Obstructive Sleep Apnea Syndrome
Humans spend about one third of a lifetime sleeping. We have learned a great deal about sleep and sleep disorders since the discovery of REM sleep in 1953. It is well known that obstructive sleep apnea (OSA) is a sleep-related disorder in which affected i
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Obstructive Sleep Apnea Syndrome Manisha Budhdeo Witmans
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Introduction
Sleep is a basic physiological need, and humans spend about one third of their lives sleeping. Sleep architecture is composed of two basic types of sleep called rapid eye movement (REM) sleep and non-REM (NREM) sleep. NREM sleep can be further subdivided into stages N1, N2, and N3, which make up different portions of the night that the individual spends sleeping. The amount of each stage can change on the basis of the person’s age. Less is known about gender differences in sleep. The different sleep stages are characterized by different electroencephalogram patterns and electro-oculography patterns. NREM sleep makes up 75% of the night (5% is stage N1 sleep, 45–55% is stage N2 sleep, and about 25% is stage N3 sleep), while REM sleep accounts for the remaining 25% [1]. In contrast to children and adults, infants spend almost 50% of the time in REM sleep, and as much as 80% of sleep is spent in REM sleep in premature infants. Physiologically, humans are most vulnerable to perturbations in breathing during REM sleep, thus often classified as sleeprelated breathing disorders when there are associated disturbances in gas exchange. The primary sleep disorder associated with breathing abnormalities in REM sleep is obstructive sleep apnea (OSA). Different names are used to describe the spectrum of this disorder and may include upper airway resistance syndrome, sleep apnea, obstructive apnea, sleep-disordered breathing, and obstructive sleep apnea hypopnea syndrome. This form of sleep-disordered breathing is different from central sleep apnea and hypoventilation, which are related to other pathophysiological mechanisms and involve different treatment options. The reader is encouraged to read the International Classification of Sleep Disorders (3rd Edition) for more comprehensive discussion and explanations about the various sleep-related breathing disorders. The focus of the following discussion will be relevant to obstructive sleep apnea. This is arguably a very important disorder in sleep medicine, as it has many M. B. Witmans (*) University of Alberta, Edmonton, AB, Canada © Springer Nature Switzerland AG 2019 E. Liem (ed.), Sleep Disorders in Pediatric Dentistry, https://doi.org/10.1007/978-3-030-13269-9_1
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serious consequences for the affected individuals, including increased morbidity and mortality and for society in general as its impact affects performance, vigilance, and optimal functioning. Unfortunately, at this time, although there are treatment options that may help manage the resulting symptoms and prevent complications, we are certainly nowhere near the point of lifelong cure. The treatment may alleviate or reduce symptoms and sequelae for a period of time; age is a risk factor for persistence or recurrence of the disorder. However, we remain hopeful that advances in science and technology will improve the management of sleep apnea and enable us to develop more customized and individual specific treatment op
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