Skip to main content
WoMWeb of Medicine
SearchGraphHistory
Pulmonary Medicine›Condition·Updated Jul 11, 2026·v1

Obstructive Sleep Apnea

Obstructive sleep apnea is a common, underdiagnosed condition with significant cardiovascular and neurocognitive consequences. Diagnosis requires polysomnography; CPAP is first-line therapy. Adherence is key to benefit. Alternative therapies and weight loss are important adjuncts.

High Evidence292 references·8,833 words·36 min read·v1
Obstructive Sleep ApneaSleep MedicinePulmonary MedicineCPAPPolysomnographyHypoxiaCardiovascular Risk

Quick Reference

RxDrug of choiceContinuous positive airway pressure (CPAP)
AltAlternativesMandibular advancement device, hypoglossal nerve stimulation, pharmacotherapy (solriamfetol, atomoxetine/oxybutynin, AD109, sulthiame, tirzepatide)
⊘AvoidBenzodiazepines (e.g., triazolam), prolong apnea and worsen hypoxemia; supplemental oxygen as monotherapy
DxTest of choiceIn-laboratory polysomnography (PSG)
ScKey scoreSTOP-Bang (score ≥3 high risk), Epworth Sleepiness Scale (>10 abnormal)
→When to referCPAP intolerance, residual symptoms despite adherence, consideration of HGNS or surgery, pediatric OSA with persistent disease after adenotonsillectomy, complex overlap syndromes
CPAP is first-line for moderate-severe OSA; adherence is critical for cardiovascular benefit. Alternative therapies exist for CPAP-intolerant patients. Weight loss and treatment of comorbidities are essential.
Obstructive sleep apnea (OSA) is a highly prevalent sleep disorder characterized by repetitive pharyngeal collapse, intermittent hypoxia, and sleep fragmentation. It affects an estimated 22.6% of adults with moderate-to-severe disease, yet most remain undiagnosed. Untreated OSA is independently associated with hypertension, cardiovascular disease, stroke, and cognitive decline. Diagnosis is confirmed by polysomnography (AHI ≥5 events/h), with severity stratified by AHI. First-line therapy is continuous positive airway pressure (CPAP), which improves symptoms and blood pressure; cardiovascular benefit is most pronounced in adherent patients. Alternative therapies include mandibular advancement devices, hypoglossal nerve stimulation, and emerging pharmacotherapy. Weight loss is a critical adjunct. Management requires a multidisciplinary approach with attention to adherence, comorbidities, and long-term surveillance.

Overview and Recommendations

Background

  • •Obstructive sleep apnea (OSA) is a sleep-related breathing disorder defined by repetitive pharyngeal collapse during sleep, causing intermittent hypoxia and sleep fragmentation. Diagnosis requires an apnea-hypopnea index (AHI) ≥5 events/h on polysomnography, with severity stratified as mild (5-14), moderate (15-29), and severe (≥30).
  • •OSA is highly prevalent: multinight monitoring estimates 22.6% of adults have moderate-to-severe disease (AHI >15), yet >90% remain undiagnosed. It is independently associated with hypertension, cardiovascular disease, stroke, and cognitive decline, with a dose-response relationship between hypoxic burden and adverse outcomes.
  • •Pathophysiology involves anatomical predisposition (obesity-related pharyngeal fat deposition, craniofacial restriction) and dynamic endotypic traits, collapsibility, loop gain, arousal threshold, and neuromuscular compensation. These endotypes predict response to oral appliances and hypoglossal nerve stimulation.
  • •Dominant risk factors: obesity (strongest modifiable), male sex, older age, menopause, family history, and craniofacial abnormalities. The STOP-Bang questionnaire (score ≥3) has 93% sensitivity for moderate-to-severe OSA and is the preferred screening tool.
  • •Untreated OSA carries significant prognostic stakes: hypoxic burden (area under desaturation curve) predicts incident CVD (HR 1.45 per SD), and overlap syndrome with COPD increases mortality (HR 1.74). CPAP reduces blood pressure and symptoms, but cardiovascular benefit is most evident in adherent patients with high pulse rate response to events.

Evaluation

  • •Suspect OSA in patients with habitual snoring, witnessed apneas, gasping/choking, or excessive daytime sleepiness (Epworth >10). However, up to 50% with moderate-severe OSA deny sleepiness; maintain high suspicion in obesity, hypertension, or CVD.
  • •Ask about nocturia, morning headache, dry mouth, impaired concentration. In women, atypical symptoms include insomnia, fatigue, mood disturbance. In children, look for snoring, mouth breathing, enuresis, behavioral issues.
  • •Examine for obesity (BMI ≥30), neck circumference >43 cm (men) or >38 cm (women), retrognathia, macroglossia, Mallampati class III/IV, tonsillar hypertrophy, and nasal obstruction. Check for right heart failure signs in advanced disease.
  • •Screen with STOP-Bang: score ≥3 warrants confirmatory testing. Sensitivity ~93% for moderate-severe OSA; specificity ~40%.
  • •Order in-laboratory polysomnography (PSG) as gold standard. AHI ≥5 confirms OSA. For high pretest probability patients without comorbidities, home sleep apnea testing (HSAT) is an alternative but may underestimate AHI.
  • •Consider split-night PSG if diagnostic portion shows AHI ≥15 and ≥3 hours remain for CPAP titration.
  • •Assess for comorbidities: check ABG if obesity hypoventilation suspected (serum bicarbonate ≥27 mmol/L is sensitive screen); obtain PFTs if overlap with COPD.
  • •Evaluate nocturnal hypoxemia: hypoxic burden and T90 (SpO₂ <90% time) predict cardiovascular risk better than AHI. T90 >4.7% predicts postoperative complications (OR 1.91).
  • •Red flags: severe hypoxemia (SpO₂ <80% for >10% sleep), hypercapnic respiratory failure (PaCO₂ >50), cor pulmonale, encephalopathy, high-risk occupations.
  • •Differential includes central sleep apnea, OHS, periodic limb movement disorder, insomnia, narcolepsy. PSG with EEG and leg EMG distinguishes.

Management

  • •Initiate CPAP as first-line for moderate-severe OSA (AHI ≥15) or symptomatic mild OSA. Use auto-CPAP or fixed pressure based on titration. Target AHI <5.
  • •Monitor adherence: aim ≥4 h/night on ≥70% nights. Use telemedicine, peer support, early follow-up to improve use. Peer interventions increased mean use from 3.7 to 4.5 h/night.
  • •For COMISA, treat insomnia with CBT-I before or concurrent with PAP.
  • •For CPAP intolerance, consider mandibular advancement device (MAD) for mild-moderate OSA. Meta-analysis: MAD reduces AHI by ~15.8 events/h vs sham, but CPAP is more effective.
  • •Hypoglossal nerve stimulation (HGNS) for moderate-severe OSA in CPAP-intolerant patients. STAR trial: 68% median AHI reduction at 12 months. Requires absence of concentric collapse on sleep endoscopy.
  • •Adenotonsillectomy is first-line for pediatric OSA. CHAT trial: 79% normalization vs 46% watchful waiting. Postoperative PSG needed if obese, severe baseline AHI, or asthma (40% residual risk).
  • •Bariatric surgery: 86.6% OSA remission at 5 years. Perioperative risk increased (OR 4.3), so optimize CPAP preoperatively.
  • •Pharmacotherapy for residual sleepiness after PAP: solriamfetol 37.5-150 mg daily (improves MWT by 11.2 min). Emerging options: atomoxetine 80 mg + oxybutynin 5 mg (AHI reduction 63%), AD109 2.5/75 mg (44.1% reduction), sulthiame 400 mg (41% reduction, but paresthesia), tirzepatide 10-15 mg weekly (20-25 events/h reduction with weight loss).
  • •Weight loss is critical adjunct: 5-10% weight loss significantly reduces AHI. CPAP plus weight loss reduces systolic BP more than either alone.
  • •Positional therapy for supine-predominant OSA (supine:non-supine AHI ratio ≥4:1, non-supine AHI <10). Use wearable vibratory devices.
  • •Oropharyngeal exercises: 30 min daily for 3 months reduced AHI from 22.4 to 13.7 events/h.
  • •In acute hypercapnic respiratory failure with OHS and severe OSA, start CPAP immediately. If fails, use NIV. Target SpO₂ 88-92%. In ADHF with OSA, in-hospital CPAP improved LVEF by 4.5%.
  • •Avoid: supplemental oxygen alone (no BP benefit), flexible pressure delivery (no adherence benefit), benzodiazepines (prolong apnea), and long-term NIV without reassessment.
  • •Monitor annually: adherence data, symptom review, repeat PSG if weight change >10% or symptoms recur. Screen for hypertension, atrial fibrillation, glaucoma.
  • •Refer to sleep specialist for CPAP intolerance, residual symptoms, HGNS/surgery consideration, pediatric persistent OSA, complex overlap syndromes.

