Obstructive sleep apnea-current state of knowledge Review article
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Published:
Apr 4, 2016
Keywords:
obstructive sleep apnea, polisomnography, AHI
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Abstract
Obstructive sleep apnea (OSA) affects about 10% to 17% of population, mainly middle age, laudly snoring male, in whom during sleep time we can identify several episodes of shallow or paused breathing caused by complete or partial obstruction of the upper airway. Symptoms observed during day time include sleepness and extensive fatigue. In patients with OSA researchers identified increased cardiovascular risk as well as increased cardiovascular mortality and morbidity. Based on many studies OSA has been indicated as independent risk factor for coronary artery disease, hypertension and stroke. Polisomnography is a gold standard in making the correct diagnosis.
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Laszuk , M., Masalski , J., Różańska , M., Możeńska , O., Gierałtowski , J., Petelczyc , M., & Kosior , D. A. (2016). Obstructive sleep apnea-current state of knowledge. Cardiology in Practice, 10(1), 17-22. Retrieved from https://journalsmededu.pl/index.php/kwp/article/view/1292
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References
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5. Qaseem A., Holty J.E., Douglas K. et al.: Management of obstructive sleep apnea in adults: a clinical practice guideline from the American College of Physicians. Ann. Intern. Med. 2013; 159(7): 471-483.
6. Qaseem A., Dallas P., Owens D.K. et al.: Diagnosis of obstructive sleep apnea in adults: a clinical practice guideline from the American College of Physicians. Ann. Intern. Med. 2014; 161(3): 210-220.
7. Pływaczewski R., Brzecka A., Bielicki P. et al.: [Sleep related breathing disorders in adults – recommendations of Polish Society of Lung Diseases]. Pneumonol. Alergol. Pol. 2013; 81(3): 221-258.
8. Lyle D., Victor L.D.: Obstructive sleep apnea. Am. Fam. Physician. 1999; 60(8): 2279-2286.
9. Teran-Santos J., Jimenez-Gomez A., Cordero-Guevara J.: The association between sleep apnea and the risk of traffic accidents. Cooperative Group Burgos-Santander. N. Engl. J. Med. 1999; 340(11): 847-851.
10. Howard M.E., Desai A.V., Grunstein R.R. et al.: Sleepiness, sleep-disordered breathing, and accident risk factors in commercial vehicle drivers. Am. J. Respir. Crit. Care Med. 2004; 170(9): 1014-1021.
11. Young T., Palta M., Dempsey J. et al.: The occurrence of sleep-disordered breathing among middle-aged adults. N. Engl. J. Med. 1993; 328(17): 1230-1235.
12. Nieto F.J., Young T.B., Lind B.K. et al.: Association of sleep-disordered breathing, sleep apnea, and hypertension in a large community-based study. Sleep Heart Health Study. JAMA 2000; 283(14): 1829-1836.
13. Peppard P.E., Young T., Palta M. et al.: Prospective study of the association between sleep-disordered breathing and hypertension. N. Engl. J. Med. 2000; 342(19): 1378-1384.
14. Shahar E., Whitney C.W., Redline S. et al.: Sleep-disordered breathing and cardiovascular disease: cross-sectional results of the Sleep Heart Health Study. Am. J. Respir. Crit. Care Med. 2001; 163(1): 19-25.
15. Marin J.M., Carrizo S.J., Vicente E. et al.: Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet 2005; 365(9464): 1046-1053.
16. Yaggi H.K., Concato J., Kernan W.N. et al.: Obstructive sleep apnea as a risk factor for stroke and death. N. Engl. J. Med. 2005; 353(19): 2034-2041.
17. Punjabi N.M.: The epidemiology of adult obstructive sleep apnea. Proc. Am. Thorac. Soc. 2008; 5(2): 136-143.
18. Young T., Peppard P., Palta M. et al.: Population-based study of sleep-disordered breathing as a risk factor for hypertension. Arch. Intern. Med. 1997; 157(15): 1746-1752.
