Journal of Sleep Disorders & Therapy

Journal of Sleep Disorders & Therapy
Open Access

ISSN: 2167-0277

Commentary - (2025)Volume 14, Issue 1

Public Health Strategies for Early Identification and Intervention in Obstructive Sleep Apnea

Kimani Ali*
 
*Correspondence: Kimani Ali, Department of Integrative Health and Sleep Sciences, Mount Kenya University, Thika, Kenya, Email:

Author info »

Description

Obstructive Sleep Apnea (OSA) is a serious and common sleeprelated breathing disorder that is characterized by repetitive episodes of partial or complete upper airway obstruction during sleep. These episodes lead to disrupted sleep architecture, intermittent hypoxia, and increased sympathetic nervous system activity. Although awareness of OSA has grown in recent years, it remains significantly underdiagnosed and undertreated, despite the profound impact it has on health, quality of life, and healthcare systems globally. The prevalence of OSA is rising due to contributing factors such as obesity, aging populations, and changes in lifestyle, necessitating a stronger public health focus on its early detection and effective management.

The consequences of untreated OSA are substantial and span across multiple organ systems. One of the most concerning outcomes is its impact on cardiovascular health. Repeated episodes of hypoxia and arousals from sleep activate the sympathetic nervous system, leading to increased heart rate, elevated blood pressure, and systemic inflammation. OSA is independently associated with hypertension, especially resistant hypertension, and is considered a risk factor for myocardial infarction, stroke, arrhythmias, and heart failure. These associations have been consistently documented in observational studies, and emerging research continues to uncover the biological pathways connecting OSA to cardiovascular morbidity.

OSA also plays a significant role in the development of metabolic dysfunction. It has a bidirectional relationship with type 2 diabetes, wherein OSA can worsen glucose metabolism, and diabetes can predispose individuals to OSA. Sleep fragmentation and hypoxia interfere with insulin sensitivity, glucose tolerance, and appetite-regulating hormones, thereby contributing to weight gain and metabolic syndrome. The interaction between OSA and obesity is particularly complex; obesity is a leading risk factor for OSA due to fat deposition around the neck and upper airway, while OSA exacerbates obesity by reducing energy expenditure and promoting leptin resistance.

Diagnosis of OSA typically begins with clinical suspicion based on symptoms such as loud snoring, witnessed apneas, nocturnal gasping or choking, unrefreshing sleep, and daytime sleepiness. However, many individuals with OSA are asymptomatic or unaware of their nighttime disturbances. Therefore, a high index of suspicion is essential, particularly in high-risk groups such as obese individuals, older adults, males, and those with comorbidities like hypertension or atrial fibrillation. The gold standard for diagnosis remains overnight Polysomnography (PSG), a comprehensive sleep study that monitors brain activity, oxygen levels, heart rate, respiratory effort, and body movements during sleep. Home Sleep Apnea Testing (HSAT) is an alternative for patients without complex medical conditions and has gained popularity due to convenience and lower cost.

Once diagnosed, the primary goal of OSA management is to restore normal breathing during sleep, reduce symptoms, and mitigate associated health risks. Continuous Positive Airway Pressure (CPAP) therapy is the cornerstone of treatment. CPAP delivers a constant stream of air through a mask to keep the airway open, effectively preventing apneas and hypopneas. Numerous studies have shown that CPAP improves sleep quality, reduces daytime sleepiness, lowers blood pressure, and enhances overall quality of life. However, adherence remains a major challenge due to discomfort, nasal congestion, mask intolerance, or perceived inconvenience. Addressing these barriers through patient education, mask fitting, and support services is critical to ensuring therapeutic success.

Children with OSA represent a distinct subgroup, often presenting with behavioral problems, poor academic performance, or growth delays. The most common cause of pediatric OSA is adenotonsillar hypertrophy, and adenotonsillectomy remains the first-line treatment. In some cases, orthodontic interventions, anti-inflammatory medications, or CPAP may be necessary. Early recognition and intervention in children are vital to prevent long-term developmental and health consequences. Many individuals remain undiagnosed due to lack of awareness, limited access to sleep testing, and the misconception that snoring is benign.

Author Info

Kimani Ali*
 
Department of Integrative Health and Sleep Sciences, Mount Kenya University, Thika, Kenya
 

Citation: Ali K (2025). Public Health Strategies for Early Identification and Intervention in Obstructive Sleep Apnea. J Sleep Disord Ther. 14:628.

Received: 03-Feb-2025, Manuscript No. JSDT-25-37883; Editor assigned: 05-Feb-2025, Pre QC No. JSDT-25-37883 (PQ); Reviewed: 18-Feb-2025, QC No. JSDT-25-37883; Revised: 25-Feb-2025, Manuscript No. JSDT-25-37883 (R); Published: 04-Mar-2025 , DOI: 10.35248/2167-0277.25.14.628

Copyright: © 2025 Ali K. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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