Board Review — High Yield

  • •STOP-Bang score ≥3, 93% sensitivity for moderate-to-severe OSA; use as first screen.
  • •AHI ≥5 events/h, diagnostic threshold for OSA on polysomnography.
  • •CPAP reduces 24-hour mean arterial pressure by ~2.4 mm Hg, HeartBEAT trial.
  • •Hypoxic burden, area under desaturation curve; predicts CVD better than AHI (HR 1.45 per SD).
  • •T90 >4.7%, predicts postoperative cardiorespiratory complications (OR 1.91).
  • •Adenotonsillectomy normalizes PSG in 79% of children, CHAT trial; residual disease common if obese.
  • •Atomoxetine 80 mg + oxybutynin 5 mg, reduces AHI by 63% in single-night study.
  • •Untreated overlap syndrome (COPD+OSA), increases all-cause mortality (HR 1.74).

Deep Dive — Evidence Details

References

  1. [1]

    Mokhlesi B, Masa JF, Brozek JL et al.. “Evaluation and Management of Obesity Hypoventilation Syndrome. An Official American Thoracic Society Clinical Practice Guideline.” American journal of respiratory and critical care medicine (2019). PMID: 31368798 ↗

    L1GUIDELINECited in: 1. Definition, Classification and Nomenclature, 5. Diagnosis and Workup (Pulmonary Function, Bronchoscopy and Imaging Anchored), 7. Acute Management and Exacerbation Rescue, History and Evolution of Treatment, 10. Complications
  2. [2]

    Ehsan Z, Ishman SL, Soghier I et al.. “Management of Persistent, Post-adenotonsillectomy Obstructive Sleep Apnea in Children: An Official American Thoracic Society Clinical Practice Guideline.” American journal of respiratory and critical care medicine (2024). PMID: 37890009 ↗

    L1GUIDELINECited in: 1. Definition, Classification and Nomenclature, History and Evolution of Treatment, 12. Special Populations & Pregnancy
  3. [3]

    Macrea M, Oczkowski S, Rochwerg B et al.. “Long-Term Noninvasive Ventilation in Chronic Stable Hypercapnic Chronic Obstructive Pulmonary Disease. An Official American Thoracic Society Clinical Practice Guideline.” American journal of respiratory and critical care medicine (2020). PMID: 32795139 ↗

    L1GUIDELINECited in: 1. Definition, Classification and Nomenclature, 7. Acute Management and Exacerbation Rescue, 8. Long-term and Definitive Management, History and Evolution of Treatment, 10. Complications, 11. Prognosis and Natural History
  4. [4]

    Hudgel DW, Patel SR, Ahasic AM et al.. “The Role of Weight Management in the Treatment of Adult Obstructive Sleep Apnea. An Official American Thoracic Society Clinical Practice Guideline.” American journal of respiratory and critical care medicine (2018). PMID: 30215551 ↗

    L1GUIDELINECited in: 1. Definition, Classification and Nomenclature
  5. [5]

    Mukherjee S, Patel SR, Kales SN et al.. “An Official American Thoracic Society Statement: The Importance of Healthy Sleep. Recommendations and Future Priorities.” American journal of respiratory and critical care medicine (2015). PMID: 26075423 ↗

    L5GUIDELINECited in: 1. Definition, Classification and Nomenclature
  6. [6]

    Ng SSS, Tam WWS, Lee RWW et al.. “Effect of Weight Loss and Continuous Positive Airway Pressure on Obstructive Sleep Apnea and Metabolic Profile Stratified by Craniofacial Phenotype: A Randomized Clinical Trial.” American journal of respiratory and critical care medicine (2022). PMID: 34936531 ↗

    L1RCTCited in: 1. Definition, Classification and Nomenclature
  7. [7]

    MacLean JE, Adeleye A, Van Dam A et al.. “The Canadian Thoracic Society/Canadian Sleep Society Guideline on the diagnosis of obstructive sleep apnea in children.” Chest (2026). PMID: 41887281 ↗

    L1GUIDELINECited in: 1. Definition, Classification and Nomenclature, 12. Special Populations & Pregnancy
  8. [8]

    Joosten SA, O'Donoghue FJ, Rochford PD et al.. “Night-to-night repeatability of supine-related obstructive sleep apnea.” Annals of the American Thoracic Society (2014). PMID: 24720558 ↗

    L4RCTCited in: 1. Definition, Classification and Nomenclature, 5. Diagnosis and Workup (Pulmonary Function, Bronchoscopy and Imaging Anchored), 7. Acute Management and Exacerbation Rescue, 8. Long-term and Definitive Management, History and Evolution of Treatment
  9. [9]

    Bamagoos AA, Cistulli PA, Sutherland K et al.. “Polysomnographic Endotyping to Select Patients with Obstructive Sleep Apnea for Oral Appliances.” Annals of the American Thoracic Society (2019). PMID: 31394914 ↗

    L4RCTCited in: 1. Definition, Classification and Nomenclature
  10. [10]

    Schmickl CN, Orr JE, Sands SA et al.. “Loop Gain as a Predictor of Blood Pressure Response in Patients Treated for Obstructive Sleep Apnea: Secondary Analysis of a Clinical Trial.” Annals of the American Thoracic Society (2024). PMID: 37938917 ↗

    L2TRIAL_NONRANDOMCited in: 1. Definition, Classification and Nomenclature
  11. [11]

    Xu H, Liu F, Li Z et al.. “Genome-Wide Association Study of Obstructive Sleep Apnea and Objective Sleep-related Traits Identifies Novel Risk Loci in Han Chinese Individuals.” American journal of respiratory and critical care medicine (2022). PMID: 35819321 ↗

    L3OTHERCited in: 1. Definition, Classification and Nomenclature
  12. [12]

    Lechat B, Naik G, Reynolds A et al.. “Multinight Prevalence, Variability, and Diagnostic Misclassification of Obstructive Sleep Apnea.” American journal of respiratory and critical care medicine (2022). PMID: 34904935 ↗

    L4OTHERCited in: 1. Definition, Classification and Nomenclature, 3. Epidemiology, Etiology and Risk Factors, 5. Diagnosis and Workup (Pulmonary Function, Bronchoscopy and Imaging Anchored)
  13. [13]

    Kendzerska T, Radhakrishnan D, Amin R et al.. “Obstructive Sleep Apnea and Mental Health Disorders in the Pediatric Population: A Retrospective, Population-based Cohort Study.” Annals of the American Thoracic Society (2024). PMID: 38669619 ↗

    L2COHORTCited in: 1. Definition, Classification and Nomenclature, 12. Special Populations & Pregnancy
  14. [14]

    Chung F, Abdullah HR, Liao P. “STOP-Bang Questionnaire: A Practical Approach to Screen for Obstructive Sleep Apnea.” Chest (2016). PMID: 26378880 ↗

    L5OTHERCited in: 1. Definition, Classification and Nomenclature, 3. Epidemiology, Etiology and Risk Factors, 4. Clinical Presentation, 6. Severity, Staging and Risk Stratification, 12. Special Populations & Pregnancy
  15. [15]

    Wickwire EM, Collop NA. “Insomnia and sleep-related breathing disorders.” Chest (2010). PMID: 20525657 ↗

    L5REVIEW_NARRATIVECited in: 1. Definition, Classification and Nomenclature, 3. Epidemiology, Etiology and Risk Factors
  16. [16]

    Dyken ME, Afifi AK, Lin-Dyken DC. “Sleep-related problems in neurologic diseases.” Chest (2012). PMID: 22315121 ↗

    L5REVIEW_NARRATIVECited in: 1. Definition, Classification and Nomenclature, 6. Severity, Staging and Risk Stratification
  17. [17]

    Teodorescu M, Polomis DA, Hall SV et al.. “Association of obstructive sleep apnea risk with asthma control in adults.” Chest (2010). PMID: 20495105 ↗

    L4OTHERCited in: 1. Definition, Classification and Nomenclature
  18. [18]

    Ibrahim LH, Patel SR, Modarres M et al.. “A measure of ventilatory variability at wake-sleep transition predicts sleep apnea severity.” Chest (2008). PMID: 18347208 ↗

    L2OTHERCited in: 1. Definition, Classification and Nomenclature
  19. [19]

    Mysliwiec V, Gill J, Lee H et al.. “Sleep disorders in US military personnel: a high rate of comorbid insomnia and obstructive sleep apnea.” Chest (2013). PMID: 23681455 ↗

    L4OTHERCited in: 1. Definition, Classification and Nomenclature
  20. [20]

    Brunetti L, Tesse R, Miniello VL et al.. “Sleep-disordered breathing in obese children: the southern Italy experience.” Chest (2010). PMID: 20139225 ↗

