This review article where Dr. Almeida is one of the co-authors is an interesting overview of obstructive sleep apnea. It covers the areas of P4 medicine, which is currently being used more and more in various areas. The four P’s stands for prediction (risk one person has to develop sleep apnea); prevention (risk prevention strategies); personalized (addressing individual needs and specific characteristics); and participation (getting patient involvement in their own care).
Important risk factors known to be associated with sleep apnea are obesity (general and localized), smaller jaws and or head features and neuromuscular control. As the last one we are starting to better understand, obesity is an important factor to pay attention to. Some studies suggest that 10% of weight loss can lead to about a 30% decrease in the apneas at night.
In term of symptoms, not everyone feels the same as a result of the decrease breathing at night. Some individuals develops sleepiness, others develop insomnia while up to 30% could feel completely normal (asymptomatic). A very important are of research today, with unfortunate not many answers, is the understanding on who will develop problems because of sleep apnea. There is consensus that moderate to severe patients have higher chances, but not everyone will have them.
This article further describes treatments such as CPAP, oral appliance, weight loss, surgeries and some new approaches which are still under testing for a promising improved care for all patients in the future.