Defining obstructive sleep apnoea syndrome: a failure of semantic rules

Obstructive sleep apnoea syndrome (OSAS) is one of the most ubiquitous medical conditions in industrialised society. Since the recognition that symptoms of excessive daytime somnolence, problems with concentration, mood and cognitive impairment, as well as cardiometabolic abnormalities can arise as a consequence of obstructed breathing during sleep, it has been subject to variation in its definition. Over the past five decades, attempts have been made to standardise the definitions and scoring criteria used for apnoeas and hypopnoea, which are the hallmarks of obstructive sleep apnoea (OSA). However, applying these definitions in clinical and research practice has resulted in over- and under-estimation of the severity and prevalence of OSAS. Furthermore, the definitions may eventually become redundant in the context of rapid technological advances in breathing measurement and other signal acquisition. Increased efforts towards precision medicine have led to a focus on the pathophysiology of obstructed breathing during sleep. However, the same degree of effort has not been focused on how and why the latter does or does not result in diurnal symptoms, integral to the definition of OSAS. This review focuses on OSAS in adults and discusses some of the difficulties with current definitions and the possible reasons behind them

The obstructive sleep apnoea/hypopnoea syndrome – An overview

AbstractIn the last 30 years, there has been an explosion in facilities for the diagnosis and treatment of the obstructive sleep apnoea/hypopnoea syndrome (OSAHS) as well as a rapid advancement in the understanding of its consequences. In the general population, the prevalence of OSAHS is approximately 3–7% in adult men and 2–5% in adult women. OSAHS has been recognised as an independent risk factor for disorders such as hypertension, cardiovascular disease and sleepiness-related accidents. Currently, it is considered to be a systemic disease. This review provides a general overview of OSAHS: its epidemiology, pathophysiology, clinical features, diagnosis and treatment, as well as its consequences for public health

Breathe: respiratory health and disability

The December issue of Breathe looks at respiratory health in people with disabilities http://ow.ly/Vn9y305KcL

Breathe:exploring respiratory health and exercise

The June issue of Breathe explores topics relating to respiratory health and exercise http://ow.ly/L3Zy300oWU

Breathe:New features and new ways to get involved

Breathe’s new Chief Editor welcomes us to the next three years http://ow.ly/UHuy

Sex and gender in lung health and disease: more than just Xs and Ys

A new series explores the role of sex and gender-related factors in respiratory physiology, lung health, and across respiratory diseases https://bit.ly/3mP0BV

European Union directive 2014/85/EU on driver licensing in obstructive sleep apnoea:early experiences with its application in the UK

OSA patients’ risk of RTA should be assessed using detailed driving history with specific focus on “red flags” http://ow.ly/mxPi305isn

Sex differences in obstructive sleep apnoea

Obstructive sleep apnoea (OSA) and obstructive sleep apnoea/hypopnoea syndrome (OSAHS) have long been considered predominantly male-related conditions. The clinical presentation of sleep disordered breathing in females differs from males and can vary with age and physiological status, e.g. menopause and pregnancy. Overall, females appear to be more symptomatic, with lower apnoea–hypopnoea index scores compared to males. Furthermore, they appear to have more prolonged partial upper airway obstruction, and may report insomnia as a symptom of OSAHS more frequently. As a consequence of these differences in clinical presentation, females with sleep disordered breathing are often underdiagnosed and undertreated compared to males. This review is aimed at discussing the epidemiology, clinical presentation, pathophysiology and hormonal and metabolic differences in females who present with OSA/OSAHS in comparison to males