Mild obstructive sleep apnoea: clinical relevance and approaches to management

The Lancet Respiratory Medicine

Volumn 4, Issue 10, 2016, Pages 826-834

  McNicholas, Walter T ^a,b   Bonsignore, Maria R ^c,d   Lévy, Patrick ^e   Ryan, Silke ^a,b  

^a ST VINCENT S UNIVERSITY HOSPITAL   (Ireland)

^b UNIVERSITY COLLEGE DUBLIN   (Ireland)

^c UNIVERSITY OF PALERMO   (Italy)

^d CNR   (Italy)

^e UNIV GRENOBLE ALPES   (France)

Author keywords

[No Author keywords available]

Indexed keywords

2' (4 METHOXYPHENYLACETAMIDOMETHYL) N [2 (3 PYRIDYL)ETHYL] 2 BIPHENYLCARBOXAMIDE; CORTICOSTEROID; THEOPHYLLINE;

APNEA HYPOPNEA INDEX; BODY POSITION; BODY POSTURE; CLINICAL ASSESSMENT; CLINICAL FEATURE; COMORBIDITY; HUMAN; META ANALYSIS (TOPIC); NONHUMAN; ORAL APPLIANCE THERAPY; POLYSOMNOGRAPHY; POSITIVE END EXPIRATORY PRESSURE; PREVALENCE; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL (TOPIC); REM SLEEP; REVIEW; SLEEP DISORDERED BREATHING; SLEEP THERAPY; WEIGHT REDUCTION; DEVICES; DISEASE MANAGEMENT; PATIENT POSITIONING; PROCEDURES; RESPIRATORY CARE;

CONTINUOUS POSITIVE AIRWAY PRESSURE; DISEASE MANAGEMENT; HUMANS; PATIENT POSITIONING; RESPIRATORY THERAPY; SLEEP APNEA, OBSTRUCTIVE;

EID: 84969915638     PISSN: 22132600     EISSN: 22132619     Source Type: Journal    
DOI: 10.1016/S2213-2600(16)30146-1     Document Type: Review

References (101)

