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Obstructive sleep apnea (OSA) is a relatively common sleep disorder characterized by repetitive narrowing or obstruction of the upper airway, including the nasal cavity, pharynx, and larynx, during sleep. OSA can cause a variety of symptoms and/or complications, such as excessive daytime sleepiness, reduced concentration, hypertension, type II diabetes, and stroke. Accordingly, an accurate diagnosis and appropriate treatments are required for OSA. Obesity is an important risk factor for OSA and is characterized by the abnormal accumulation of fat in the body, including the upper airway. When the body weight increases, adipose tissue accumulates in the pharynx, which can narrow the diameter of the upper airway and lead to dysfunction of the pharynx dilator muscles. These changes caused by weight gain can cause or exacerbate OSA. Various therapeutic options exist for patients with overweight or obesity, including diet, behavioral modifications, exercise, pharmacological treatments, and surgical procedures. Of these, diet, behavioral modifications, and exercise constitute the first-line management for obesity. However, their results are relatively unsatisfactory, and pharmacotherapy and bariatric surgery are generally implemented in obese patients with OSA. Therefore, the purpose of this paper is to review pharmacological and surgical management strategies for obesity that are currently commonly used in overweight or obese adult patients with OSA. [ABSTRACT FROM AUTHOR]

This paper summarizes a recent meta-analysis of various topics in obstructive sleep apnea (OSA). In addition to cardiovascular disease and neurocognitive dysfunction, a wide variety of diseases have been associated with OSA, and associations with cancer have also been reported. Although continuous positive airway pressure is a very effective treatment, the results have shown that it does not reduce the incidence of various complications. It has been reported that uvulopalatopharyngoplasty was effective, and robotic surgery for the tongue root and hypoglossal nerve stimulation were also effective. The effectiveness of various medications to reduce daytime sleepiness has also been demonstrated. Although exercise lowered the apnea-hypopnea index, it was not related to changes in body composition, and it was also reported that exercise combined with weight control were effective. Additionally, interesting and clinically meaningful meta-analysis results were summarized and presented. [ABSTRACT FROM AUTHOR]

Background and Objectives: Positional therapy is a therapeutic method for obstructive sleep apnea (OSA). However, little is known about the effectiveness of positional OSA treatment based on meta-analysis. Therefore, we undertook a review and meta-analysis of studies to assess the effect of positional therapy on OSA. Subjects and Method: We searched PubMed (Medline), OVID Medline, EMBASE, Cochrane Library, SCOPUS, KoreaMed, MedRIC, and KSI KISS using the key words "obstructive sleep apnea" and "positional therapy". To estimate the effect of positional OSA therapy, we analyzed the ratio of means (ROM) for pre- and post-treatment polysomnographic data including apnea-hypopnea index (AHI), lowest oxygen saturation, arousal index, and sleep efficiency. Results: Finally, twenty two studies from 21 papers were included in the meta-analysis. Positional therapy significantly decreased AHI by 54.1% [ROM, 0.459; 95% confidence interval (CI), 0.394 to 0.534] and increased lowest oxygen saturation by 3.3% (ROM, 1.033; 95% CI, 1.020 to 1.046). However, positional therapy did not significantly change arousal index (ROM, 0.846; 95% CI, 0.662 to 1.081) or sleep efficiency (ROM, 1.008; 95% CI, 0.990 to 1.027). Conclusion: Positional therapy significantly improves respiratory parameters including AHI and lowest oxygen saturation in patients with OSA. [ABSTRACT FROM AUTHOR]

Background and Objectives: Although positive airway pressure (PAP) is known to be more effective than uvulopalatopharyngoplasty (UPPP) in the treatment of obstructive sleep apnea (OSA), PAP is a more expensive treatment in Korea. Therefore, it is necessary to compare the cost-effectiveness of these two treatments. Methods: We assumed patients with moderate to severe OSA and divided them into three groups: those who used PAP (the PAP Treatment group), those who received UPPP (surgery group), and those who did not receive a diagnosis or treatment (No Treatment group). We compared their medical costs over 10 years. The incidence rate of common complications and accidents (coronary heart disease, heart failure, stroke, depression, diabetes, vehicle accident, and work-related accident) with or without treatment was adopted through a literature review. The average medical expenses for treating each complication and accident were also found by searching several databases. Results: The incidence of all complications was higher in the control group than in the PAP Treatment group or the surgery group. However, since the absolute incidence rate was not high in all groups and medical expenses in Korea are low, the expected treatment cost was not high (KRW 108,209 per year for the PAP Treatment group, KRW 141,228 for the surgery group, and KRW 178,369 for the No Treatment group). In contrast, the costs of a polysomnography examination, PAP rental, and mask purchase were relatively high. Based on these results, the 10-year medical expenses for the PAP Treatment group were KRW 10,246,948, and those for the surgery were only KRW 925,095. Conclusion: Although PAP treatment reduces the incidence of complications in OSA patients, it is not as cost-effective as UPPP in Korea, where medical costs are low. [ABSTRACT FROM AUTHOR]

Background and Objectives: Although many studies have explored the factors affecting compliance with continuous positive airway pressure (CPAP) in patients with obstructive sleep apnea (OSA), the findings remain controversial. This study aimed to analyze CPAP compliance after insurance coverage began in Korea and to investigate what factors influenced CPAP compliance. Materials and Method: The subjects were 1,037 patients who were prescribed a CPAP after polysomnography at the Seoul Sleep Clinic; data were reviewed retrospectively. We classified those that used a CPAP for more than 4 hours per day for 70% or more days per month as into the good compliance group. We compared the ratio of good compliance by gender, position dependence, rapid eye movement (REM) dependence, telemonitoring of CPAP, pressure modification, and OSA severity. Results: There were no statistically significant differences in ratio of good compliance group according to gender, position dependence, REM dependence, or disease severity. When using a fixed CPAP (92.2%) rather than an auto PAP (88.4%), the ratio of patients in the good compliance group was significantly higher. Non-positioner and fixed CPAP users showed significantly longer average usage time. Conclusion: In a 3-month short-term follow-up study of CPAP compliance, the telemonitoring group and those using a fixed CPAP showed a higher ratio of good compliance. Average CPAP usage time was longer when using a fixed CPAP and in nonpositioners. As age increased, CPAP usage time was longer, and the average compliance rate tended to increase. [ABSTRACT FROM AUTHOR]