    L4OTHERCited in: 1. Definition, Classification and Nomenclature
  21. [21]

    Pihtili A, Glantz H, Thunström E et al.. “CPAP therapy may improve HFpEF-like features in coronary artery disease with obstructive sleep apnea: A randomized controlled trial.” Sleep medicine (2026). PMID: 42250441 ↗

    L1RCTCited in: 1. Definition, Classification and Nomenclature
  22. [22]

    Zinchuk AV, Jeon S, Koo BB et al.. “Polysomnographic phenotypes and their cardiovascular implications in obstructive sleep apnoea.” Thorax (2017). PMID: 28935698 ↗

    L2OTHERCited in: 1. Definition, Classification and Nomenclature, 3. Epidemiology, Etiology and Risk Factors, 6. Severity, Staging and Risk Stratification, 11. Prognosis and Natural History
  23. [23]

    Abdelaal A, Mahmoud YA, Alsouri W et al.. “Bidirectional association between obstructive sleep apnea and diabetic retinopathy: a severity-stratified systematic review and meta-analysis with GRADE assessment.” Acta diabetologica (2026). PMID: 42334598 ↗

    L3SR_OBSCited in: 1. Definition, Classification and Nomenclature, 11. Prognosis and Natural History
  24. [24]

    Sung C, Kim HC, Lee HB et al.. “Drug-induced sleep endoscopy in obstructive sleep apnea: a systematic review and meta-analysis of sedative agents, monitoring methods, and administration techniques.” Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine (2026). PMID: 42298088 ↗

    L4SR_OBSCited in: 1. Definition, Classification and Nomenclature
  25. [25]

    Mustafa M. “Sleep-related problems among patients with rheumatoid arthritis in the World Health Organization Eastern Mediterranean region: a systematic review and meta-analysis.” Frontiers in psychiatry (2026). PMID: 42290998 ↗

    L4SR_OBSCited in: 1. Definition, Classification and Nomenclature, 4. Clinical Presentation
  26. [26]

    Zhu Y, Luo Y, Du R et al.. “The association between obstructive sleep apnea syndrome and sarcopenia: a meta-analysis.” Frontiers in medicine (2026). PMID: 42180727 ↗

    L1SR_OBSCited in: 1. Definition, Classification and Nomenclature
  27. [27]

    Jin Y, Xu J, Yue H et al.. “Performance evaluation of finger-worn devices for sleep stage classification and sleep apnea detection: a systematic review and meta-analysis.” Journal of translational medicine (2026). PMID: 42141446 ↗

    L5SR_OBSCited in: 1. Definition, Classification and Nomenclature
  28. [28]

    Malhotra A, Sterling KL, Cistulli PA et al.. “Dose-Response Relationship between Obstructive Sleep Apnea Therapy Adherence and Healthcare Utilization.” Annals of the American Thoracic Society (2023). PMID: 36735928 ↗

    L2OTHERCited in: 1. Definition, Classification and Nomenclature, 5. Diagnosis and Workup (Pulmonary Function, Bronchoscopy and Imaging Anchored), 7. Acute Management and Exacerbation Rescue
  29. [29]

    Athar W, Card ME, Charokopos A et al.. “Obstructive Sleep Apnea and Pain Intensity in Young Adults.” Annals of the American Thoracic Society (2020). PMID: 32644865 ↗

    L4OTHERCited in: 1. Definition, Classification and Nomenclature, 3. Epidemiology, Etiology and Risk Factors, 5. Diagnosis and Workup (Pulmonary Function, Bronchoscopy and Imaging Anchored), 6. Severity, Staging and Risk Stratification
  30. [30]

    Cohen O, Kundel V, Barbé F et al.. “The Great Controversy of Obstructive Sleep Apnea Treatment for Cardiovascular Risk Benefit: Advancing the Science through Expert Consensus: An Official American Thoracic Society Workshop Report.” Annals of the American Thoracic Society (2025). PMID: 39513996 ↗

    L1OTHERCited in: 1. Definition, Classification and Nomenclature, 4. Clinical Presentation, 5. Diagnosis and Workup (Pulmonary Function, Bronchoscopy and Imaging Anchored)
  31. [31]

    Pendharkar SR, Sharpe H, Rosychuk RJ et al.. “Temporal and Regional Trends in Obstructive Sleep Apnea Using Administrative Health Data in Alberta, Canada.” Annals of the American Thoracic Society (2023). PMID: 36516070 ↗

    L2OTHERCited in: 1. Definition, Classification and Nomenclature
  32. [32]

    Mavroudis I, Petridis F, Ciobica A et al.. “Sexsomnia: an umbrella review of clinical, neurophysiological and diagnostic evidence.” Frontiers in neurology (2026). PMID: 42246051 ↗

    L1SR_OBSCited in: 1. Definition, Classification and Nomenclature, 5. Diagnosis and Workup (Pulmonary Function, Bronchoscopy and Imaging Anchored)
  33. [33]

    Mohsen Y, Novikov I, Sabareesan S et al.. “Documented Obstructive Sleep Apnea, Cardiometabolic Phenotype, and Rhythm-Related Outcomes After Atrial Fibrillation Ablation: An Observational Cohort Study.” Journal of arrhythmia (2026). PMID: 42382280 ↗

    L2COHORTCited in: 1. Definition, Classification and Nomenclature
  34. [34]

    Stöwhas AC, Namdar M, Biaggi P et al.. “The effect of simulated obstructive apnea and hypopnea on aortic diameter and BP.” Chest (2011). PMID: 21393398 ↗

    L4RCTCited in: 2. Pathophysiology and Mechanism, 8. Long-term and Definitive Management
  35. [35]

    Smales ET, Edwards BA, Deyoung PN et al.. “Trazodone Effects on Obstructive Sleep Apnea and Non-REM Arousal Threshold.” Annals of the American Thoracic Society (2015). PMID: 25719754 ↗

    L1RCTCited in: 2. Pathophysiology and Mechanism, 7. Acute Management and Exacerbation Rescue, 8. Long-term and Definitive Management, History and Evolution of Treatment
  36. [36]

    Op de Beeck S, Dieltjens M, Azarbarzin A et al.. “Mandibular Advancement Device Treatment Efficacy Is Associated with Polysomnographic Endotypes.” Annals of the American Thoracic Society (2021). PMID: 32946702 ↗

    L2TRIAL_NONRANDOMCited in: 2. Pathophysiology and Mechanism
  37. [37]

    Soghier I, Brożek JL, Afshar M et al.. “Noninvasive Ventilation versus CPAP as Initial Treatment of Obesity Hypoventilation Syndrome.” Annals of the American Thoracic Society (2019). PMID: 31365842 ↗

    L1SR_OBSCited in: 2. Pathophysiology and Mechanism, 4. Clinical Presentation, 7. Acute Management and Exacerbation Rescue, 11. Prognosis and Natural History
  38. [38]

    Kakazu MT, Soghier I, Afshar M et al.. “Weight Loss Interventions as Treatment of Obesity Hypoventilation Syndrome. A Systematic Review.” Annals of the American Thoracic Society (2020). PMID: 31978317 ↗

    L1SR_OBSCited in: 2. Pathophysiology and Mechanism
  39. [39]

    Shang F, Wang SC, Gongol B et al.. “Obstructive Sleep Apnea-induced Endothelial Dysfunction Is Mediated by miR-210.” American journal of respiratory and critical care medicine (2023). PMID: 36191258 ↗

    L4OTHERCited in: 2. Pathophysiology and Mechanism, 10. Complications
  40. [40]

    Tolbert TM, Schmickl CN, Gell LK et al.. “Research Priorities for Translating Endophenotyping of Adult Obstructive Sleep Apnea to the Clinic: An Official American Thoracic Society Research Statement.” American journal of respiratory and critical care medicine (2025). PMID: 40737283 ↗

    L1OTHERCited in: 2. Pathophysiology and Mechanism, 3. Epidemiology, Etiology and Risk Factors
  41. [41]

    Katz ES, Mitchell RB, D'Ambrosio CM. “Obstructive sleep apnea in infants.” American journal of respiratory and critical care medicine (2011). PMID: 22135346 ↗

    L5REVIEW_NARRATIVECited in: 2. Pathophysiology and Mechanism
  42. [42]

    Op de Beeck S, Wellman A, Dieltjens M et al.. “Endotypic Mechanisms of Successful Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea.” American journal of respiratory and critical care medicine (2021). PMID: 32970962 ↗

    L2OTHERCited in: 2. Pathophysiology and Mechanism
  43. [43]

    Prasad B, Nyenhuis SM, Imayama I et al.. “Asthma and Obstructive Sleep Apnea Overlap: What Has the Evidence Taught Us?” American journal of respiratory and critical care medicine (2020). PMID: 31841642 ↗