1. 1 Lévy, P, Kohler, M, McNicholas, WT, et al. Obstructive sleep apnoea syndrome. Nat Rev Dis Primers, 1, 2015, 15024.
2. 2 Alonso-Álvarez, ML, Cordero-Guevara, JA, Terán-Santos, J, et al. Obstructive sleep apnea in obese community-dwelling children: the NANOS study. Sleep 37 (2014), 943–949.
3. 3 Deegan, PC, McNicholas, WT, Pathophysiology of obstructive sleep apnoea. Eur Respir J 8 (1995), 1161–1178.
4. 4 Kent, BD, Ryan, S, McNicholas, WT, The genetics of obstructive sleep apnoea. Curr Opin Pulm Med 16 (2010), 536–542.
5. 5 Eckert, DJ, White, DP, Jordan, AS, Malhotra, A, Wellman, A, Defining phenotypic causes of obstructive sleep apnea. Identification of novel therapeutic targets. Am J Respir Crit Care Med 188 (2013), 996–1004.
6. 6 Flemons, WW, Buysse, D, Redline, S, et al. Sleep-related breathing disorders in adults: Recommendations for syndrome definition and measurement techniques in clinical research. Sleep 22 (1999), 667–689.
7. 7 Peppard, PE, Young, T, Barnet, JH, Palta, M, Hagen, EW, Hla, KM, Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol 177 (2013), 1006–1014.
8. 8 Tufik, S, Santos-Silva, R, Taddei, JA, Bittencourt, LR, Obstructive sleep apnea syndrome in the Sao Paulo Epidemiologic Sleep Study. Sleep Med 11 (2010), 441–446.
9. 9 Bearpark, H, Elliot, L, Grunstein, R, et al. Snoring and sleep apnea: a population study in Australian men. Am J Respir Crit Care Med 151 (1995), 1459–1465.
10. 10 Arnardottir, ES, Bjornsdottir, E, Olafsdottir, KA, Benediktsdottir, B, Gislason, T, Obstructive sleep apnoea in the general population: highly prevalent but minimal symptoms. Eur Respir J 47 (2016), 194–202.
11. 11 Heinzer, R, Vat, S, Marques-Vidal, P, et al. Prevalence of sleep-disordered breathing in the general population: the HypnoLaus study. Lancet Respir Med 3 (2015), 310–318.
12. 12 Ip, MS, Lam, B, Lauder, IJ, et al. A community study of sleep-disordered breathing in middle-aged Chinese men in Hong Kong. Chest 119 (2001), 62–69.
13. 13 Ip, MS, Lam, B, Tang, LC, Lauder, IJ, Ip, TY, Lam, WK, A community study of sleep-disordered breathing in middle-aged Chinese women in Hong Kong: prevalence and gender differences. Chest 125 (2004), 127–134.
14. 14 McNicholas, WT, Diagnosis of obstructive sleep apnea in adults. Proc Am Thorac Soc 5 (2008), 1540–1560.
15. 15 Guilleminault, C, Palombini, L, Poyares, D, Chowdhuri, S, Chronic insomnia, premenopausal women and sleep disordered breathing: part 2. Comparison of nondrug treatment trials in normal breathing and UARS post menopausal women complaining of chronic insomnia. J Psychosom Res 53 (2002), 617–623.
16. 16 Chen, X, Wang, R, Lutsey, PL, et al. Racial/ethnic differences in the associations between obesity measures and severity of sleep-disordered breathing: the Multi-Ethnic Study of Atherosclerosis. Sleep Med, 2015, 10.1016/S1389-9457(15)00817-5 published online June 25.
17. 17 Deegan, PC, McNicholas, WT, Predictive value of clinical features for the obstructive sleep apnoea syndrome. Eur Respir J 9 (1996), 117–124.
18. 18 Young, T, Peppard, PE, Gottlieb, DJ, Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med 165 (2002), 1217–1239.
19. 19 Johns, MW, Daytime sleepiness, snoring, and obstructive sleep apnea. The Epworth Sleepiness Scale. Chest 103 (1993), 30–36.
20. 20 Guilleminault, C, Partinen, M, Quera-Salva, MA, Hayes, B, Dement, WC, Nino-Murcia, G, Determinants of daytime sleepiness in obstructive sleep apnea. Chest 94 (1988), 32–37.
21. 21 Chen, R, Xiong, KP, Lian, YX, et al. Daytime sleepiness and its determining factors in Chinese obstructive sleep apnea patients. Sleep Breath 15 (2011), 129–135.
22. 22 Quan, SF, Budhiraja, R, Batool-Anwar, S, et al. Lack of impact of mild obstructive sleep apnea on sleepiness, mood and quality of life. Southwest J Pulm Crit Care 9 (2014), 44–56.
23. 23 Redline, S, Strauss, ME, Adams, N, et al. Neuropsychological function in mild sleep-disordered breathing. Sleep 20 (1997), 160–167.