19. Babu A.R., Herdegen J., Fogelfeld L. et al.: Type 2 diabetes, glycemic control, and continuous positive airway pressure in obstructive sleep apnea. Arch. Intern. Med. 2005; 165(4): 447-452.
20. Caples S.M., Gami A.S., Somers V.K.: Obstructive sleep apnea. Ann. Intern. Med. 2005; 142(3): 187-197.
21. Gruber A., Horwood F., Sithole J. et al.: Obstructive sleep apnoea is independently associated with the metabolic syndrome but not insulin resistance state. Cardiovasc. Diabetol. 2006; 5: 22.
22. Young T., Peppard P.E., Gottlieb D.J.: Epidemiology of obstructive sleep apnea: a population health perspective. Am. J. Respir. Crit. Care Med. 2002; 165(9): 1217-1239.
23. Chung S.A., Yuan H., Chung F.: A systemic review of obstructive sleep apnea and its implications for anesthesiologists. Anesth. Analg. 2008; 107(5): 1543-1563.
24. Norman D., Loredo J.S.: Obstructive sleep apnea in older adults. Clin. Geriatr. Med. 2008; 24(1): 151-165.
25. Young T., Finn L., Peppard P.E. et al.: Sleep disordered breathing and mortality: eighteen-year follow-up of the Wisconsin sleep cohort. Sleep 2008; 31(8): 1071-1078.
26. Punjabi N.M., Caffo B.S., Goodwin J.L. et al.: Sleep-disordered breathing and mortality: a prospective cohort study. PLoS Med. 2009; 6(8): e1000132.
27. Dancey D.R., Hanly P.J., Soong C. et al.: Impact of menopause on the prevalence and severity of sleep apnea. Chest 2001; 120(1): 151-155.
28. Eichling P.S., Sahni J.: Menopause related sleep disorders. J. Clin. Sleep Med. 2005; 1(3): 291-300.
29. Bixler E.O., Vgontzas A.N., Ten Have T. et al.: Effects of age on sleep apnea in men: I. Prevalence and severity. Am. J. Respir. Crit. Care Med. 1998; 157(1): 144-148.
30. Durán J., Esnaola S., Rubio R., Iztueta A.: Obstructive sleep apnea-hypopnea and related clinical features in a population-based sample of subjects aged 30 to 70 yr. Am. J. Respir. Crit. Care Med. 2001; 163(3 Pt 1): 685-689.
31. Pływaczewski R., Bednarek M., Jonczak L. et al.: Sleep-disordered breathing in a middle-aged and older Polish urban population. J. Sleep Res. 2008; 17(1): 73-81.
32. Jennum P., Riha R.L.: Epidemiology of sleep apnoea/hypopnoea syndrome and sleep-disordered breathing. Eur. Respir. J. 2009; 33(4): 907-914.
33. Russell T., Duntley S.: Sleep disordered breathing in the elderly. Am. J. Med. 2011; 124(12): 1123-1126.
34. Guilleminault C., Partinen M., Hollman K. et al.: Familial aggregates in obstructive sleep apnea syndrome. Chest 1995; 107(6): 1545-1551.
35. Kaparianos A., Sampsonas F., Karkoulias K. et al.: Obstructive sleep apnoea syndrome and genes. Neth. J. Med. 2006; 64(8): 280-289.
36. Polotsky V.Y., O’Donnell C.P.: Genomics of sleep-disordered breathing. Proc. Am. Thorac. Soc. 2007; 4(1): 121-126.
37. Campana L., Eckert D.J., Patel S.R. et al.: Pathophysiology & genetics of obstructive sleep apnoea. Indian J. Med. Res. 2010; 131: 176-187.
38. Resta O., Pannacciulli N., Di Gioia G. et al.: High prevalence of previously unknown subclinical hypothyroidism in obese patients referred to a sleep clinic for sleep disordered breathing. Nutr. Metab. Cardiovasc. Dis. 2004; 14(5): 248-253.