    L5REVIEW_NARRATIVECited in: 2. Pathophysiology and Mechanism, 3. Epidemiology, Etiology and Risk Factors
  44. [44]

    Edwards BA, Redline S, Sands SA et al.. “More Than the Sum of the Respiratory Events: Personalized Medicine Approaches for Obstructive Sleep Apnea.” American journal of respiratory and critical care medicine (2019). PMID: 31022356 ↗

    L5REVIEW_NARRATIVECited in: 2. Pathophysiology and Mechanism, 4. Clinical Presentation
  45. [45]

    Díaz-García E, García-Tovar S, Alfaro E et al.. “Inflammasome Activation: A Keystone of Proinflammatory Response in Obstructive Sleep Apnea.” American journal of respiratory and critical care medicine (2022). PMID: 35363597 ↗

    L3OTHERCited in: 2. Pathophysiology and Mechanism
  46. [46]

    Malhotra A, Schwartz AR, Schneider H et al.. “Research Priorities in Pathophysiology for Sleep-disordered Breathing in Patients with Chronic Obstructive Pulmonary Disease. An Official American Thoracic Society Research Statement.” American journal of respiratory and critical care medicine (2018). PMID: 29388824 ↗

    L1REVIEW_NARRATIVECited in: 2. Pathophysiology and Mechanism, 5. Diagnosis and Workup (Pulmonary Function, Bronchoscopy and Imaging Anchored)
  47. [47]

    Sands SA, Edwards BA, Terrill PI et al.. “Phenotyping Pharyngeal Pathophysiology using Polysomnography in Patients with Obstructive Sleep Apnea.” American journal of respiratory and critical care medicine (2018). PMID: 29327943 ↗

    L4OTHERCited in: 2. Pathophysiology and Mechanism
  48. [48]

    Altaf QA, Dodson P, Ali A et al.. “Obstructive Sleep Apnea and Retinopathy in Patients with Type 2 Diabetes. A Longitudinal Study.” American journal of respiratory and critical care medicine (2017). PMID: 28594570 ↗

    L2OTHERCited in: 2. Pathophysiology and Mechanism
  49. [49]

    Reutrakul S, Mokhlesi B. “Obstructive Sleep Apnea and Diabetes: A State of the Art Review.” Chest (2017). PMID: 28527878 ↗

    L5REVIEW_NARRATIVECited in: 2. Pathophysiology and Mechanism, 10. Complications
  50. [50]

    Patil SP, Schneider H, Schwartz AR et al.. “Adult obstructive sleep apnea: pathophysiology and diagnosis.” Chest (2007). PMID: 17625094 ↗

    L5REVIEW_NARRATIVECited in: 2. Pathophysiology and Mechanism, 4. Clinical Presentation, 5. Diagnosis and Workup (Pulmonary Function, Bronchoscopy and Imaging Anchored), History and Evolution of Treatment, 10. Complications
  51. [51]

    Parish JM. “Genetic and immunologic aspects of sleep and sleep disorders.” Chest (2013). PMID: 23648914 ↗

    L5REVIEW_NARRATIVECited in: 2. Pathophysiology and Mechanism, 5. Diagnosis and Workup (Pulmonary Function, Bronchoscopy and Imaging Anchored)
  52. [52]

    Chan AS, Lee RW, Cistulli PA. “Dental appliance treatment for obstructive sleep apnea.” Chest (2007). PMID: 17699143 ↗

    L5REVIEW_NARRATIVECited in: 2. Pathophysiology and Mechanism, 8. Long-term and Definitive Management, 11. Prognosis and Natural History
  53. [53]

    Kawata N, Tatsumi K, Terada J et al.. “Daytime hypercapnia in obstructive sleep apnea syndrome.” Chest (2007). PMID: 18079218 ↗

    L2OTHERCited in: 2. Pathophysiology and Mechanism, 3. Epidemiology, Etiology and Risk Factors, 6. Severity, Staging and Risk Stratification
  54. [54]

    Kuźniar TJ, Morgenthaler TI. “Treatment of complex sleep apnea syndrome.” Chest (2012). PMID: 23032455 ↗

    L5REVIEW_NARRATIVECited in: 2. Pathophysiology and Mechanism
  55. [55]

    Beatty CJ, Wong AM, Landry SA et al.. “The Impact of Weight Loss on the Physiological Endotypes Associated With OSA.” Chest (2026). PMID: 41713777 ↗

    L4OTHERCited in: 2. Pathophysiology and Mechanism
  56. [56]

    Hoffman M, Schulman DA. “The appearance of central sleep apnea after treatment of obstructive sleep apnea.” Chest (2012). PMID: 22871763 ↗

    L5REVIEW_NARRATIVECited in: 2. Pathophysiology and Mechanism
  57. [57]

    Luo YM, Tang J, Jolley C et al.. “Distinguishing obstructive from central sleep apnea events: diaphragm electromyogram and esophageal pressure compared.” Chest (2008). PMID: 19118271 ↗

    L2OTHERCited in: 2. Pathophysiology and Mechanism
  58. [58]

    Van de Steen L, Van den Ende M, Bou Kheir G et al.. “Circadian rhythm disturbances in nocturia and nocturnal polyuria: A systematic review.” Autonomic neuroscience : basic & clinical (2026). PMID: 42090872 ↗

    L2SR_OBSCited in: 2. Pathophysiology and Mechanism
  59. [59]

    Fei H, Cheng G, Zeng Y et al.. “Chronic Cerebral Hypoxia and Cognitive Impairment: A Systematic Review and Meta-Analysis Based on Chronic Mountain Sickness, Anemia, Chronic Obstructive Pulmonary Disease, and Obstructive Sleep Apnea.” CNS neuroscience & therapeutics (2026). PMID: 41992647 ↗

    L2SR_OBSCited in: 2. Pathophysiology and Mechanism
  60. [60]

    Lin CH, Hang LW, Finnsson E et al.. “Pathological Endotypic Traits of Paediatric Obstructive Sleep Apnea: Age and Sex Differences.” Respirology (Carlton, Vic.) (2025). PMID: 40937486 ↗

    L2OTHERCited in: 2. Pathophysiology and Mechanism
  61. [61]

    Lal C, Weaver TE, Bae CJ et al.. “Excessive Daytime Sleepiness in Obstructive Sleep Apnea. Mechanisms and Clinical Management.” Annals of the American Thoracic Society (2021). PMID: 33621163 ↗

    L5REVIEW_NARRATIVECited in: 2. Pathophysiology and Mechanism, 6. Severity, Staging and Risk Stratification
  62. [62]

    Imayama I, Prasad B. “Role of Leptin in Obstructive Sleep Apnea.” Annals of the American Thoracic Society (2017). PMID: 28796527 ↗

    L5REVIEW_NARRATIVECited in: 2. Pathophysiology and Mechanism, 3. Epidemiology, Etiology and Risk Factors
  63. [63]

    Deacon NL, Jen R, Li Y et al.. “Treatment of Obstructive Sleep Apnea. Prospects for Personalized Combined Modality Therapy.” Annals of the American Thoracic Society (2016). PMID: 26569377 ↗

    L5REVIEW_NARRATIVECited in: 2. Pathophysiology and Mechanism, 8. Long-term and Definitive Management
  64. [64]

    İnam MG, İnam O, Lin JM et al.. “Predicting the presence and severity of obstructive sleep apnea with optical coherence tomography.” Annals of the American Thoracic Society (2026). PMID: 41025935 ↗

    L4OTHERCited in: 2. Pathophysiology and Mechanism, 5. Diagnosis and Workup (Pulmonary Function, Bronchoscopy and Imaging Anchored), 6. Severity, Staging and Risk Stratification, 11. Prognosis and Natural History
  65. [65]

    Jaoude P, Vermont LN, Porhomayon J et al.. “Sleep-disordered breathing in patients with post-traumatic stress disorder.” Annals of the American Thoracic Society (2015). PMID: 25535907 ↗

    L5REVIEW_NARRATIVECited in: 2. Pathophysiology and Mechanism, 4. Clinical Presentation
  66. [66]

    Giatti S, Santos RB, Aielo AN et al.. “Association of Sodium with Obstructive Sleep Apnea. The ELSA-Brasil Study.” Annals of the American Thoracic Society (2021). PMID: 33090879 ↗

    L2OTHERCited in: 2. Pathophysiology and Mechanism
  67. [67]

    Zhang P, Liang D. “Effects of modified uvulopalatopharyngoplasty combined with pharyngeal and genioglossus exercises on sleep quality, cognitive function, and quality of life in patients with obstructive sleep apnea-hypopnea syndrome: a retrospective study.” Frontiers in surgery (2026). PMID: 42305806 ↗

    L2COHORTCited in: 2. Pathophysiology and Mechanism
  68. [68]