24. 24 McNicholas, WT, Bonsignore, MR, Sleep apnoea as an independent risk factor for cardiovascular disease: current evidence, basic mechanisms and research priorities. Eur Respir J 29 (2007), 156–178.
25. 25 Polotsky, VY, Patil, SP, Savransky, V, et al. Obstructive sleep apnea, insulin resistance, and steatohepatitis in severe obesity. Am J Respir Crit Care Med 179 (2009), 228–234.
26. 26 Kent, BD, Grote, L, Ryan, S, et al. Diabetes mellitus prevalence and control in sleep-disordered breathing: the European Sleep Apnea Cohort (ESADA) study. Chest 146 (2014), 982–990.
27. 27 Peppard, PE, Szklo-Coxe, M, Hla, K, Young, T, Longitudinal association of sleep-related breathing disorder and depression. Arch Intern Med 166 (2006), 1709–1715.
28. 28 Bonsignore, MR, McNicholas, WT, Montserrat, JM, Eckel, J, Adipose tissue in obesity and obstructive sleep apnoea. Eur Respir J 39 (2012), 746–767.
29. 29 Kent, BD, Ryan, S, McNicholas, WT, Obstructive sleep apnea and inflammation: relationship to cardiovascular co-morbidity. Respir Physiol Neurobiol 178 (2011), 475–481.
30. 30 Yaggi, HK, Concato, J, Kernan, WN, Lichtman, JH, Brass, LM, Mohsenin, V, Obstructive sleep apnea as a risk factor for stroke and death. N Engl J Med 353 (2005), 2034–2041.
31. 31 Peppard, PE, Young, T, Palta, M, Skatrud, J, Prospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med 342 (2000), 1378–1384.
32. 32 Kohler, M, Craig, S, Nicoll, D, Leeson, P, Davies, RJ, Stradling, JR, Endothelial function and arterial stiffness in minimally symptomatic obstructive sleep apnea. Am J Respir Crit Care Med 178 (2008), 984–988.
33. 33 Drager, LF, Bortolotto, LA, Lorenzi, MC, Figueiredo, AC, Krieger, EM, Lorenzi-Filho, G, Early signs of atherosclerosis in obstructive sleep apnea. Am J Respir Crit Care Med 172 (2005), 613–618.
34. 34 Marin, JM, Carrizo, SJ, Vicente, E, Agusti, AG, Long-term cardiovascular outcomes in men with obstructive sleep apnoea–hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet 365 (2005), 1046–1053.
35. 35 Wang, X, Ouyang, Y, Wang, Z, Zhao, G, Liu, L, Bi, Y, Obstructive sleep apnea and risk of cardiovascular disease and all-cause mortality: a meta-analysis of prospective cohort studies. Int J Cardiol 169 (2013), 207–214.
36. 36 Marshall, NS, Wong, KK, Cullen, SR, Knuiman, MW, Grunstein, RR, Sleep apnea and 20-year follow-up for all-cause mortality, stroke, and cancer incidence and mortality in the Busselton Health Study cohort. J Clin Sleep Med 10 (2014), 355–362.
37. 37 Lavie, L, Oxidative stress in obstructive sleep apnea and intermittent hypoxia—revisited—the bad ugly and good: implications to the heart and brain. Sleep Med Rev 20 (2015), 27–45.
38. 38 Monasterio, C, Vidal, S, Duran, J, et al. Effectiveness of continuous positive airway pressure in mild sleep apnea-hypopnea syndrome. Am J Respir Crit Care Med 164 (2001), 939–943.
39. 39 Hoyos, CM, Melehan, KL, Liu, PY, Grunstein, RR, Phillips, CL, Does obstructive sleep apnea cause endothelial dysfunction? A critical review of the literature. Sleep Med Rev 20 (2015), 15–26.
40. 40 Ryan, S, Ward, S, Heneghan, C, McNicholas, WT, Predictors of decreased spontaneous baroreflex sensitivity in obstructive sleep apnea syndrome. Chest 131 (2007), 1100–1107.
41. 41 Ryan, S, Taylor, CT, McNicholas, WT, Systemic inflammation: a key factor in the pathogenesis of cardiovascular complications in obstructive sleep apnoea syndrome?. Thorax 64 (2009), 631–636.
42. 42 Punjabi, NM, Shahar, E, Redline, S, et al. Sleep-disordered breathing, glucose intolerance, and insulin resistance: the Sleep Heart Health Study. Am J Epidemiol 160 (2004), 521–530.
43. 43 Harris, M, Glozier, N, Ratnavadivel, R, Grunstein, RR, Obstructive sleep apnea and depression. Sleep Med Rev 13 (2009), 437–444.
44. 44 Lutsey, PL, Bengtson, LG, Punjabi, NM, et al. Obstructive sleep apnea and 15-year cognitive decline: the Atherosclerosis Risk in Communities (ARIC) study. Sleep 39 (2016), 309–316.