39. Weiss V., Sonka K., Pretl M. et al.: Prevalence of the sleep apnea syndrome in acromegaly population. J. Endocrinol. Invest. 2000; 23(8): 515-519.
40. Martinez D., Breitenbach T.C., Lumertz M.S. et al.: Repeating administration of Epworth Sleepiness Scale is clinically useful. Sleep Breath 2011; 15(4): 763-773.
41. Netzer N.C., Stoohs R.A., Netzer C.M. et al.: Using the Berlin Questionnaire to identify patients at risk for the sleep apnea syndrome. Ann. Intern. Med. 1999; 131(7): 485-491.
42. Chung F., Yegneswaran B., Liao P. et al.: Validation of the Berlin questionnaire and American Society of Anesthesiologists checklist as screening tools for obstructive sleep apnea in surgical patients. Anesthesiology 2008; 108(5): 822-830.
43. Geiger-Brown J., Rogers V.E., Han K. et al.: Occupational screening for sleep disorders in 12-h shift nurses using the Berlin Questionnaire. Sleep Breath 2013; 17(1): 381-388.
44. Collop N.A., Anderson W.M., Boehlecke B. et al.: Clinical guidelines for the use of unattended portable monitors in the diagnosis of obstructive sleep apnea in adult patients. Portable Monitoring Task Force of the American Academy of Sleep Medicine. J. Clin. Sleep. Med. 2007; 3(7): 737-747.
45. Epstein L.J., Kristo D., Strollo P.J. et al.: Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. J. Clin. Sleep. Med. 2009; 5(3): 263-276.
46. Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force. Sleep 1999; 22(5): 667-689.
47. Foster G.D., Young T., Palta M. et al.: A randomized study on the effect of weight loss on obstructive sleep apnea among obese patients with type 2 diabetes: the Sleep AHEAD study. Arch. Intern. Med. 2009; 169(17): 1619-1626.
48. Johansson K., Neovius M., Lagerros Y.T. et al.: Effect of a very low energy diet on moderate and severe obstructive sleep apnoea in obese men: a randomised controlled trial. BMJ 2009; 339: b4609.
49. Tuomilehto H.P., Seppä J.M., Partinen M.M. et al.: Lifestyle intervention with weight reduction: first-line treatment in mild obstructive sleep apnea. Am. J. Respir. Crit. Care Med. 2009; 179(4): 320-327.
50. Cartwright R.D.: Effect of sleep position on sleep apnea severity. Sleep 1984; 7(2): 110-114.
51. Neill A.M., Angus S.M., Sajkov D. et al.: Effects of sleep posture on upper airway stability in patients with obstructive sleep apnea. Am. J. Respir. Crit. Care Med. 1997; 155(1): 199-204.
52. Dolly F.R., Block A.J.: Effect of flurazepam on sleep-disordered breathing and nocturnal oxygen desaturation in asymptomatic subjects. Am. J. Med. 1982; 73(2): 239-243.
53. Berry R.B., Bonnet M.H., Light R.W.: Effect of ethanol on the arousal response to airway occlusion during sleep in normal subjects. Am. Rev. Respir. Dis. 1992; 145(2 Pt 1): 445-452.
54. Boushra N.N.: Anaesthetic management of patients with sleep apnoea syndrome. Can. J. Anaesth. 1996; 43(6): 599-616.
55. Hoflstein V.: Relationship between smoking and sleep apnea in clinic population. Sleep 2002; 25(5): 519-524.
56. Bloch K.E., Iseli A., Zhang J.N. et al.: A randomized, controlled crossover trial of two oral appliances for sleep apnea treatment. Am. J. Respir. Crit. Care Med. 2000; 162(1): 246-251.
57. Petri N., Svanholt P., Solow B. et al.: Mandibular advancement appliance for obstructive sleep apnoea: results of a randomised placebo controlled trial using parallel group design. J. Sleep Res. 2008; 17(2): 221-229.
