime fatigue, and headaches upon waking. Techniques developed specifically to teach
creative thinking and examine how they may be applied to the classroom, are precise things to be
considered. Dr. Singh is the Medical Director of the Indiana Sleep Center. Diagnosis of obstructive
sleep apnea in adults: a clinical practice guideline from the American College of Physicians.
UpToDate delivers evidence-based clinical decision support that is clear, actionable, and rich with
real-world insights. The goal of this publication is to inform and educate healthcare providers from
all backgrounds and levels of care who are interested in improving patient outcomes through
attention to sleep medicine. We believe that patients at high risk (SACS ?15) should be encouraged
to undergo sleep evaluations as their posttest probability (PTP) of OSA is 75% to 80%. Patients with
undiagnosed sleep apnea represent a major public health problem. OpenUrl PubMed ? Sheu JJ, Lee
HC, Lin HC, Kao LT, Chung SD. Google Scholar More in this TOC Section Departments. When
airflow is reduced by at least 30% for 10 seconds or more, the episode may be called a hypopnea.
This review aims to give a concise overview on the disease, its pathophysiology, clinical presentation,
diagnosis and various methods of management. An estimated 50 to 70 million Americans have sleep
disturbances, including 10% to 17% of men and 3% to 9% of women with moderate to severe
obstructive sleep apnea (OSA). 1 Not only is OSA highly prevalent, 82% to 93% of individuals with
moderate to severe OSA are unaware they have it, and it remains undiagnosed. 2 OSA is a
potentially serious medical disorder affecting the heart, brain, and metabolism. Sleep apnea can be
diagnosed using an at-home test. Treatment options often involve PAP therapy and lifestyle changes
to reduce symptoms. The complete texts of the articles were searched for relevant references.
NOTE: We only request your email address so that the person you are recommending the page to
knows that you wanted them to see it, and that it is not junk mail. The primary treatment for OSA is
positive airway pressure (PAP) therapy. J Clin Sleep Med. 2007;3:582-588. 9. Myers KA,
Mrkobrada M, Simel DL. While a person can be diagnosed with both OSA and a sleep-related
hypoventilation disorder, abnormal levels of oxygen and carbon dioxide typically do not persist as
long in people with OSA. Results Epidemiological, radiographical and clinical data were comparable
in the two groups and better restoration of propulsive function was found after osteotomy as shown
by ANOVA (two way: surgery. Canl?larda bag?s?kl?k, dogal bag?s?kl?k ve edinsel bag?s?kl?k
olmak uzere ikiye ayr?lmaktad?r. All articles published by MDPI are made immediately available
worldwide under an open access license. No special. Prevalence of symptoms and risk of sleep
apnea in primary care. International Journal of Turbomachinery, Propulsion and Power (IJTPP). The
American Academy of Sleep Medicine suggests three opportunities to screen for OSA 1. Primary
care nurses and physicians have received training on OSA risk factors, symptoms, associated
comorbidities, and treatment options, as well as using screening tools to ensure early diagnosis. The
Sleep Foundation editorial team is dedicated to providing content that meets the highest standards
for accuracy and objectivity. PAP therapy may be provided using continuous positive airway pressure
(CPAP), bilevel positive airway pressure (BiPAP or BPAP), or auto-titrating positive airway pressure
(APAP). Through the involvement of primary care professionals, OSA underdiagnosis may be
improved. Please note that many of the page functionalities won't work as expected without
javascript enabled. Learn more about the causes and diagnosis of OSA, as well as treatment options
that can restore healthy nighttime breathing. Netzer NC, Hoegel JJ, Loube D, et al Sleep in Primary
Care International Study Group. Somers VK, White DP, Amin R, et al American Heart Association
Council for High Blood Pressure Research Professional Education Committee, Council on Clinical
Cardiology American Heart Association Stroke Council American Heart Association Council on
Cardiovascular Nursing American College of Cardiology Foundation. Is it beneficial to also
document episodes of apnea or hypopnea that do not result in arterial desaturation. These
physiological changes negatively impact public safety, occupational and academic achievement, and
even mortality. Does this patient have obstructive sleep apnea?: The rational clinical examination
systematic review. JAMA. 2013;310(7):731-741. The nursing profession should be prepared to
actively participate in the diagnostic and therapeutic process of patients with chronic diseases such
as OSA. RA is a predoctoral researcher in the University of Lleida, Faculty of Nursing and
Physiotherapy. Use of this website is subject to the website terms of use and privacy policy.
Estimation of the clinically diagnosed proportion of sleep apnea syndrome in middle-aged men and
women. Management plan to reduce risks in perioperative care of patients with presumed obstructive
sleep apnea syndrome. Mehra R, Benjamin EJ, Shahar E, et al Sleep Heart Health Study. However,
the management approach should be based upon the principle that individuals with different
characteristics will be treated differently. Obstructive sleep apnea (January 2016) In reply:
Obstructive sleep apnea (January 2016) Google Scholar More in this TOC Section. Sleep apnea..
Accessed September 14, 2018. 2. Grover M, Mookadam M, Armas D, et al.
Some of the first noticeable signs of obstructive sleep apnea may include excessive tiredness during
the day, reports from loved ones, or early morning symptoms. Management plan to reduce risks in
perioperative care of patients with presumed obstructive sleep apnea syndrome. Previous Article in
Journal Special Issue on Current Trends and Future Directions in Voice Acoustics Measurement. The
study's findings reveal a relationship between basic need satisfaction of teachers and researcherly
disposition. J Am Board Fam Med. 2011;24:152-160. 3. Mold JW, Quattlebaum C, Schinnerer E, et
al. Of the 45 articles which were retrieved fully, only 10 met all the inclusion and exclusion criteria (
Figure 1 ). ODI was defined as the number of 4% drops in saturation from baseline divided by the
number of hours of recording time. These studies suggest that HSAT is also cost-effective, results in
comparable treatment decisions, and is associated with similar compliance with PAP therapy. In
StatPearls. StatPearls Publishing., Retrieved July 4, 2022, from. If you’re concerned your sleep
problems are due to sleep apnea, a home sleep test can be a helpful first step in the right direction.