45. 45 Blackwell, T, Yaffe, K, Laffan, A, et al. Associations between sleep-disordered breathing, nocturnal hypoxemia, and subsequent cognitive decline in older community-dwelling men: the Osteoporotic Fractures in Men Sleep study. J Am Geriatr Soc 63 (2015), 453–461.
46. 46 Lau, EY, Choi, EWM, Lai, ESK, et al. Working memory impairment and its associated sleep-related respiratory parameters in children with obstructive sleep apnea. Sleep Med 16 (2015), 1109–1115.
47. 47 Calhoun, SL, Mayes, SD, Vgontzas, AN, Tsaoussoglou, M, Shifflett, LJ, Bixler, EO, No relationship between neurocognitive functioning and mild sleep disordered breathing in a community sample of children. J Clin Sleep Med 5 (2009), 228–234.
48. 48 Biggs, SN, Vlahandonis, A, Anderson, V, et al. Long-term changes in neurocognition and behavior following treatment of sleep disordered breathing in school-aged children. Sleep 37 (2014), 77–84.
49. 49 Kohler, MJ, Lushington, K, van den Heuvel, CJ, Martin, J, Pamula, Y, Kennedy, D, Adenotonsillectomy and neurocognitive deficits in children with sleep disordered breathing. PLoS One, 4, 2009, e7343.
50. 50 Quan, SF, Archbold, K, Gevins, AS, Goodwin, JL, Long-term neurophysiologic impact of childhood sleep disordered breathing on neurocognitive performance. Southwest J Pulm Crit Care 7 (2013), 165–175.
51. 51 Kuna, ST, Badr, MS, Kimoff, RJ, et al. An official ATS/AASM/ACCP/ERS workshop report: research priorities in ambulatory management of adults with obstructive sleep apnea. Proc Am Thorac Soc 8 (2011), 1–16.
52. 52 Berry, RB, Budhiraja, R, Gottlieb, DJ, et al. American Academy of Sleep Medicine. Rules for scoring respiratory events in sleep: update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events. Deliberations of the Sleep Apnea Definitions Task Force of the American Academy of Sleep Medicine. J Clin Sleep Med 8 (2012), 597–619.
53. 53 Joosten, SA, O'Driscoll, DM, Berger, PJ, Hamilton, GS, Supine position related obstructive sleep apnea in adults: pathogenesis and treatment. Sleep Med Rev 18 (2014), 7–17.
54. 54 Masa, JF, Corral, J, Pereira, R, et al. Therapeutic decision-making for sleep apnea and hypopnea syndrome using home respiratory polygraphy: a large multicentric study. Am J Respir Crit Care Med 184 (2011), 964–971.
55. 55 Guerrero, A, Embid, C, Isetta, V, et al. Management of sleep apnea without high pretest probability or with comorbidities by three nights of portable sleep monitoring. Sleep 37 (2014), 1363–1373.
56. 56 Masa, JF, Duran-Cantolla, J, Capote, F, et al. Efficacy of home single-channel nasal pressure for recommending continuous positive airway pressure treatment in sleep apnea. Sleep 38 (2015), 13–21.
57. 57 Ayappa, I, Norman, RG, Krieger, AC, Rosen, A, O'malley, RL, Rapoport, DM, Non-invasive detection of respiratory effort-related arousals (REras) by a nasal cannula/pressure transducer system. Sleep 23 (2000), 763–771.
58. 58 Conwell, W, Patel, B, Doeing, D, et al. Prevalence, clinical features, and CPAP adherence in REM-related sleep-disordered breathing: a cross-sectional analysis of a large clinical population. Sleep Breath 16 (2012), 519–526.
59. 59 Mokhlesi, B, Finn, LA, Hagen, EW, et al. Obstructive sleep apnea during REM sleep and hypertension. Results of the Wisconsin Sleep Cohort. Am J Respir Crit Care Med 190 (2014), 1158–1167.
60. 60 Grimaldi, D, Beccuti, G, Touma, C, Van Cauter, E, Mokhlesi, B, Association of obstructive sleep apnea in rapid eye movement sleep with reduced glycemic control in type 2 diabetes: therapeutic implications. Diabetes Care 37 (2014), 355–363.
61. 61 Ravesloot, MJL, van Maanen, JP, Dun, L, de Vries, N, The undervalued potential of positional therapy in position-dependent snoring and obstructive sleep apnea—a review of the literature. Sleep Breath 17 (2013), 39–49.
62. 62 Oksenberg, A, Silverberg, DS, The effect of body posture on sleep-related breathing disorders: facts and therapeutic implications. Sleep Med Rev 2 (1998), 139–162.