58. Campos-Rodriguez F., Peña-Griñan N., Reyes-Nuñez N. et al.: Mortality in obstructive sleep apnea-hypopnea patients treated with positive airway pressure. Chest 2005; 128(2): 624-633.
59. Buchner N.J., Sanner B.M., Borgel J. et al.: Continuous positive airway pressure treatment of mild to moderate obstructive sleep apnea reduces cardiovascular risk. Am. J. Respir. Crit. Care Med. 2007; 176(12): 1274-1280.
60. Campos-Rodriguez F., Martinez-Garcia M.A., de la Cruz-Moron I. et al.: Cardiovascular mortality in women with obstructive sleep apnea with or without continuous positive airway pressure treatment: a cohort study. Ann. Intern. Med. 2012; 156(2): 115-122.
61. Richards D., Bartlett D.J., Wong K. et al.: Increased adherence to CPAP with a group cognitive behavioral treatment intervention: a randomized trial. Sleep 2007; 30(5): 635-640.
62. Stepnowsky C.J., Palau J.J., Marler M.R. et al.: Pilot randomized trial of the effect of wireless telemonitoring on compliance and treatment efficacy in obstructive sleep apnea. J. Med. Internet Res. 2007; 9(2): e14.
63. Damjanovic D., Fluck A., Bremer H. et al.: Compliance in sleep apnoea therapy: influence of home care support and pressure mode. Eur. Respir. J. 2009; 33(4): 804-811.
64. Bradshaw D.A., Ruff G.A., Murphy D.P.: An oral hypnotic medication does not improve continuous positive airway pressure compliance in men with obstructive sleep apnea. Chest 2006; 130(5): 1369-1376.
65. Antic N.A., Buchan C., Esterman A. et al.: A randomized controlled trial of nurse-led care for symptomatic moderate-severe obstructive sleep apnea. Am. J. Respir. Crit. Care Med. 2009; 179(6): 501-508.
66. Balk E.M., Moorthy D., Obadan N.O. et al.: Diagnosis and Treatment of Obstructive Sleep Apnea in Adults. 2011: Rockville (MD).
2. Young T., Shahar E., Nieto F.J. et al.: Predictors of sleep-disordered breathing in community-dwelling adults: the Sleep Heart Health Study. Arch. Intern. Med. 2002; 162(8): 893-900.
3. Lavie P., Herer P., Peled R. et al.: Mortality in sleep apnea patients: a multivariate analysis of risk factors. Sleep 1995; 18(3): 149-157.
4. Marti S., Sampol G., Munoz X. et al.: Mortality in severe sleep apnoea/hypopnoea syndrome patients: impact of treatment. Eur. Respir. J. 2002; 20(6): 1511-1518.
5. Qaseem A., Holty J.E., Douglas K. et al.: Management of obstructive sleep apnea in adults: a clinical practice guideline from the American College of Physicians. Ann. Intern. Med. 2013; 159(7): 471-483.
6. Qaseem A., Dallas P., Owens D.K. et al.: Diagnosis of obstructive sleep apnea in adults: a clinical practice guideline from the American College of Physicians. Ann. Intern. Med. 2014; 161(3): 210-220.
7. Pływaczewski R., Brzecka A., Bielicki P. et al.: [Sleep related breathing disorders in adults – recommendations of Polish Society of Lung Diseases]. Pneumonol. Alergol. Pol. 2013; 81(3): 221-258.
8. Lyle D., Victor L.D.: Obstructive sleep apnea. Am. Fam. Physician. 1999; 60(8): 2279-2286.
9. Teran-Santos J., Jimenez-Gomez A., Cordero-Guevara J.: The association between sleep apnea and the risk of traffic accidents. Cooperative Group Burgos-Santander. N. Engl. J. Med. 1999; 340(11): 847-851.
