β Scribed by Ioachimescu, Octavian C.; Collop, Nancy A.
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Sleep Disordered Breathing (SDB) spans a spectrum of conditions, including isolated primary snoring (PS), upper airway resistance syndrome (UARS), obstructive sleep apnea (OSA), central sleep apnea (CSA), and obesity hypoventilation syndrome (OHS). OSA implies an intermittent mechanical obstruction of the upper airway during sleep, which leads to reduced airflow to the lungs. CSA is characterized by impaired flow and absent ventilatory effort. UARS describes airflow limitation with frequent arousals from sleep due to flow impairment, whereas PS is generally defined as noisy vibration of the upper airway during sleep without associated alterations in sleep architecture.
Patients suspected of SDB and their bed partners should be subjected to a thorough history, with attention to sleep schedules, daytime symptoms, onset and progression of nocturnal manifestations, exacerbating factors, comorbidities, family history, etc. A targeted physical examination includes assessment of body mass index (BMI), neck circumference, nasal passages, and oropharyngeal area presence of macroglossia, retrognathia, micrognathia, or any palatal abnormalities-all anatomic factors of importance in the pathogenesis of obstructive SDB. PSG and OSG (ie, home sleep
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