    Wang J, Cheng Z, Du J et al.. “Biventricular dysfunction and blood oxygenation deficits in obstructive sleep apnea: a prospective study with non-contrast cardiac MRI.” BMC medical imaging (2026). PMID: 42226066 ↗

    L2COHORTCited in: 2. Pathophysiology and Mechanism, 7. Acute Management and Exacerbation Rescue
  69. [69]

    Yi H, Drager LF, Wang X et al.. “SLEEP-DISORDERED BREATHING IN HEART FAILURE: PHENOTYPES, MECHANISMS, AND PRECISION APPROACH.” Journal of cardiac failure (2026). PMID: 42431393 ↗

    L5REVIEW_NARRATIVECited in: 2. Pathophysiology and Mechanism
  70. [70]

    Zhang CT, Ye YX, Huang XX et al.. “Intermittent hypoxia drives lung microbiome-metabolome remodeling to create a pro-inflammatory landscape in murine OSAHS.” Frontiers in microbiology (2026). PMID: 42422729 ↗

    L5OTHERCited in: 2. Pathophysiology and Mechanism
  71. [71]

    Peng C, Sun X, Zhang Z et al.. “Chronic intermittent hypoxia impairs glymphatic function in male mice through ENT-dependent adenosine dysregulation.” Sleep (2026). PMID: 42412752 ↗

    L5OTHERCited in: 2. Pathophysiology and Mechanism
  72. [72]

    Zhu W, Hou Y, Yang C et al.. “METTL3 suppresses pyroptosis in obstructive sleep apnea-associated hypertension via YTHDF2-mediated SOX4 mRNA degradation.” Journal of physiology and biochemistry (2026). PMID: 42384250 ↗

    L5OTHERCited in: 2. Pathophysiology and Mechanism
  73. [73]

    Vakka A, Kyriakoulis KG, Tatakis F et al.. “Pleiotropic effects of renal denervation beyond blood pressure reduction.” Hypertension research : official journal of the Japanese Society of Hypertension (2026). PMID: 42362815 ↗

    L5OTHERCited in: 2. Pathophysiology and Mechanism
  74. [74]

    Boltaboyeva A, Amangeldy B, Baigarayeva Z et al.. “Frailty-Driven Prediction of Inpatient Obstructive Sleep Apnea and Related Sleep Disorder Diagnoses Using Explainable AI.” Biomedicines (2026). PMID: 42351732 ↗

    L2OTHERCited in: 2. Pathophysiology and Mechanism
  75. [75]

    Peker Y, Glantz H, Eulenburg C et al.. “Effect of Positive Airway Pressure on Cardiovascular Outcomes in Coronary Artery Disease Patients with Nonsleepy Obstructive Sleep Apnea. The RICCADSA Randomized Controlled Trial.” American journal of respiratory and critical care medicine (2016). PMID: 26914592 ↗

    L1RCTCited in: 3. Epidemiology, Etiology and Risk Factors, 6. Severity, Staging and Risk Stratification, 7. Acute Management and Exacerbation Rescue, 8. Long-term and Definitive Management, History and Evolution of Treatment, 11. Prognosis and Natural History
  76. [76]

    Azarbarzin A, Zinchuk A, Wellman A et al.. “Cardiovascular Benefit of Continuous Positive Airway Pressure in Adults with Coronary Artery Disease and Obstructive Sleep Apnea without Excessive Sleepiness.” American journal of respiratory and critical care medicine (2022). PMID: 35579605 ↗

    L2RCTCited in: 3. Epidemiology, Etiology and Risk Factors, 6. Severity, Staging and Risk Stratification, 7. Acute Management and Exacerbation Rescue, 8. Long-term and Definitive Management, History and Evolution of Treatment, 11. Prognosis and Natural History
  77. [77]

    Malhotra A, Grunstein RR, Fietze I et al.. “Tirzepatide for the Treatment of Obstructive Sleep Apnea and Obesity.” The New England journal of medicine (2024). PMID: 38912654 ↗

    L1RCTCited in: 3. Epidemiology, Etiology and Risk Factors, 6. Severity, Staging and Risk Stratification, 7. Acute Management and Exacerbation Rescue, 8. Long-term and Definitive Management, History and Evolution of Treatment, 10. Complications
  78. [78]

    Lee MH, Lee WJ, Lee SK et al.. “Impact of Sleep Apnea on Perivascular Diffusivity and Cognition: A 4-Year Prospective Cohort Study.” American journal of respiratory and critical care medicine (2025). PMID: 40788707 ↗

    L2COHORTCited in: 3. Epidemiology, Etiology and Risk Factors, 6. Severity, Staging and Risk Stratification, 11. Prognosis and Natural History
  79. [79]

    O'Donnell C, Crilly S, O'Mahony A et al.. “Continuous Positive Airway Pressure but Not GLP1-mediated Weight Loss Improves Early Cardiovascular Disease in Obstructive Sleep Apnea: A Randomized Proof-of-Concept Study.” Annals of the American Thoracic Society (2024). PMID: 38096106 ↗

    L1RCTCited in: 3. Epidemiology, Etiology and Risk Factors, 6. Severity, Staging and Risk Stratification, 7. Acute Management and Exacerbation Rescue, 8. Long-term and Definitive Management, History and Evolution of Treatment, 11. Prognosis and Natural History
  80. [80]

    Cheong AJY, Tan BKJ, Teo YH et al.. “Obstructive Sleep Apnea and Lung Cancer: A Systematic Review and Meta-Analysis.” Annals of the American Thoracic Society (2022). PMID: 34792438 ↗

    L1SR_OBSCited in: 3. Epidemiology, Etiology and Risk Factors, 6. Severity, Staging and Risk Stratification, 11. Prognosis and Natural History
  81. [81]

    Labarca G, Vena D, Hu WH et al.. “Sleep Apnea Physiological Burdens and Cardiovascular Morbidity and Mortality.” American journal of respiratory and critical care medicine (2023). PMID: 37418748 ↗

    L2OTHERCited in: 3. Epidemiology, Etiology and Risk Factors, 5. Diagnosis and Workup (Pulmonary Function, Bronchoscopy and Imaging Anchored), 6. Severity, Staging and Risk Stratification, 7. Acute Management and Exacerbation Rescue, 11. Prognosis and Natural History
  82. [82]

    Trzepizur W, Blanchard M, Ganem T et al.. “Sleep Apnea-Specific Hypoxic Burden, Symptom Subtypes, and Risk of Cardiovascular Events and All-Cause Mortality.” American journal of respiratory and critical care medicine (2022). PMID: 34648724 ↗

    L2OTHERCited in: 3. Epidemiology, Etiology and Risk Factors, 6. Severity, Staging and Risk Stratification, 7. Acute Management and Exacerbation Rescue, 11. Prognosis and Natural History
  83. [83]

    Pack AI. “Advances in sleep-disordered breathing.” American journal of respiratory and critical care medicine (2005). PMID: 16284108 ↗

    L5REVIEW_NARRATIVECited in: 3. Epidemiology, Etiology and Risk Factors
  84. [84]

    Arzt M, Bradley TD. “Treatment of sleep apnea in heart failure.” American journal of respiratory and critical care medicine (2006). PMID: 16528015 ↗

    L5REVIEW_NARRATIVECited in: 3. Epidemiology, Etiology and Risk Factors, 4. Clinical Presentation, 8. Long-term and Definitive Management
  85. [85]

    Calhoun DA, Harding SM. “Sleep and hypertension.” Chest (2010). PMID: 20682533 ↗

    L5OTHERCited in: 3. Epidemiology, Etiology and Risk Factors, 6. Severity, Staging and Risk Stratification, 11. Prognosis and Natural History
  86. [86]

    Baffi CW, Wood L, Winnica D et al.. “Metabolic Syndrome and the Lung.” Chest (2016). PMID: 26836925 ↗

    L5REVIEW_NARRATIVECited in: 3. Epidemiology, Etiology and Risk Factors, 4. Clinical Presentation, 5. Diagnosis and Workup (Pulmonary Function, Bronchoscopy and Imaging Anchored), 10. Complications
  87. [87]

    Lal C, Strange C, Bachman D. “Neurocognitive impairment in obstructive sleep apnea.” Chest (2012). PMID: 22670023 ↗

    L5REVIEW_NARRATIVECited in: 3. Epidemiology, Etiology and Risk Factors, 10. Complications
  88. [88]

    Adesanya AO, Lee W, Greilich NB et al.. “Perioperative management of obstructive sleep apnea.” Chest (2010). PMID: 21138886 ↗

    L5REVIEW_NARRATIVECited in: 3. Epidemiology, Etiology and Risk Factors, 12. Special Populations & Pregnancy
  89. [89]

    Dyken ME, Im KB. “Obstructive sleep apnea and stroke.” Chest (2009). PMID: 19995768 ↗