10. Howard M.E., Desai A.V., Grunstein R.R. et al.: Sleepiness, sleep-disordered breathing, and accident risk factors in commercial vehicle drivers. Am. J. Respir. Crit. Care Med. 2004; 170(9): 1014-1021.
11. Young T., Palta M., Dempsey J. et al.: The occurrence of sleep-disordered breathing among middle-aged adults. N. Engl. J. Med. 1993; 328(17): 1230-1235.
12. Nieto F.J., Young T.B., Lind B.K. et al.: Association of sleep-disordered breathing, sleep apnea, and hypertension in a large community-based study. Sleep Heart Health Study. JAMA 2000; 283(14): 1829-1836.
13. Peppard P.E., Young T., Palta M. et al.: Prospective study of the association between sleep-disordered breathing and hypertension. N. Engl. J. Med. 2000; 342(19): 1378-1384.
14. Shahar E., Whitney C.W., Redline S. et al.: Sleep-disordered breathing and cardiovascular disease: cross-sectional results of the Sleep Heart Health Study. Am. J. Respir. Crit. Care Med. 2001; 163(1): 19-25.
15. Marin J.M., Carrizo S.J., Vicente E. et al.: Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet 2005; 365(9464): 1046-1053.
16. Yaggi H.K., Concato J., Kernan W.N. et al.: Obstructive sleep apnea as a risk factor for stroke and death. N. Engl. J. Med. 2005; 353(19): 2034-2041.
17. Punjabi N.M.: The epidemiology of adult obstructive sleep apnea. Proc. Am. Thorac. Soc. 2008; 5(2): 136-143.
18. Young T., Peppard P., Palta M. et al.: Population-based study of sleep-disordered breathing as a risk factor for hypertension. Arch. Intern. Med. 1997; 157(15): 1746-1752.
19. Babu A.R., Herdegen J., Fogelfeld L. et al.: Type 2 diabetes, glycemic control, and continuous positive airway pressure in obstructive sleep apnea. Arch. Intern. Med. 2005; 165(4): 447-452.
20. Caples S.M., Gami A.S., Somers V.K.: Obstructive sleep apnea. Ann. Intern. Med. 2005; 142(3): 187-197.
21. Gruber A., Horwood F., Sithole J. et al.: Obstructive sleep apnoea is independently associated with the metabolic syndrome but not insulin resistance state. Cardiovasc. Diabetol. 2006; 5: 22.
22. Young T., Peppard P.E., Gottlieb D.J.: Epidemiology of obstructive sleep apnea: a population health perspective. Am. J. Respir. Crit. Care Med. 2002; 165(9): 1217-1239.
23. Chung S.A., Yuan H., Chung F.: A systemic review of obstructive sleep apnea and its implications for anesthesiologists. Anesth. Analg. 2008; 107(5): 1543-1563.
24. Norman D., Loredo J.S.: Obstructive sleep apnea in older adults. Clin. Geriatr. Med. 2008; 24(1): 151-165.
25. Young T., Finn L., Peppard P.E. et al.: Sleep disordered breathing and mortality: eighteen-year follow-up of the Wisconsin sleep cohort. Sleep 2008; 31(8): 1071-1078.
26. Punjabi N.M., Caffo B.S., Goodwin J.L. et al.: Sleep-disordered breathing and mortality: a prospective cohort study. PLoS Med. 2009; 6(8): e1000132.
27. Dancey D.R., Hanly P.J., Soong C. et al.: Impact of menopause on the prevalence and severity of sleep apnea. Chest 2001; 120(1): 151-155.
28. Eichling P.S., Sahni J.: Menopause related sleep disorders. J. Clin. Sleep Med. 2005; 1(3): 291-300.
29. Bixler E.O., Vgontzas A.N., Ten Have T. et al.: Effects of age on sleep apnea in men: I. Prevalence and severity. Am. J. Respir. Crit. Care Med. 1998; 157(1): 144-148.
