Obstructive Sleep Apnoea

Obstructive sleep apnoea (OSA) is a common and progressive chronic disease. It is responsible for a high number of comorbidities and is linked with increased mortality, including a rise in the rate of sudden cardiac death. It is widely acknowledged that OSA now affects millions of people worldwide. This Monograph considers this high-impact condition from four different perspectives: pathogenesis; at-risk populations; clinical scenarios; and treatment and management. Comprehensive and up-to-date chapters provide the reader with a concise overview of OSA, making this book a useful reference for pulmonologists concerned with the management of this disease.

This book aims to provide a comprehensive and clear review of the current knowledge of the relationship between obstructive sleep apnea (OSA) and cardiovascular and metabolic diseases, a subject of concern to a wide range of specialists and general practitioners. Separate chapters describe: the definition, symptoms and sequelae of OSA, and the diagnostic strategies and treatment options for adults with OSA according to the American Academy of Sleep Medicine; pathogenic mechanisms, by which OSA may contribute to the development and progression of cardiovascular and metabolic disorders, including inflammation, oxidative stress and thrombosis; links between OSA and obesity, alterations in glucose metabolism, metabolic syndrome and liver injury; relationships between OSA, endothelial dysfunction, autonomic dysfunction and cardiovascular disorders, and the results of studies investigating the effect of treatment for OSA on the concomitant cardiovascular disease. Each chapter summarizes the essential information and is illustrated by tables and figures, which will aid the readers in their understanding of the complex systemic interactions involved in this disease.Reviewed by internationally recognized experts, this publication will be of benefit to clinicians and scientists in the fields of pulmonology, cardiology, endocrinology and neurology as well as to sleep specialists and general practitioners.

This book provides comprehensive information on the etiology, pathophysiology, medical implications, diagnosis, and surgical and nonsurgical treatment of obstructive sleep apnea (OSA). Divided into five parts, the book begins with principles and fundamentals of OSA and its diagnostic considerations. Subsequent parts then address non-surgical management, surgical management, and maxillomandibular advancements for OSA. Chapters seek to approach this common disorder from the viewpoint of multiple specialties, thereby promoting the development of a broad strategy for the evaluation and management of OSA patients that draws on each of them. An invaluable reference, Management of Obstructive Sleep Apnea: An Evidence-Based, Multidisciplinary Textbook meets the needs of advanced dental and medical students, orthodontic, maxillofacial, ENT, neurology, and plastic surgery residents, and sleep medicine and pulmonary physicians.​​

The definitive resource on the innovative use of DISE for obstructive sleep apnea Obstructive sleep apnea is the most prevalent sleep-related breathing disorder, impacting an estimated 1.36 billion people worldwide. In the past, OSA was almost exclusively treated with Continuous Positive Airway Pressure (CPAP), however, dynamic assessment of upper airway obstruction with Drug-Induced Sleep Endoscopy (DISE) has been instrumental in developing efficacious alternatives. Drug-Induced Sleep Endoscopy: Diagnostic and Therapeutic Applications by Nico de Vries, Ottavio Piccin, Olivier Vanderveken, and Claudio Vicini is the first textbook on DISE written by world-renowned sleep medicine pioneers. Twenty-four chapters feature contributions from an impressive group of multidisciplinary international experts. Foundational chapters encompass indications, contraindications, informed consent, organization and logistics, patient preparation, and drugs used in DISE. Subsequent chapters focus on treatment outcomes, the role of DISE in therapeutic decision making and upper airway stimulation, pediatric sleep endoscopy, craniofacial syndromes, advanced techniques, and more. Key Highlights Comprehensive video library highlights common and rare DISE findings A full spectrum of sleep disordered breathing and OSA topics, from historic to future perspectives Insightful clinical pearls on preventing errors and managing complications including concentric and epiglottis collapse Discussion of controversial DISE applications including oral appliances and positional and combination therapies This unique book is essential reading for otolaryngology residents, fellows, and surgeons. Clinicians in other specialties involved in sleep medicine will also benefit from this reference, including pulmonologists, neurologists, neurophysiologists, maxillofacial surgeons, and anesthesiologists.

