As part of our continued effort to provide a high quality user experience while also ensuring the integrity of the information of those that we service is protected,
we will be implementing changes to evicore.com in the near future.
Beginning on 3/15/21, web users will be required to log in to evicore.com in order to check the status
of authorization request(s). Please click here to register for an account.
Resources
I Would Like To
Learn How To
 Primer', 'During the last 40 years, medical professionals have come to recognize that getting a good night s sleep is critical to maintaining overall health and wellness.', '/-/media/Images/eviCore/Insight/712_SleepSolution_Banner.png','url')){kind=link}
A Sleep Apnea (OSA) Primer
During the last 40 years, medical professionals have come to recognize that getting a good night's sleep is critical to maintaining overall health and wellness. In fact, studies have found that sleep disorders contribute significantly to the incidence of high blood pressure, diabetes, obesity, heart failure, coronary artery disease, and stroke.
Not surprisingly, a lot of recent sleep research focuses on obstructive sleep apnea (OSA) because millions of adults—a full 12 percent of the population—suffer from this condition in the United States alone. That's why it's vital to understand its causes and symptoms.
What triggers OSA and what damage can it do?
OSA is caused by a collapsed airway that blocks airflow during sleep, disrupting breathing throughout the night and forcing sufferers to awaken briefly to take a breath. Apnea events can occur hundreds of times every night, and because sufferers aren't breathing normally their bodies may experience a number of reactions, including:
- Reduced blood oxygen levels
- A slowed heart rate
- More pressure inside the chest
- Fragmented sleep
- High blood pressure, depression, and insomnia are also common consequences of the disorder.
Most experts agree that OSA is still vastly under-recognized. The evidence: 75 percent of people with the disorder remain undiagnosed and untreated. Yet, managing OSA can make a real difference to patient well-being, so it's important to be aware of the following symptoms:
- Snoring
- Daytime sleepiness
- Non-refreshing sleep
- Morning headaches
- Dry mouth
- Poor concentration
- Irritability.
Who is most at risk?
People who are obese, who have large necks, or who have crowded airways are particularly susceptible to OSA. The condition is also more prevalent in men, older people, and those with a genetic predisposition. Associated medical conditions include, but aren't limited to, Type II diabetes, heart disease, high blood pressure, and heart arrhythmia.
OSA — a symptom as well as a condition?
OSA has a negative impact on quality of life, productivity, and mood. What's more, the sleepiness it causes ups the risk of accidents, absenteeism, and workplace errors. And because it significantly affects breathing for up to one-third of the day, it can exacerbate existing high blood pressure, diabetes, heart disease, depression, and high cholesterol.
Interestingly, an estimated 50‒75% of heart-failure patients also suffer from OSA, so some researchers have suggested that everyone with chronic heart failure should be screened for sleep apnea. In addition, a recent paper advocated that all diabetics should be assessed for sleep apnea—and that all OSA patients be tested for diabetes. Another study showed that high cholesterol, tobacco use, and ischemic heart conditions are relatively common in sleep apnea sufferers.
Do you screen patients with these conditions for sleep apnea? Visit our
sleep solution page to learn more.
References:
2.Schäfer H, et al. Cardiology. 1999;92(2):79-84.
3.Stroke: Johnson KG; Johnson DC. Frequency of sleep apnea in stroke and TIA patients: a meta-analysis. J Clin Sleep Med 2010;6(2):131-137.
4.Foster, et al. Diabetes Care. 2009 Jun;32(6):1017-9.
5.Logan et al. J Hypertens. 2001 Dec;19(12):2271-7. Sjöström C, et al. Thorax. 2002 Jul;57(7):602-7.
6.O'Keeffe T, Patterson EJ. Obes Surg. 2004 Jan;14(1):23-6
7.Ronald, J. et al. (1999). Sleep, 22, 225 – 229.
8.McKinsey & Co with Harvard Medical School (2010). The Price of Fatigue: the surprising economic costs of unmanaged Sleep apnea.
9.Jencks S.F., Williams M.V., Coleman E.A.; Rehospitalizations among patients in the Medicare fee-for-service program. N Engl J Med. 2009;360:1418-1428.
10.Oldenburg et al. Eur J Heart Fail 2007
11.Kaneko et al. New Engl J Med 2003
12.Kauta, S.R., et al. (2014). Diagnosis and treatment of sleep disordered breathing in hospitalized cardiac patients: a reduction in 30-day hospital readmission rates. Journal of Clinical Sleep Medicine, 10, 1051-1059.
13.Bahammam, A. et al. (1999). Sleep, 22, 740 – 747.
14.Collop NA; Anderson WM; Boehlecke B; Claman D; Goldberg R; Gottlieb DJ; Hudgel D; Sateia M; Schwab R. Clinical guidelines for the use of unattended portable monitors in the diagnosis of obstructive sleep apnea in adult patients. J Clin Sleep Med 2007; 3(7):737-747.
15.Guerrero A, Embid C, Isetta V, Farre R, Duran-Cantolla J, Parra O, Barbé F, Montserrat JM, Masa JF. Management of sleep apnea without high pretest probability or with comorbidities by three nights of portable sleep monitoring. SLEEP 2014;37(8):1363-1373.
16.Atrial Fib: Gami, et al. Circulation. 2004 Jul 27;110(4):364-7.
17.Albarrak, et al. (2005). Sleep, 28, 1306 – 1311.
18.Becker, et al. (2003). Circulation,
19.Babu, et al., (2005). Arch Intern Med
20.Harsch, et al. (2004).
21.Hoffman, B., et al. (2010). The long-term health plan and disability cost benefit of OSA treatment in a commercial motor vehicle driver population. JOEM, 52, 473 – 477.
Related Insights
Nurses - Our “Most Trusted” Profession