30. Durán J., Esnaola S., Rubio R., Iztueta A.: Obstructive sleep apnea-hypopnea and related clinical features in a population-based sample of subjects aged 30 to 70 yr. Am. J. Respir. Crit. Care Med. 2001; 163(3 Pt 1): 685-689.
31. Pływaczewski R., Bednarek M., Jonczak L. et al.: Sleep-disordered breathing in a middle-aged and older Polish urban population. J. Sleep Res. 2008; 17(1): 73-81.
32. Jennum P., Riha R.L.: Epidemiology of sleep apnoea/hypopnoea syndrome and sleep-disordered breathing. Eur. Respir. J. 2009; 33(4): 907-914.
33. Russell T., Duntley S.: Sleep disordered breathing in the elderly. Am. J. Med. 2011; 124(12): 1123-1126.
34. Guilleminault C., Partinen M., Hollman K. et al.: Familial aggregates in obstructive sleep apnea syndrome. Chest 1995; 107(6): 1545-1551.
35. Kaparianos A., Sampsonas F., Karkoulias K. et al.: Obstructive sleep apnoea syndrome and genes. Neth. J. Med. 2006; 64(8): 280-289.
36. Polotsky V.Y., O’Donnell C.P.: Genomics of sleep-disordered breathing. Proc. Am. Thorac. Soc. 2007; 4(1): 121-126.
37. Campana L., Eckert D.J., Patel S.R. et al.: Pathophysiology & genetics of obstructive sleep apnoea. Indian J. Med. Res. 2010; 131: 176-187.
38. Resta O., Pannacciulli N., Di Gioia G. et al.: High prevalence of previously unknown subclinical hypothyroidism in obese patients referred to a sleep clinic for sleep disordered breathing. Nutr. Metab. Cardiovasc. Dis. 2004; 14(5): 248-253.
39. Weiss V., Sonka K., Pretl M. et al.: Prevalence of the sleep apnea syndrome in acromegaly population. J. Endocrinol. Invest. 2000; 23(8): 515-519.
40. Martinez D., Breitenbach T.C., Lumertz M.S. et al.: Repeating administration of Epworth Sleepiness Scale is clinically useful. Sleep Breath 2011; 15(4): 763-773.
41. Netzer N.C., Stoohs R.A., Netzer C.M. et al.: Using the Berlin Questionnaire to identify patients at risk for the sleep apnea syndrome. Ann. Intern. Med. 1999; 131(7): 485-491.
42. Chung F., Yegneswaran B., Liao P. et al.: Validation of the Berlin questionnaire and American Society of Anesthesiologists checklist as screening tools for obstructive sleep apnea in surgical patients. Anesthesiology 2008; 108(5): 822-830.
43. Geiger-Brown J., Rogers V.E., Han K. et al.: Occupational screening for sleep disorders in 12-h shift nurses using the Berlin Questionnaire. Sleep Breath 2013; 17(1): 381-388.
44. Collop N.A., Anderson W.M., Boehlecke B. et al.: Clinical guidelines for the use of unattended portable monitors in the diagnosis of obstructive sleep apnea in adult patients. Portable Monitoring Task Force of the American Academy of Sleep Medicine. J. Clin. Sleep. Med. 2007; 3(7): 737-747.
45. Epstein L.J., Kristo D., Strollo P.J. et al.: Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. J. Clin. Sleep. Med. 2009; 5(3): 263-276.
46. Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force. Sleep 1999; 22(5): 667-689.
47. Foster G.D., Young T., Palta M. et al.: A randomized study on the effect of weight loss on obstructive sleep apnea among obese patients with type 2 diabetes: the Sleep AHEAD study. Arch. Intern. Med. 2009; 169(17): 1619-1626.
48. Johansson K., Neovius M., Lagerros Y.T. et al.: Effect of a very low energy diet on moderate and severe obstructive sleep apnoea in obese men: a randomised controlled trial. BMJ 2009; 339: b4609.