The ultimate guide to the evidence-based clinical encounter "This book is an excellent source of supported evidence that provides useful and clinically relevant information for the busy practitioner, student, resident, or educator who wants to hone skills of physical diagnosis. It provides a tool to improve patient care by using the history and physical examination items that have the most reliability and efficiency."--Annals of Internal Medicine "The evidence-based examination techniques put forth by Rational Clinical Examination is the sort that can be brought to bear on a daily basis – to save time, increase confidence in medical decisions, and help decrease unnecessary testing for conditions that do not require absolute diagnostic certainty. In the end, the whole of this book is greater than its parts and can serve as a worthy companion to a traditional manual of physical examination."--Baylor University Medical Center (BUMC)Proceedings 5 STAR DOODY'S REVIEW! "Physical diagnosis has been taught to every medical student but this evidence-based approach now shows us why, presenting one of medicine's most basic tenets in a new and challenging light. The format is extraordinary, taking previously published material and updating the pertinent evidence since the initial publication, affirming or questioning or refining the conclusions drawn from the data. "This is a book for everyone who has studied medicine and found themselves doubting what they have been taught over the years, not that they have been deluded, but that medical traditions have been unquestionably believed because there was no evidence to believe otherwise. The authors have uncovered the truth. "This extraordinary, one-of-a-kind book is a valuable addition to every medical library."--Doody's Review Service Completely updated with new literature analyses, here is a uniquely practical, clinically relevant approach to the use of evidence in the content of physical examination. Going far beyond the scope of traditional physical examination texts, this invaluable resource compiles and presents the evidence-based meanings of signs, symptoms, and results from physical examination maneuvers and other diagnostic studies. Page after page, you'll find a focus on actual clinical questions and presentations, making it an incomparably practical resource that you'll turn to again and again. Importantly, the high-yield content of The Rational Clinical Examination is significantly expanded and updated from the original JAMA articles, much of it published here for the first time. It all adds up to a definitive, ready-to-use clinical exam sourcebook that no student or clinician should be without. FEATURES Packed with updated, new, and previously unpublished information from the original JAMA articles Standardized template for every issue covered, including: Case Presentation; Why the Issue Is Clinically Important; Research and Statistical Methods Used to Find the Evidence Presented; The Sensitivity and Specificity of Each Key Result; Resolution of the Case Presentation; and the Clinical Bottom Line Completely updated with all-new literature searches and appraisals supplementing each chapter Full-color format with dynamic clinical illustrations and images Real-world focus on a specific clinical question in each chapter, reflecting the way clinicians approach the practice of evidence-based medicine More than 50 complete chapters on common and challenging clinical questions and patient presentations Also available: JAMAevidence.com, a new interactive database for the best practice of evidence based medicine

Finally, a multi-disciplinary approach that covers both the surgical and non-surgical interventions for sleep apnea and snoring. From the editor of Operative Techniques in Otolaryngology, this new reference will quickly become the standard in surgery for this key area within otolaryngology. ., Full-color line drawings illustrate key concepts and create a comprehensive way of learning surgical techniques. Provides consistent, templated chapters and a contemporary, full-color format for quick, easy access to the most up-to-date surgical and non surgical interventions for sleep apnea and snoring. Includes contributions from leaders in neurology, pulmonology, psychiatry, otolaryngology, and oral & maxillofacial surgery. to create a truly multi-disciplinary approach. Covers new and innovative procedures including ZPP (Zeta palatopharyngoplasty), Transpalatal Advancement Pharyngoplasty and Minimally invasive submucosal glossectomy Details when and why surgery is necessary, and how to perform a successful operation for snoring and sleep apnea.

This book provides detailed, specific information regarding the non-surgical and surgical treatment modalities currently employed for the management of obstructive sleep apnea (OSA) with the aim of enabling practitioners to achieve optimal outcomes in individual patients. The book opens by offering clear guidance on the medical and surgical evaluation of patients with OSA. Coverage of medical management options includes positive airway pressure therapy, positional therapy, the use of mandibular repositioning devices, along with other treatment modalities. Surgical interventions are then exhaustively described in a series of chapters that document the approaches to specific sites of obstruction. Information is included on operative airway management, and the concluding chapter addresses the care of pediatric patients. Modern Management of Obstructive Sleep Apnea will be a valuable asset for oral and maxillofacial surgeons, otolaryngologists, and sleep medicine physicians.

There are many books describing in detail the evaluation,diagnosis and management of OSA, but this is a first practical guide which comprehensively describes this condition. The incidence of snoring and obstructive sleep apnea is on rise and this practical guide will help not just specialists but also residents and fellows in treating their patients with Obstructive sleep apnea. Essential information is summarized in the form of charts and surgical steps are summarized in the form of diagrammatic illustration making it easy for the learners.This book additionally would help the medical practitioners to get a practical insight in the management of patients .This book will describe each entity of sleep disordered breathing, evidence based protocols , diagnostic tools required for identifying , medical therapies that will help in appropriate patients, Devices that can be used for its management . This book will also describe on how to select patients for surgery and how tailor the surgery as per the anatomy of the patient.