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      Adult obstructive sleep apnoea.

        1 , 2 , 3

      Lancet (London, England)

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          Abstract

          Obstructive sleep apnoea is an increasingly common disorder of repeated upper airway collapse during sleep, leading to oxygen desaturation and disrupted sleep. Features include snoring, witnessed apnoeas, and sleepiness. Pathogenesis varies; predisposing factors include small upper airway lumen, unstable respiratory control, low arousal threshold, small lung volume, and dysfunctional upper airway dilator muscles. Risk factors include obesity, male sex, age, menopause, fluid retention, adenotonsillar hypertrophy, and smoking. Obstructive sleep apnoea causes sleepiness, road traffic accidents, and probably systemic hypertension. It has also been linked to myocardial infarction, congestive heart failure, stroke, and diabetes mellitus though not definitively. Continuous positive airway pressure is the treatment of choice, with adherence of 60-70%. Bi-level positive airway pressure or adaptive servo-ventilation can be used for patients who are intolerant to continuous positive airway pressure. Other treatments include dental devices, surgery, and weight loss.

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          Author and article information

          Journal
          Lancet
          Lancet (London, England)
          1474-547X
          0140-6736
          Feb 22 2014
          : 383
          : 9918
          Affiliations
          [1 ] University of Melbourne, Melbourne, VIC, Australia; Institute for Breathing and Sleep, Melbourne, VIC, Australia. Electronic address: ajordan@unimelb.edu.au.
          [2 ] Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Letterkenny General Hospital, County Donegal, Ireland.
          [3 ] Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; University of California, San Diego, CA, USA.
          Article
          S0140-6736(13)60734-5 NIHMS524777
          10.1016/S0140-6736(13)60734-5
          23910433
          Copyright © 2014 Elsevier Ltd. All rights reserved.

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