Obstructive sleep apnoea

Overview

Obstructive sleep apnoea is a common, underdiagnosed condition characterised by recurrent upper-airway narrowing during sleep. It presents with the triad of habitual snoring, witnessed apnoeas and unrefreshing sleep, and its cardinal daytime consequence is excessive sleepiness that impairs concentration, driving safety and quality of life.^[1]

The cardiometabolic associations — hypertension, atrial fibrillation, type 2 diabetes and stroke — cluster with OSA, but SAVE demonstrated that CPAP at real-world adherence (mean 3.3 hours/night) did not prevent cardiovascular events in patients with established cardiovascular disease, while significantly reducing snoring, daytime sleepiness and improving mood and quality of life. The treatment case for OSA rests on symptoms and quality of life, not cardiovascular event prevention.^[1]

References11ShowHide

1. [1]McEvoy RD, Antic NA, Heeley E et al. CPAP for Prevention of Cardiovascular Events in Obstructive Sleep Apnea. The New England journal of medicine, 2016.PMID 27571048
2. [2]Mokhlesi B, Ayas NT Cardiovascular Events in Obstructive Sleep Apnea - Can CPAP Therapy SAVE Lives? The New England journal of medicine, 2016.PMID 27571490
3. [3]Nagappa M, Liao P, Wong J et al. Validation of the STOP-Bang Questionnaire as a Screening Tool for Obstructive Sleep Apnea among Different Populations: A Systematic Review and Meta-Analysis. PloS one, 2015.PMID 26658438
4. [4]Chung F, Subramanyam R, Liao P et al. High STOP-Bang score indicates a high probability of obstructive sleep apnoea. British journal of anaesthesia, 2012.PMID 22401881
5. [5]Chung F, Liao P, Farney R Correlation between the STOP-Bang Score and the Severity of Obstructive Sleep Apnea. Anesthesiology, 2015.PMID 25988411
6. [6]Ghosh P, Janakiram C, Nk SV et al. Oral appliance therapy for the management of obstructive sleep apnea in adults: an umbrella review. JBI evidence synthesis, 2025.PMID 40159944
7. [7]Tregear S, Reston J, Schoelles K et al. Continuous positive airway pressure reduces risk of motor vehicle crash among drivers with obstructive sleep apnea: systematic review and meta-analysis. Sleep, 2010.PMID 21061860
8. [8]Kuhn E, Schwarz EI, Bratton DJ et al. Effects of CPAP and Mandibular Advancement Devices on Health-Related Quality of Life in OSA: A Systematic Review and Meta-analysis. Chest, 2017.PMID 28130044
9. [9]Dandamudi M, Lucena L, Gamarra-Valverde NN et al. Efficacy of GLP-1 Receptor agonists in treating Obstructive sleep apnea: A systematic review and meta-analysis of cardiometabolic and respiratory outcomes. Sleep & breathing = Schlaf & Atmung, 2026.PMID 42029967
10. [10]Chen X Effectiveness of non-surgical weight loss interventions on obstructive sleep apnoea severity and cardiometabolic outcomes: A systematic review and meta-analysis. Sleep medicine, 2026.PMID 41762860
11. [11]Figard C, Ben Messaoud R, Baillieul S et al. Effect of sleep apnoea interventions on multiple health outcomes: an umbrella review of meta-analyses of randomised controlled trials. EClinicalMedicine, 2025.PMID 41140453