Lung India (Jan 2015)

Consensus and evidence-based Indian initiative on obstructive sleep apnea guidelines 2014 (first edition)

  • Surendra K Sharma,
  • Vishwa Mohan Katoch,
  • Alladi Mohan,
  • T Kadhiravan,
  • A Elavarasi,
  • R Ragesh,
  • Neeraj Nischal,
  • Prayas Sethi,
  • D Behera,
  • Manvir Bhatia,
  • A G Ghoshal,
  • Dipti Gothi,
  • Jyotsna Joshi,
  • M S Kanwar,
  • O P Kharbanda,
  • Suresh Kumar,
  • P R Mohapatra,
  • B N Mallick,
  • Ravindra Mehta,
  • Rajendra Prasad,
  • S C Sharma,
  • Kapil Sikka,
  • Sandeep Aggarwal,
  • Garima Shukla,
  • J C Suri,
  • B Vengamma,
  • Ashoo Grover,
  • V K Vijayan,
  • N Ramakrishnan,
  • Rasik Gupta

DOI
https://doi.org/10.4103/0970-2113.159677
Journal volume & issue
Vol. 32, no. 4
pp. 422 – 434

Abstract

Read online

Obstructive sleep apnea (OSA) and obstructive sleep apnea syndrome (OSAS) are subsets of sleep-disordered breathing. Awareness about OSA and its consequences among the general public as well as the majority of primary care physicians across India is poor. This necessitated the development of the Indian initiative on obstructive sleep apnea (INOSA) guidelines under the auspices of Department of Health Research, Ministry of Health and Family Welfare, Government of India. OSA is the occurrence of an average five or more episodes of obstructive respiratory events per hour of sleep with either sleep-related symptoms or co-morbidities or ≥15 such episodes without any sleep-related symptoms or co-morbidities. OSAS is defined as OSA associated with daytime symptoms, most often excessive sleepiness. Patients undergoing routine health check-up with snoring, daytime sleepiness, obesity, hypertension, motor vehicular accidents, and high-risk cases should undergo a comprehensive sleep evaluation. Medical examiners evaluating drivers, air pilots, railway drivers, and heavy machinery workers should be educated about OSA and should comprehensively evaluate applicants for OSA. Those suspected to have OSA on comprehensive sleep evaluation should be referred for a sleep study. Supervised overnight polysomnography is the "gold standard" for evaluation of OSA. Positive airway pressure (PAP) therapy is the mainstay of treatment of OSA. Oral appliances (OA) are indicated for use in patients with mild to moderate OSA who prefer OA to PAP, or who do not respond to PAP or who fail treatment attempts with PAP or behavioral measures. Surgical treatment is recommended in patients who have failed or are intolerant to PAP therapy.

Keywords