    L5REVIEW_NARRATIVECited in: 3. Epidemiology, Etiology and Risk Factors
  90. [90]

    Tasali E, Mokhlesi B, Van Cauter E. “Obstructive sleep apnea and type 2 diabetes: interacting epidemics.” Chest (2008). PMID: 18252916 ↗

    L5REVIEW_NARRATIVECited in: 3. Epidemiology, Etiology and Risk Factors, 6. Severity, Staging and Risk Stratification, 8. Long-term and Definitive Management, 11. Prognosis and Natural History
  91. [91]

    Drager LF, Polotsky VY, Lorenzi-Filho G. “Obstructive sleep apnea: an emerging risk factor for atherosclerosis.” Chest (2011). PMID: 21813534 ↗

    L5REVIEW_NARRATIVECited in: 3. Epidemiology, Etiology and Risk Factors, 10. Complications
  92. [92]

    Sanchez-Cordero S, Lopez-Gonzalez R, Hermoza R et al.. “Systematic review of five-year outcomes after one-anastomosis gastric bypass.” Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery (2026). PMID: 42431778 ↗

    L2SR_OBSCited in: 3. Epidemiology, Etiology and Risk Factors, 6. Severity, Staging and Risk Stratification, 8. Long-term and Definitive Management, 10. Complications, 11. Prognosis and Natural History
  93. [93]

    Elagib T, Fan Y, Cornelis MA et al.. “Prevalence of Sleep-Disordered Breathing in Cleft-Affected Children: A Systematic Review and Meta-Analysis.” The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association (2026). PMID: 42429555 ↗

    L2SR_OBSCited in: 3. Epidemiology, Etiology and Risk Factors, 6. Severity, Staging and Risk Stratification, 11. Prognosis and Natural History, 12. Special Populations & Pregnancy
  94. [94]

    Yam KJM, Lim CYJ, Gao EY et al.. “Artificial Intelligence Diagnosis of Obstructive Sleep Apnea Using Overnight Pulse Oximetry: A Systematic Review and Bayesian Meta-Analysis.” Journal of medical Internet research (2026). PMID: 42418449 ↗

    L2SR_OBSCited in: 3. Epidemiology, Etiology and Risk Factors, 5. Diagnosis and Workup (Pulmonary Function, Bronchoscopy and Imaging Anchored), 7. Acute Management and Exacerbation Rescue
  95. [95]

    Kherallah K, Chung CS, Ghanshani R et al.. “The Impact of Chronic Spontaneous Urticaria on Sleep-A Systematic Review.” Dermatology and therapy (2026). PMID: 42366326 ↗

    L2SR_OBSCited in: 3. Epidemiology, Etiology and Risk Factors, 6. Severity, Staging and Risk Stratification, 8. Long-term and Definitive Management
  96. [96]

    Kuhle S, Urschitz MS. “Anti-inflammatory medications for obstructive sleep apnea in children.” The Cochrane database of systematic reviews (2011). PMID: 21249687 ↗

    L1SR_OBSCited in: 3. Epidemiology, Etiology and Risk Factors, 8. Long-term and Definitive Management, 12. Special Populations & Pregnancy
  97. [97]

    Sadeghi E, Kozlov M, Hasan N et al.. “Associations between psychiatric disorders and medication use, and retinal occlusion: a large-scale retrospective cohort study.” Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie (2026). PMID: 42371026 ↗

    L3COHORTCited in: 3. Epidemiology, Etiology and Risk Factors, 6. Severity, Staging and Risk Stratification, 11. Prognosis and Natural History
  98. [98]

    Thangjui S, Knutsen K, Hollowell B et al.. “Natural history and outcomes of post-operative atrial fibrillation after non-cardiac surgery: a clinically adjudicated single-center retrospective study.” Clinical research in cardiology : official journal of the German Cardiac Society (2026). PMID: 42370998 ↗

    L3COHORTCited in: 3. Epidemiology, Etiology and Risk Factors, 6. Severity, Staging and Risk Stratification, History and Evolution of Treatment, 11. Prognosis and Natural History, 13. Prevention, Screening & Surveillance
  99. [99]

    Jia Z, Xu Y, Zhang C et al.. “Transnasal Humidified Rapid-Insufflation Ventilatory Exchange versus Oropharyngeal Airway-Assisted Face-Mask Ventilation for Gastric Insufflation During Induction of General Anesthesia in Patients at High Risk for Obstructive Sleep Apnea.” Therapeutics and clinical risk management (2026). PMID: 42382179 ↗

    L1TRIAL_NONRANDOMCited in: 3. Epidemiology, Etiology and Risk Factors, 5. Diagnosis and Workup (Pulmonary Function, Bronchoscopy and Imaging Anchored)
  100. [100]

    Henney AE, Riley DR, Anson M et al.. “Comparative Efficacy of Tirzepatide, Liraglutide, and Semaglutide in Reduction of Risk of Major Adverse Cardiovascular Events in Patients with Obstructive Sleep Apnea and Type 2 Diabetes: Real-World Evidence.” Annals of the American Thoracic Society (2025). PMID: 40590655 ↗

    L3OTHERCited in: 3. Epidemiology, Etiology and Risk Factors, 6. Severity, Staging and Risk Stratification, 11. Prognosis and Natural History
  101. [101]

    Marin JM, Soriano JB, Marin-Oto M et al.. “Sleep-disordered Breathing in Patients with Chronic Obstructive Pulmonary Disease: Prevalence and Outcomes.” Annals of the American Thoracic Society (2025). PMID: 40208311 ↗

    L2OTHERCited in: 3. Epidemiology, Etiology and Risk Factors, 6. Severity, Staging and Risk Stratification, 7. Acute Management and Exacerbation Rescue, 11. Prognosis and Natural History
  102. [102]

    Kundel V, Gans A, Lee JH et al.. “Heterogeneity of vascular inflammation in obstructive sleep apnea: effects of continuous positive airway pressure therapy.” Annals of the American Thoracic Society (2026). PMID: 41691476 ↗

    L2OTHERCited in: 3. Epidemiology, Etiology and Risk Factors, 11. Prognosis and Natural History
  103. [103]

    O'Donnell DE, Ciavaglia CE, Neder JA. “When obesity and chronic obstructive pulmonary disease collide. Physiological and clinical consequences.” Annals of the American Thoracic Society (2014). PMID: 24625243 ↗

    L5REVIEW_NARRATIVECited in: 3. Epidemiology, Etiology and Risk Factors, 4. Clinical Presentation, 5. Diagnosis and Workup (Pulmonary Function, Bronchoscopy and Imaging Anchored), 7. Acute Management and Exacerbation Rescue, 9. Respiratory Support, Procedures & Interventional Pulmonology (Specialty-Distinctive), 10. Complications, 11. Prognosis and Natural History
  104. [104]

    Xu L, Keenan BT, Wiemken AS et al.. “The Relationship between Upper Airway Anatomy and Obesity in Patients with Obstructive Sleep Apnea.” Annals of the American Thoracic Society (2025). PMID: 40523212 ↗

    L4OTHERCited in: 3. Epidemiology, Etiology and Risk Factors
  105. [105]

    Kobayashi Frisk M, Bergqvist J, Svedmyr S et al.. “Comorbid Insomnia and Sleep Apnea Is Associated with Uncontrolled Hypertension in a Middle-aged Population.” Annals of the American Thoracic Society (2026). PMID: 40921000 ↗

    L4OTHERCited in: 3. Epidemiology, Etiology and Risk Factors, 6. Severity, Staging and Risk Stratification, 7. Acute Management and Exacerbation Rescue, 11. Prognosis and Natural History
  106. [106]

    Siranart N, Fangsaard P, Pajareya P et al.. “Improvement of Obesity-Related Comorbidities After Bariatric Procedures: A Network Meta-Analysis of Endoscopic Versus Surgical Interventions.” Digestive diseases and sciences (2026). PMID: 42423932 ↗

    L1SR_OBSCited in: 3. Epidemiology, Etiology and Risk Factors, 6. Severity, Staging and Risk Stratification
  107. [107]

    Zhang KL, Wallon R, Laukaitis CM et al.. “Obstructive sleep apnea and CPAP efficacy in patients with Hypermobile Ehlers-Danlos syndrome and hypermobility spectrum disorder: a case-control study.” Sleep & breathing = Schlaf & Atmung (2026). PMID: 42417930 ↗

    L3CASE_CONTROLCited in: 3. Epidemiology, Etiology and Risk Factors
  108. [108]

    Liu X, Liu HL, Hu K. “[Interpretation and reflections on the 2025 American Academy of Sleep Medicine clinical practice guideline for the treatment of central sleep apnea in adults].” Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases (2026). PMID: 42373444 ↗