49. Tuomilehto H.P., Seppä J.M., Partinen M.M. et al.: Lifestyle intervention with weight reduction: first-line treatment in mild obstructive sleep apnea. Am. J. Respir. Crit. Care Med. 2009; 179(4): 320-327.
50. Cartwright R.D.: Effect of sleep position on sleep apnea severity. Sleep 1984; 7(2): 110-114.
51. Neill A.M., Angus S.M., Sajkov D. et al.: Effects of sleep posture on upper airway stability in patients with obstructive sleep apnea. Am. J. Respir. Crit. Care Med. 1997; 155(1): 199-204.
52. Dolly F.R., Block A.J.: Effect of flurazepam on sleep-disordered breathing and nocturnal oxygen desaturation in asymptomatic subjects. Am. J. Med. 1982; 73(2): 239-243.
53. Berry R.B., Bonnet M.H., Light R.W.: Effect of ethanol on the arousal response to airway occlusion during sleep in normal subjects. Am. Rev. Respir. Dis. 1992; 145(2 Pt 1): 445-452.
54. Boushra N.N.: Anaesthetic management of patients with sleep apnoea syndrome. Can. J. Anaesth. 1996; 43(6): 599-616.
55. Hoflstein V.: Relationship between smoking and sleep apnea in clinic population. Sleep 2002; 25(5): 519-524.
56. Bloch K.E., Iseli A., Zhang J.N. et al.: A randomized, controlled crossover trial of two oral appliances for sleep apnea treatment. Am. J. Respir. Crit. Care Med. 2000; 162(1): 246-251.
57. Petri N., Svanholt P., Solow B. et al.: Mandibular advancement appliance for obstructive sleep apnoea: results of a randomised placebo controlled trial using parallel group design. J. Sleep Res. 2008; 17(2): 221-229.
58. Campos-Rodriguez F., Peña-Griñan N., Reyes-Nuñez N. et al.: Mortality in obstructive sleep apnea-hypopnea patients treated with positive airway pressure. Chest 2005; 128(2): 624-633.
59. Buchner N.J., Sanner B.M., Borgel J. et al.: Continuous positive airway pressure treatment of mild to moderate obstructive sleep apnea reduces cardiovascular risk. Am. J. Respir. Crit. Care Med. 2007; 176(12): 1274-1280.
60. Campos-Rodriguez F., Martinez-Garcia M.A., de la Cruz-Moron I. et al.: Cardiovascular mortality in women with obstructive sleep apnea with or without continuous positive airway pressure treatment: a cohort study. Ann. Intern. Med. 2012; 156(2): 115-122.
61. Richards D., Bartlett D.J., Wong K. et al.: Increased adherence to CPAP with a group cognitive behavioral treatment intervention: a randomized trial. Sleep 2007; 30(5): 635-640.
62. Stepnowsky C.J., Palau J.J., Marler M.R. et al.: Pilot randomized trial of the effect of wireless telemonitoring on compliance and treatment efficacy in obstructive sleep apnea. J. Med. Internet Res. 2007; 9(2): e14.
63. Damjanovic D., Fluck A., Bremer H. et al.: Compliance in sleep apnoea therapy: influence of home care support and pressure mode. Eur. Respir. J. 2009; 33(4): 804-811.
64. Bradshaw D.A., Ruff G.A., Murphy D.P.: An oral hypnotic medication does not improve continuous positive airway pressure compliance in men with obstructive sleep apnea. Chest 2006; 130(5): 1369-1376.
65. Antic N.A., Buchan C., Esterman A. et al.: A randomized controlled trial of nurse-led care for symptomatic moderate-severe obstructive sleep apnea. Am. J. Respir. Crit. Care Med. 2009; 179(6): 501-508.
66. Balk E.M., Moorthy D., Obadan N.O. et al.: Diagnosis and Treatment of Obstructive Sleep Apnea in Adults. 2011: Rockville (MD).