Abstract
Background: Obstructive sleep apnea (OSA) is a prevalent, serious disease that is
under-recognized and under-treated. It results from a combination of increased pharyngeal
collapsibility and impaired compensatory pharyngeal muscle dilator activity. OSA causes
serious morbidity and mortality. OSA is also a public health problem in that it is
an independent cause of car crashes, at great cost to society in dollars and lives.
OSA is conservatively estimated to affect 2–4% of Americans; however, recent estimates
are much higher. Objectives: To educate emergency physicians on the pathophysiology,
epidemiology, diagnosis, and management of OSA and discuss diagnostic approaches and
recommendations that can be made from the emergency department (ED). Discussion: Emergency
physicians can play an important role in the recognition and referral of patients
at risk for OSA. A focused history and physical examination or the use of a structured
evaluation can identify patients at risk for OSA. In addition to referring patients
at risk for OSA for further diagnostic work-up, emergency physicians can offer recommendations
such as weight loss, moderation of alcohol use and certain medications, and smoking
cessation. Conclusion: OSA is a common disease in the United States that is under-recognized
and under-treated. ED patients who do not regularly see a primary care provider or
have no primary care provider are particularly at risk for undiagnosed OSA. Emergency
physicians can play an important role in recognizing patients at risk for OSA, referring
them for further diagnostic work-up, and offering recommendations from the ED.
Keywords
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Article info
Publication history
Published online: March 15, 2010
Accepted:
January 5,
2010
Received in revised form:
October 15,
2009
Received:
September 16,
2009
Identification
Copyright
© 2011 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
