![]() ![]() Obstructive sleep apnea may be underdiagnosed only 3% of Canadians aged 18 years or older reported a formal diagnosis despite high rates of symptom reporting 3 yet, high-quality prospective studies have shown clear benefit of treatment for patients with sleepiness, cognitive or psychological dysfunction, or poor quality of life owing to obstructive sleep apnea. 1, 2 A survey conducted by the Public Health Agency of Canada in 2009 found that 26% of Canadian adults reported symptoms and risk factors that are associated with a high risk of OSA 3 however, prevalence data in Canada are limited by the absence of studies using objective sleep testing. ![]() In recent population-based studies, the estimated prevalence of moderate to severe sleep-disordered breathing ranges from 3% to nearly 50% depending on age group and sex. Obstructive sleep apnea (OSA) is characterized by recurring episodes of cessation (apnea) or reduction (hypopnea) in airflow during sleep caused by obstruction of the upper airway. Good evidence supports treatment of OSA with targeted therapies including continuous positive airway pressure or oral appliances, as well as promotion of weight loss and moderate exercise for those who are overweight (alternative treatments may be tried for those who do not tolerate usual therapies). Polysomnography is the gold standard for diagnosis however, home sleep apnea testing may be used to confirm the diagnosis in symptomatic patients with a high pretest probability of OSA and without clinically important cardiopulmonary comorbidity. Obstructive sleep apnea should be considered in symptomatic patients with suggestive craniofacial features or comorbidities, even in the absence of classic risk factors such as older age, male sex or obesity. Obstructive sleep apnea (OSA) is likely underdiagnosed in Canada however, lack of appropriate treatment puts many at risk of poor quality of life, comorbidity, motor vehicle crashes and increased health care utilization. ![]()
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