63. 63 Frank, MH, Ravesloot, MJL, van Maanen, JP, Verhagen, E, de Lange, J, de Vries, N, Positional OSA part 1: towards a clinical classification system for position-dependent obstructive sleep apnoea. Sleep Breath 19 (2015), 473–480.
64. 64 Mazza, S, Pepin, JL, Naegele, B, Plante, J, Deschaux, C, Levy, P, Most obstructive sleep apnoea patients exhibit vigilance and attention deficits on an extended battery of tests. Eur Respir J 25 (2005), 75–80.
65. 65 Engleman, H, Kingshott, R, Wraith, P, MacKay, T, Deary, I, Douglas, N, Randomized placebo-controlled crossover trial of continuous positive airway pressure for mild sleep apnea/hypopnea syndrome. Am J Respir Crit Care Med 159 (1999), 461–467.
66. 66 Engleman, HM, McDonald, JP, Graham, D, et al. Randomized crossover trial of two treatments for sleep apnea/hypopnea syndrome: continuous positive airway pressure and mandibular repositioning splint. Am J Respir Crit Care Med 166 (2002), 855–859.
67. 67 Randerath, WJ, Heise, M, Hinz, R, Ruehle, KH, An individually adjustable oral appliance vs continuous positive airway pressure in mild-to-moderate obstructive sleep apnea syndrome. Chest 122 (2002), 569–575.
68. 68 Barnes, M, McEvoy, RD, Banks, S, et al. Efficacy of positive airway pressure and oral appliance in mild to moderate obstructive sleep apnea. Am J Respir Crit Care Med 170 (2004), 656–664.
69. 69 Marshall, NS, Barnes, M, Travier, N, et al. Continuous positive airway pressure reduces daytime sleepiness in mild to moderate obstructive sleep apnoea: a meta-analysis. Thorax 61 (2006), 430–434.
70. 70 Bartlett, D, Wong, K, Richards, D, et al. Increasing adherence to obstructive sleep apnea treatment with a group social cognitive therapy treatment intervention: a randomized trial. Sleep 36 (2013), 1647–1654.
71. 71 Redline, S, Adams, N, Strauss, ME, Roebuck, T, Winters, M, Rosenberg, C, Improvement of mild sleep-disordered breathing with CPAP compared with conservative therapy. Am J Respir Crit Care Med 157 (1998), 858–865.
72. 72 Weaver, TE, Mancini, C, Maislin, G, et al. Continuous positive airway pressure treatment of sleepy patients with milder obstructive sleep apnea: results of the CPAP Apnea Trial North American Program (CATNAP) randomized clinical trial. Am J Respir Crit Care Med 186 (2012), 677–683.
73. 73 Craig, SE, Kohler, M, Nicoll, D, et al. Continuous positive airway pressure improves sleepiness but not calculated vascular risk in patients with minimally symptomatic obstructive sleep apnoea: the MOSAIC randomised controlled trial. Thorax 67 (2012), 1090–1096.
74. 74 Turnbull, CD, Craig, SE, Kohler, M, Nicoll, D, Stradling, J, Cardiovascular event rates in the MOSAIC trial: 2-year follow-up data. Thorax, 69, 2014, 950.
75. 75 Bratton, DJ, Gaisl, T, Schlatzer, C, Kohler, M, Comparison of the effects of continuous positive airway pressure and mandibular advancement devices on sleepiness in patients with obstructive sleep apnoea: a network meta-analysis. Lancet Respir Med 3 (2015), 869–878.
76. 76 Phillips, CL, Grunstein, RR, Darendeliler, MA, et al. Health outcomes of continuous positive airway pressure versus oral appliance treatment for obstructive sleep apnea: a randomized controlled trial. Am J Respir Crit Care Med 187 (2013), 879–887.
77. 77 Lim, J, Lasserson, TJ, Fleetham, J, Wright, J, Oral appliances for obstructive sleep apnoea. Cochrane Database Syst Rev, 1, 2006 CD004435.
78. 78 Bratton, DJ, Gaisl, T, Wons, AM, Kohler, M, CPAP vs mandibular advancement devices and blood pressure in patients with obstructive sleep apnea: a systematic review and meta-analysis. JAMA 314 (2015), 2280–2293.
79. 79 Gotsopoulos, H, Kelly, JJ, Cistulli, PA, Oral appliance therapy reduces blood pressure in obstructive sleep apnea: a randomized, controlled trial. Sleep 27 (2004), 934–941.
