Abstract

Sleep-disordered breathing (SDB) encompasses a spectrum of breathing abnormalities during sleep, ranging from habitual snoring to obstructive sleep apnea (OSA), central sleep apnea (CSA), and complex sleep apnea syndrome (CompSAS). These conditions disrupt the normal respiratory pattern during sleep, leading to intermittent hypoxemia, hypercapnia, and sleep fragmentation. OSA, the most prevalent form of SDB, is characterized by recurrent partial or complete collapse of the upper airway during sleep, resulting in repetitive cessations of airflow. CSA involves a lack of respiratory effort due to the temporary cessation of central neural drive to the respiratory muscles. CompSAS, a combination of OSA and CSA features, presents unique challenges in diagnosis and management. SDB is associated with a myriad of adverse health outcomes, including cardiovascular diseases, metabolic disturbances, neurocognitive deficits, and decreased quality of life. Risk factors for SDB include obesity, male gender, aging, craniofacial abnormalities, and certain medical conditions. Diagnosis typically involves polysomnography or home sleep apnea testing, with treatment options ranging from lifestyle modifications to positive airway pressure therapy, oral appliances, surgery, and positional therapy. Continuous positive airway pressure (CPAP) remains the gold standard treatment for moderate to severe OSA, although adherence can be challenging for some patients. Emerging therapies such as hypoglossal nerve stimulation, upper airway surgery, and pharmacotherapy offer alternative approaches for select patients. Multidisciplinary collaboration involving sleep specialists, pulmonologists, otolaryngologists, dentists, and psychologists is essential for comprehensive management of SDB. Future research efforts should focus on improving diagnostic accuracy, enhancing treatment efficacy and adherence, identifying novel therapeutic targets, and elucidating the underlying pathophysiological mechanisms of SDB.