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• W2009973493 abstract "When the Journal requested that I contribute to this topic, my initial thought was that there should not be any controversy in treating obstructive sleep apnea syndrome (OSA). OSA is associated with increased cardiovascular morbidity and mortality. 1 Shahar E. Whitney C.W. Redline S. et al. Sleep-disordered breathing and cardiovascular disease Cross-sectional results of the Sleep Heart Health Study. Am J Respir Crit Care Med. 2001; 163: 19 Crossref PubMed Google Scholar , 2 Peker Y. Hedner J. Kraicze H. et al. Respiratory disturbance index An independent predictor of mortality in coronary artery disease. Am J Respir Crit Care Med. 2000; 162: 81 Crossref PubMed Scopus (430) Google Scholar The psychomotor sequelae of OSA are well established, some of which include excessive daytime sleepiness, daytime fatigue and poor sleep quality due to sleep fragmentation. 3 Gottlieb D.J. Whitney C.W. Bonekat W.H. et al. Relation of sleepiness to respiratory disturbance index The Sleep Heart Health Study. Am J Respir Crit Care Med. 1999; 159: 502 Crossref PubMed Scopus (479) Google Scholar , 4 Young T. Paltz M. Dempsey J. et al. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med. 1993; 328: 1230 Crossref PubMed Scopus (8496) Google Scholar It is also widely accepted that nasal continuous positive airway pressure (nCPAP) is the first line of treatment. Nasal CPAP expands the airway, thereby eliminating airway obstruction during sleep. 5 Schwab R.J. Pack A.I. Gupta K.B. et al. Upper airway and soft tissue structural changes induced by CPAP in normal subjects. Am J Respir Crit Care Med. 1996; 154: 1106 Crossref PubMed Scopus (175) Google Scholar Indeed, the effectiveness of nCPAP in improving the sequlae of OSA is irrefutable. 6 Jenkinson C. Davies R.J. Mullins R. et al. Comparison of therapeutic and subtherapeutic nasal continuous positive airway pressure for obstructive sleep apnoea A randomized prospective parallel trial. Lancet. 1999; 353: 2100 Abstract Full Text Full Text PDF PubMed Scopus (676) Google Scholar , 7 Hack M. Davies R.J. Mullins R. et al. Randomised prospective parallel trial of therapeutic versus subtherapeutic nasal continuous positive airway pressure on simulated steering performance in patients with obstructive sleep apnoea. Thorax. 2000; 55: 224 Crossref PubMed Scopus (180) Google Scholar This nonsurgical treatment modality encompasses the most data to support its use based on multiple randomized and controlled trials. Given that a surgeon’s primary goal should be improving a patient’s health with the least invasive modality available, nCPAP represents my first line of treatment in addressing OSA." @default.
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• W2009973493 date "2006-08-01" @default.
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• W2009973493 title "Controversy in Surgical Versus Nonsurgical Treatment of Obstructive Sleep Apnea Syndrome" @default.
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