80. 80 Trzepizur, W, Gagnadoux, F, Abraham, P, et al. Microvascular endothelial function in obstructive sleep apnea: impact of continuous positive airway pressure and mandibular advancement. Sleep Med 10 (2009), 746–752.
81. 81 Petit, FX, Pepin, JL, Bettega, G, Sadek, H, Raphael, B, Levy, P, Mandibular advancement devices: rate of contraindications in 100 consecutive obstructive sleep apnea patients. Am J Respir Crit Care Med 166 (2002), 274–278.
82. 82 de Almeida, FR, Lowe, AA, Tsuiki, S, et al. Long-term compliance and side effects of oral appliances used for the treatment of snoring and obstructive sleep apnea syndrome. J Clin Sleep Med 1 (2005), 143–152.
83. 83 Gagnadoux, F, Fleury, B, Vielle, B, et al. Titrated mandibular advancement versus positive airway pressure for sleep apnoea. Eur Respir J 34 (2009), 914–920.
84. 84 Sutherland, K, Vanderveken, OM, Tsuda, H, et al. Oral appliance treatment for obstructive sleep apnea: an update. J Clin Sleep Med 10 (2014), 215–227.
85. 85 Mason, M, Welsh, EJ, Smith, I, Drug therapy for obstructive sleep apnoea in adults. Cochrane Database Syst Rev, 5, 2013 CD003002.pub3.
86. 86 Veasey, SC, Will we ever have an effective pharmacotherapy for obstructive sleep apnea?. Sleep 28 (2005), 18–19.
87. 87 Kiely, JL, Nolan, P, McNicholas, WT, Intranasal corticosteroid therapy for obstructive sleep apnoea in patients with co-existing rhinitis. Thorax 59 (2004), 50–55.
88. 88 McNicholas, WT, The nose and OSA: variable nasal obstruction may be more important in pathophysiology than fixed obstruction. Eur Respir J 32 (2008), 3–8.
89. 89 Mulloy, E, McNicholas, WT, Theophylline in obstructive sleep apnea. A double-blind evaluation. Chest 101 (1992), 753–757.
90. 90 Wirth, KJ, Steinmeyer, K, Ruetten, H, Sensitization of upper airway mechanoreceptors as a new pharmacologic principle to treat obstructive sleep apnea: investigations with AVE0118 in anesthetized pigs. Sleep 36 (2013), 699–708.
91. 91 Wang, D, Eckert, DJ, Grunstein, RR, Drug effects on ventilatory control and upper airway physiology related to sleep apnea. Respir Physiol Neurobiol 188 (2013), 257–266.
92. 92 McNicholas, WT, Arousal in the sleep apnoea syndrome: a mixed blessing?. Eur Respir J 12 (1998), 1239–1241.
93. 93 Anandam, A, Akinnusi, M, Kufel, T, Porhomayon, J, El-Solh, A, Effects of dietary weight loss on obstructive sleep apnea: a meta-analysis. Sleep Breath 17 (2013), 227–234.
94. 94 Chirinos, JA, Gurubhagavatula, I, Teff, K, et al. CPAP, weight loss, or both for obstructive sleep apnea. N Engl J Med 370 (2014), 2265–2275.
95. 95 Boulghassoul-Pietrzykowska, N, Franceschelli, J, Still, C, New medications for obesity management: changing the landscape of obesity treatment. Curr Opin Endocrinol Diabetes Obes 20 (2013), 407–411.
96. 96 Lam, B, Sam, K, Mok, WY, et al. Randomised study of three non-surgical treatments in mild to moderate obstructive sleep apnoea. Thorax 62 (2007), 354–359.
97. 97 Mador, MJ, Kufel, TJ, Magalang, UJ, Rajesh, SK, Watwe, V, Grant, BJB, Prevalence of positional sleep apnea in patients undergoing polysomnography. Chest 128 (2005), 2130–2137.
98. 98 Cartwright, R, Ristanovic, R, Diaz, F, Caldarelli, D, Alder, G, A comparative study of treatments for positional sleep apnea. Sleep 14 (1991), 546–552.
99. 99 Jokic, R, Klimaszewski, A, Crossley, M, Sridhar, G, Fitzpatrick, MF, Positional treatment vs continuous positive airway pressure in patients with positional obstructive sleep apnea syndrome. Chest 115 (1999), 771–781.
100. 100 Veasey, SC, Guilleminault, C, Strohl, KP, Sanders, MH, Ballard, RD, Magalang, UJ, Medical therapy for obstructive sleep apnea: a review by the Medical Therapy for Obstructive Sleep Apnea Task Force of the Standards of Practice Committee of the American Academy of Sleep Medicine. Sleep 29 (2006), 1036–1044.
101. 101 Sánchez-de-la-Torre, M, Nadal, N, Cortijo, A, et al. Role of primary care in the follow-up of patients with obstructive sleep apnoea undergoing CPAP treatment: a randomised controlled trial. Thorax 70 (2015), 346–352.