Fundamentals 22 Obstructive Sleep Apnea Treatment Overview and Medical Treatments.pdf.pdf

FUNDAMENTALS 22
Obstructive Sleep
Apnea: Treatment Overview
and Medical Treatments
A number of considerations affect the decision to severe OSA is mended, even if patients are
treat a patient with obstructive sleep apnea asymptomatic.
(OSA) (Figure F22-1). The first category is the
severity of OSA, as based on the apnea-hypopnea
index, severity of arterial oxygen desaturation, CHOOSING TREATMENT
and association with significant
The second consideration is the presence or The choice of treatment modality is based on the
absence of symptoms. Symptomatic OSA should severity of OSA as well as patient characteristics
always be treated, but the choice of treatment and preferences (Table F22-1). Treatment with
may vary. Symptoms may not correlate with the PAP (Fundamentals 24 ), surgery (Fundamentals
apnea–hypopnea index (AHI), and the dictum 26) and oral appliances (Fundamentals 27) are
“Treat the patient, not the AHI” should be consid- discussed in more detail in these chapters. Prac-
ered. The third consideration is the impact of OSA tice parameters on the use of PAP, oral appli-
on the sleep of the patient’s bed partner. Loud ances (OAs), upper airway surgery and medical
snoring and apnea may cause marital discord and treatments have been –9 Although
impair the sleep of the patient’s bed weight loss is included in every cate