MANIFESTATIONS AND CONSEQUENCES OF OBSTRUCTIVE SLEEP-APNEA

Over the last two decades the diagnostic tools used in sleep medicine have developed enormously, making it possible to study the interaction of sleep-related breathing disorders (SRBD) with cardiovascular funct ion and the autonomic nervous system, as well as the effects of SRBD o n a variety of physiological processes during wakefulness, Different m odes of nasal ventilation are now available, allowing all forms of SRB D to be treated, If early diagnosis and treatment are provided, the ac ute and long-term sequelae of SRBD can be prevented. In addition to th e care and treatment of patients with severe obstructive sleep apnoea syndrome (OSAS), future patient management will need to focus on patie nts with milder forms of obstructive sleep apnoea (OSA), In particular , the consequences of SRBD on cardiac arrhythmias, arterial hypertensi on and hypersomnolence are discussed, considering epidemiological, cli nical, diagnostic and therapeutic aspects. Some economical issues aris ing from SRBD are also discussed, and the authors conclude that a Euro pewide programme for early detection, treatment and prevention of SRBD is required. This could make a large contribution to the reduction of cardiovascular morbidity and mortality and also reduce the incidence of ''human error catastrophes'' due to hypersomnolence.