Consensus & Evidence-based INOSA Guidelines 2014 (First edition).
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Date
2015-01
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Abstract
Obstructive sleep apnoea (OSA) and obstructive sleep apnoea syndrome (OSAS) are subsets
of sleep-disordered breathing. Awareness about OSA and its consequences amongst the
general public as well as the majority of primary care physcians across India is poor. This
necessiated the development of the INdian initiative on Obstructive Sleep Apnoea (INOSA)
guidelines under the auspices of Department of Health Research, Ministry of Health & Family
Welfare, Government of India. OSA is the occurrence of an average five or more episodes
of obstructive respiratory events per hour of sleep with either sleep related symptoms or comorbidities
or >15 such episodes without any sleep related symptoms or comorbidities. OSAS
is defined as OSA associated with daytime symptoms, most often excessive sleepiness. Patients
undergoing routine health check-up with snoring, daytime sleepiness, obesity, hypertension,
motor vehicular accidents and high risk cases should undergo a comprehensive sleep
evaluation. Medical examiners evaluating drivers, air pilots, railway drivers and heavy
machinery workers should be educated about OSA and should comprehensively evaluate
applicants for OSA. Those suspected to have OSA on comprehensive sleep evaluation should
be referred for a sleep study. Supervised overnight polysomnography (PSG) is the “gold
standard” for evaluation of OSA. Positive airway pressure (PAP) therapy is the mainstay of
treatment of OSA. Oral appliances are indicated for use in patients with mild to moderate OSA
who prefer oral appliances to PAP, or who do not respond to PAP or who fail treatment
attempts with PAP or behavioural measures. Surgical treatment is recommended in patients
who have failed or are intolerant to PAP therapy.
Description
Keywords
Bariatric surgery, CPAP, Indian guidelines, OSA, OSAS, polysomnography, sleep apnoea, sleep study, Syndrome Z
Citation
Sharma Surendra K, Katoch Vishwa Mohan, Mohan Alladi, Kadhiravan T, Elavarasi A, Ragesh R, Nischal Neeraj, Sethi Prayas, Behera D, Bhatia Manvir, Ghoshal A G, Gothi Dipti, Joshi Jyotsna, Kanwar M S, Kharbanda O P, Kumar Suresh, Mohapatra P R, Mallick B N, Mehta Ravindra, Prasad Rajendra, Sharma S C, Sikka Kapil, Aggarwal Sandeep, Shukla Garima, Suri J C, Vengamma B, Grover Ashoo, Vijayan V K, Ramakrishnan N, Gupta Rasik. Consensus & Evidence-based INOSA Guidelines 2014 (First edition). The Indian Journal of Chest Diseases and Allied Sciences, 2015 Jan; 57(1): 48-64.