The results showed that Islam illustrates that the three elements of the KSOC are interrelated with
one another. They may also place several belts around the chest and position a small tube beneath the
nose. Serial application of the Sleep Apnea Clinical Score and overnight oxygen desaturation index
yielded the best diagnostic results. The link between OSA and the heart is presented by Reena
Mehra, MD, MS, with an overview of the physiology of sleep-heart interactions and the association
of OSA and cardiovascular health. Additionally, 300 studies were disregarded because they failed to
present results particular to the role of nursing in OSA management. The following key search terms
were used in the search: obstructive sleep apnoea, OSA, nurses, nurses’ roles, primary care, primary
setting, management, intervention, and sleep units. Next Article in Journal Analytical and Numerical
Study of the Axial Stiffness of Fiber-Reinforced Elastomeric Isolators (FREIs) under Combined
Axial and Shear Loads. International Journal of Turbomachinery, Propulsion and Power (IJTPP). Am
J Respir Crit Care Med. 1994;150:1279-1285. 8. Gali B, Whalen FX, Gay PC, et al. The study
recommends policymakers and educational administration plan such types of programs that meet the
four dimensions of researcher disposition with the specific needs of teacher educators. Considering
the chronicity of this disease, its prevalence and long-term consequences, it is imperative to manage
it. In this context, it is suggested that the integration of primary care and specialist services as well as
improved system navigation may be crucial to improving OSA management. The study identified
several barriers, including a lack of access to specialists, a lack of knowledge of OSA among primary
care providers, and a lack of clarity regarding the roles of providers in OSA management. Nursing
Professionals’ Role in the Comprehensive Management of Obstructive Sleep Apnoea: A Literature
Review. Y Y Y Y Overall results Discussed in paper Discussed in paper Discussed in paper
Discussed in paper Precise. During the daytime, these muscles hold the airway open and facilitate
breathing. A growing publication highlights a teacher educators' role in performing research, and
becoming a teacher as a researcher is an essential part of education. Likelihood ratios for a sleep
apnea clinical prediction rule. A nn Intern Med. 2014;161:210-220. 6. Grover M, Mookadam M,
Chang Y-H, et al. I hope you enjoy this supplement and find it useful to improving the health and
quality-of-life outcomes of patients in your care.
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. If this statement is correct
as written, would the authors explain why and how specific non-CPAP treatments for OSA are more
amenable to monitoring at home than in the sleep lab. Netzer NC, Hoegel JJ, Loube D, et al Sleep in
Primary Care International Study Group. Adverse respiratory events after general anesthesia in
patients at high risk of obstructive sleep apnea syndrome. Hence, this present paper highlights the
most appropriate techniques that the educators employ to motivate the knowledge seekers most
effective and inspirational for the upcoming generation. When the three of them are put together, it
will create a professional sharia auditor. A further consideration has been that all levels of medical
care must be involved. Aim: to identify what is known about nurses’ role in comprehensive
management of obstructive sleep apnoea, and to determine the effectiveness of nurse-led
interventions as well as the cost effectiveness of management of obstructive sleep apnoea in primary
care settings. Tina Waters, MD, considers alternatives to PAP therapy, such as lifestyle changes,
expiratory PAP therapy, oral appliances, upper airway surgery, and hypoglossal nerve stimulation.
Nursing follow-up via telephone consultation was provided to patients who underwent
adenotonsillectomy in lieu of the traditional 4-to-8-week clinic visit following surgery. Please let us
know what you think of our products and services. Considering the chronicity of this disease, its
prevalence and long-term consequences, it is imperative to manage it. Based on the findings of this
review, the primary care model is more cost-effective than the sleep unit model in the management of
obstructive sleep apnoea patients. 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. Management plan to reduce risks in perioperative care of
patients with presumed obstructive sleep apnea syndrome. While a person can be diagnosed with
both OSA and a sleep-related hypoventilation disorder, abnormal levels of oxygen and carbon
dioxide typically do not persist as long in people with OSA. We use cookies on our website to ensure
you get the best experience. 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. Centers for Disease Control and Prevention.,
Retrieved July 4, 2022, from. The study's findings reveal a relationship between basic need
satisfaction of teachers and researcherly disposition. This concept. Download Free PDF View PDF
Free PDF Bariatric Surgery Does Not Exacerbate and May Be Beneficial for the Microvascular
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PDF Burn Them Right. To browse Academia.edu and the wider internet faster and more securely,
please take a few seconds to upgrade your browser. Results: In this review, 12 articles were
included, and three key themes emerged, namely the role of nurses in the diagnosis of obstructive
sleep apnoea, role of nurses in the follow up and support of obstructive sleep apnoea patients, and
role of nurses in the management of obstructive sleep apnoea in primary care and the cost-
effectiveness. 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. Alcohol and
medications including sedatives can decrease breathing and make it harder to wake up, which can be
dangerous in people with OSA. A nn Intern Med. 2014;161:210-220. 6. Grover M, Mookadam M,
Chang Y-H, et al. The complete texts of the articles were searched for relevant references. Use of
this website is subject to the website terms of use and privacy policy. Dr. Mehra also reviews central
sleep apnea and discusses 2 newer therapies for it: adaptive servoventilation and phrenic nerve
stimulation. In June 2021, the five databases yielded a total of 566 articles.