    L5GUIDELINECited in: 3. Epidemiology, Etiology and Risk Factors, 7. Acute Management and Exacerbation Rescue
  109. [109]

    Guimarães KC, Drager LF, Genta PR et al.. “Effects of oropharyngeal exercises on patients with moderate obstructive sleep apnea syndrome.” American journal of respiratory and critical care medicine (2009). PMID: 19234106 ↗

    L1RCTCited in: 4. Clinical Presentation, 6. Severity, Staging and Risk Stratification, 7. Acute Management and Exacerbation Rescue, 8. Long-term and Definitive Management, History and Evolution of Treatment
  110. [110]

    Hedner J, Stenlöf K, Zou D et al.. “A Randomized Controlled Clinical Trial Exploring Safety and Tolerability of Sulthiame in Sleep Apnea.” American journal of respiratory and critical care medicine (2022). PMID: 35202553 ↗

    L1RCTCited in: 4. Clinical Presentation, 7. Acute Management and Exacerbation Rescue, 8. Long-term and Definitive Management, History and Evolution of Treatment
  111. [111]

    Gagnadoux F, Pépin JL, Vielle B et al.. “Impact of Mandibular Advancement Therapy on Endothelial Function in Severe Obstructive Sleep Apnea.” American journal of respiratory and critical care medicine (2017). PMID: 28128967 ↗

    L1RCTCited in: 4. Clinical Presentation
  112. [112]

    Drager LF, Bortolotto LA, Figueiredo AC et al.. “Effects of continuous positive airway pressure on early signs of atherosclerosis in obstructive sleep apnea.” American journal of respiratory and critical care medicine (2007). PMID: 17556718 ↗

    L1RCTCited in: 4. Clinical Presentation
  113. [113]

    Tuomilehto HP, Seppä JM, Partinen MM et al.. “Lifestyle intervention with weight reduction: first-line treatment in mild obstructive sleep apnea.” American journal of respiratory and critical care medicine (2008). PMID: 19011153 ↗

    L1RCTCited in: 4. Clinical Presentation
  114. [114]

    Campos-Rodriguez F, Queipo-Corona C, Carmona-Bernal C et al.. “Continuous Positive Airway Pressure Improves Quality of Life in Women with Obstructive Sleep Apnea. A Randomized Controlled Trial.” American journal of respiratory and critical care medicine (2016). PMID: 27181196 ↗

    L1RCTCited in: 4. Clinical Presentation
  115. [115]

    Masa JF, Mokhlesi B, Benítez I et al.. “Echocardiographic Changes with Positive Airway Pressure Therapy in Obesity Hypoventilation Syndrome. Long-Term Pickwick Randomized Controlled Clinical Trial.” American journal of respiratory and critical care medicine (2020). PMID: 31682462 ↗

    L1RCTCited in: 4. Clinical Presentation, 10. Complications
  116. [116]

    Cintra F, Tufik S, D'Almeida V et al.. “Cysteine: a potential biomarker for obstructive sleep apnea.” Chest (2010). PMID: 20651023 ↗

    L3RCTCited in: 4. Clinical Presentation, 7. Acute Management and Exacerbation Rescue, 8. Long-term and Definitive Management, History and Evolution of Treatment
  117. [117]

    Moraes W, Poyares D, Sukys-Claudino L et al.. “Donepezil improves obstructive sleep apnea in Alzheimer disease: a double-blind, placebo-controlled study.” Chest (2008). PMID: 18198262 ↗

    L1RCTCited in: 4. Clinical Presentation, 7. Acute Management and Exacerbation Rescue, 8. Long-term and Definitive Management
  118. [118]

    McEvoy RD, Antic NA, Heeley E et al.. “CPAP for Prevention of Cardiovascular Events in Obstructive Sleep Apnea.” The New England journal of medicine (2016). PMID: 27571048 ↗

    L1RCTCited in: 4. Clinical Presentation, 7. Acute Management and Exacerbation Rescue, 8. Long-term and Definitive Management, History and Evolution of Treatment
  119. [119]

    Marcus CL, Moore RH, Rosen CL et al.. “A randomized trial of adenotonsillectomy for childhood sleep apnea.” The New England journal of medicine (2013). PMID: 23692173 ↗

    L1RCTCited in: 4. Clinical Presentation, 6. Severity, Staging and Risk Stratification, 7. Acute Management and Exacerbation Rescue, 8. Long-term and Definitive Management, History and Evolution of Treatment, 11. Prognosis and Natural History
  120. [120]

    Bakker JP, Marshall NS. “Flexible pressure delivery modification of continuous positive airway pressure for obstructive sleep apnea does not improve compliance with therapy: systematic review and meta-analysis.” Chest (2010). PMID: 21193533 ↗

    L1SR_OBSCited in: 4. Clinical Presentation, 8. Long-term and Definitive Management, 11. Prognosis and Natural History
  121. [121]

    Schmickl CN, Orr JE, Alex RM et al.. “Combination Drug Therapy with Acetazolamide, Eszopiclone ± Venlafaxine for Obstructive Sleep Apnea (RESCUE-Combo): A Randomized, Double-Blind, Placebo-controlled Clinical Trial.” Annals of the American Thoracic Society (2025). PMID: 39514000 ↗

    L1RCTCited in: 4. Clinical Presentation, 7. Acute Management and Exacerbation Rescue, 8. Long-term and Definitive Management, History and Evolution of Treatment
  122. [122]

    Aishah A, Loffler KA, Toson B et al.. “One Month Dosing of Atomoxetine plus Oxybutynin in Obstructive Sleep Apnea: A Randomized, Placebo-controlled Trial.” Annals of the American Thoracic Society (2023). PMID: 36538809 ↗

    L1RCTCited in: 4. Clinical Presentation, History and Evolution of Treatment
  123. [123]

    Zuo C, Qin J, Wang Z et al.. “Effects of inspiratory muscle training on obstructive sleep apnea: a systematic review and meta-analysis.” Annals of the American Thoracic Society (2026). PMID: 41721779 ↗

    L1SR_OBSCited in: 4. Clinical Presentation
  124. [124]

    Ozsancak A, D'Ambrosio C, Hill NS. “Nocturnal noninvasive ventilation.” Chest (2008). PMID: 18460530 ↗

    L5REVIEW_NARRATIVECited in: 4. Clinical Presentation, 7. Acute Management and Exacerbation Rescue, 10. Complications
  125. [125]

    Venkateshiah SB, Collop NA. “Sleep and sleep disorders in the hospital.” Chest (2012). PMID: 22553268 ↗

    L5OTHERCited in: 4. Clinical Presentation, 11. Prognosis and Natural History
  126. [126]

    Xu Z, Cheuk DK, Lee SL. “Clinical evaluation in predicting childhood obstructive sleep apnea.” Chest (2006). PMID: 17166994 ↗

    L4OTHERCited in: 4. Clinical Presentation, History and Evolution of Treatment
  127. [127]

    Kirkham EM, Ishman S, Garetz S et al.. “Progression of mild sleep-disordered breathing in children managed with watchful waiting.” Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine (2026). PMID: 42414790 ↗

    L2RCTCited in: 4. Clinical Presentation, 6. Severity, Staging and Risk Stratification, 7. Acute Management and Exacerbation Rescue, 8. Long-term and Definitive Management, History and Evolution of Treatment, 12. Special Populations & Pregnancy
  128. [128]

    Abraham-Aggarwal K, Hung C, Chen X et al.. “Does treatment of nonsleepy OSA with CPAP therapy change CVD risk? A systematic review.” Sleep medicine (2026). PMID: 42349065 ↗

    L1SR_OBSCited in: 4. Clinical Presentation
  129. [129]

    Izci-Balserak B, Zhu B, Gurubhagavatula I et al.. “A Screening Algorithm for Obstructive Sleep Apnea in Pregnancy.” Annals of the American Thoracic Society (2019). PMID: 31162952 ↗

    L2OTHERCited in: 4. Clinical Presentation, 5. Diagnosis and Workup (Pulmonary Function, Bronchoscopy and Imaging Anchored), 10. Complications, 12. Special Populations & Pregnancy
  130. [130]

    Thornton JD, Dudley KA, Saeed GJ et al.. “Differences in Symptoms and Severity of Obstructive Sleep Apnea between Black and White Patients.” Annals of the American Thoracic Society (2022). PMID: 34242152 ↗

    L2OTHERCited in: 4. Clinical Presentation, 5. Diagnosis and Workup (Pulmonary Function, Bronchoscopy and Imaging Anchored)
  131. [131]

    Ozden Sertcelik U, Turker M, Sertcelik A et al.. “The Association Between the STOP-Bang Score and the Integrated Pulmonary Index in Patients Undergoing Endobronchial Ultrasound with Sedation: The STOP OSA-IPI Cohort Study.” Medicina (Kaunas, Lithuania) (2026). PMID: 42356047 ↗

    L2COHORTCited in: 4. Clinical Presentation, 5. Diagnosis and Workup (Pulmonary Function, Bronchoscopy and Imaging Anchored), 7. Acute Management and Exacerbation Rescue, 9. Respiratory Support, Procedures & Interventional Pulmonology (Specialty-Distinctive), 12. Special Populations & Pregnancy
  132. [132]

    Hsu Y, Cheng WJ, Finnsson E et al.. “Endotypic trait responses to 12-month tirzepatide treatment for an obese patient with obstructive sleep apnea: a case report.” Obesity facts (2026). PMID: 42378200 ↗

    L4CASE_REPORTCited in: 4. Clinical Presentation
  133. [133]

    Ogundu PI, Bradley I, Ujari O et al.. “A 6-Year-Old Boy With Body Aches.” Pediatrics (2026). PMID: 42309516 ↗

    L4CASE_REPORTCited in: 4. Clinical Presentation
  134. [134]

    Naved SA, Khan M, Rasool S et al.. “Prophylactic bi-level non-invasive positive pressure ventilation during monitored anesthesia care for transfemoral TAVI in a morbidly obese patient with obstructive sleep apnea: a case report.” BMC anesthesiology (2026). PMID: 42260368 ↗

    L4CASE_REPORTCited in: 4. Clinical Presentation
  135. [135]

    Abideen ZU, Kolla BP, Bernard ME et al.. “Management of Central Disorders of Hypersomnolence in Pregnancy and Lactation.” Journal of primary care & community health (2026). PMID: 42212348 ↗

    L5CASE_REPORTCited in: 4. Clinical Presentation
  136. [136]

    Dantas GL, Cavalcante MLC, Gomes EF et al.. “Clinical case-control study of the proprioceptive innervation of the pharynx in patients with obstructive sleep apnea.” Brazilian journal of otorhinolaryngology (2026). PMID: 42302464 ↗

    L3CASE_CONTROLCited in: 4. Clinical Presentation
  137. [137]

    Shaw JE, Punjabi NM, Naughton MT et al.. “The Effect of Treatment of Obstructive Sleep Apnea on Glycemic Control in Type 2 Diabetes.” American journal of respiratory and critical care medicine (2016). PMID: 26926656 ↗

    L1RCTCited in: 5. Diagnosis and Workup (Pulmonary Function, Bronchoscopy and Imaging Anchored)
  138. [138]

    Zamarrón E, Jaureguizar A, García-Sánchez A et al.. “Continuous Positive Airway Pressure Effect on Albuminuria Progression in Patients with Obstructive Sleep Apnea and Diabetic Kidney Disease: A Randomized Clinical Trial.” American journal of respiratory and critical care medicine (2023). PMID: 36342964 ↗

    L1RCTCited in: 5. Diagnosis and Workup (Pulmonary Function, Bronchoscopy and Imaging Anchored), 10. Complications
  139. [139]

    Skomro RP, Gjevre J, Reid J et al.. “Outcomes of home-based diagnosis and treatment of obstructive sleep apnea.” Chest (2010). PMID: 20173052 ↗

    L1RCTCited in: 5. Diagnosis and Workup (Pulmonary Function, Bronchoscopy and Imaging Anchored), 7. Acute Management and Exacerbation Rescue, 8. Long-term and Definitive Management
  140. [140]

    Gottlieb DJ, Punjabi NM, Mehra R et al.. “CPAP versus oxygen in obstructive sleep apnea.” The New England journal of medicine (2014). PMID: 24918372 ↗

    L1RCTCited in: 5. Diagnosis and Workup (Pulmonary Function, Bronchoscopy and Imaging Anchored), 7. Acute Management and Exacerbation Rescue, 8. Long-term and Definitive Management, History and Evolution of Treatment, 10. Complications, 11. Prognosis and Natural History
  141. [141]

    Rizzi CF, Cintra F, Risso T et al.. “Exercise capacity and obstructive sleep apnea in lean subjects.” Chest (2009). PMID: 19801583 ↗

    L3TRIAL_NONRANDOMCited in: 5. Diagnosis and Workup (Pulmonary Function, Bronchoscopy and Imaging Anchored), 7. Acute Management and Exacerbation Rescue
  142. [142]

    Van Ryswyk EM, Benitez ID, Sweetman AM et al.. “Primary versus Specialist Care for Obstructive Sleep Apnea: A Systematic Review and Individual-Participant Data-Level Meta-Analysis.” Annals of the American Thoracic Society (2022). PMID: 34524936 ↗

    L1SR_OBSCited in: 5. Diagnosis and Workup (Pulmonary Function, Bronchoscopy and Imaging Anchored), 6. Severity, Staging and Risk Stratification, 11. Prognosis and Natural History
  143. [143]

    Kim JW, Lee K, Kim HJ et al.. “Predicting Obstructive Sleep Apnea Based on Computed Tomography Scans Using Deep Learning Models.” American journal of respiratory and critical care medicine (2024). PMID: 38471111 ↗

    L3OTHERCited in: 5. Diagnosis and Workup (Pulmonary Function, Bronchoscopy and Imaging Anchored)
  144. [144]

    Sharma RA, Varga AW, Bubu OM et al.. “Obstructive Sleep Apnea Severity Affects Amyloid Burden in Cognitively Normal Elderly. A Longitudinal Study.” American journal of respiratory and critical care medicine (2018). PMID: 29125327 ↗

    L2OTHERCited in: 5. Diagnosis and Workup (Pulmonary Function, Bronchoscopy and Imaging Anchored), 12. Special Populations & Pregnancy
  145. [145]

    Gervès-Pinquié C, Bailly S, Goupil F et al.. “Positive Airway Pressure Adherence, Mortality, and Cardiovascular Events in Patients with Sleep Apnea.” American journal of respiratory and critical care medicine (2022). PMID: 35816570 ↗

    L2OTHERCited in: 5. Diagnosis and Workup (Pulmonary Function, Bronchoscopy and Imaging Anchored)
  146. [146]

    Polotsky VY, Patil SP, Savransky V et al.. “Obstructive sleep apnea, insulin resistance, and steatohepatitis in severe obesity.” American journal of respiratory and critical care medicine (2008). PMID: 18990675 ↗

    L4OTHERCited in: 5. Diagnosis and Workup (Pulmonary Function, Bronchoscopy and Imaging Anchored)
  147. [147]

    Ayalon L, Ancoli-Israel S, Drummond SP. “Obstructive sleep apnea and age: a double insult to brain function?” American journal of respiratory and critical care medicine (2010). PMID: 20395556 ↗

    L3OTHERCited in: 5. Diagnosis and Workup (Pulmonary Function, Bronchoscopy and Imaging Anchored)
  148. [148]

    Armoni Domany K, Hossain MM, Nava-Guerra L et al.. “Cardioventilatory Control in Preterm-born Children and the Risk of Obstructive Sleep Apnea.” American journal of respiratory and critical care medicine (2018). PMID: 29323933 ↗

    L3OTHERCited in: 5. Diagnosis and Workup (Pulmonary Function, Bronchoscopy and Imaging Anchored)
  149. [149]

    Kendzerska T, Gershon AS, Povitz M et al.. “Polysomnographic Markers of Obstructive Sleep Apnea Severity and Cancer-related Mortality: A Large Retrospective Multicenter Clinical Cohort Study.” Annals of the American Thoracic Society (2022). PMID: 34788198 ↗

    L2COHORTCited in: 5. Diagnosis and Workup (Pulmonary Function, Bronchoscopy and Imaging Anchored)
  150. [150]

    Patel NP, Ahmed M, Rosen I. “Split-night polysomnography.” Chest (2007). PMID: 17998369 ↗

    L5REVIEW_NARRATIVECited in: 5. Diagnosis and Workup (Pulmonary Function, Bronchoscopy and Imaging Anchored)
  151. [151]

    Cooksey JA, Balachandran JS. “Portable Monitoring for the Diagnosis of OSA.” Chest (2016). PMID: 26539918 ↗

    L5REVIEW_NARRATIVECited in: 5. Diagnosis and Workup (Pulmonary Function, Bronchoscopy and Imaging Anchored)
  152. [152]

    Montesi SB, Bajwa EK, Malhotra A. “Biomarkers of sleep apnea.” Chest (2012). PMID: 22796846 ↗

    L5REVIEW_NARRATIVECited in: 5. Diagnosis and Workup (Pulmonary Function, Bronchoscopy and Imaging Anchored), 6. Severity, Staging and Risk Stratification, 11. Prognosis and Natural History
  153. [153]

    Simon S, Collop N. “Latest advances in sleep medicine: obstructive sleep apnea.” Chest (2012). PMID: 23208337 ↗

    L5REVIEW_NARRATIVECited in: 5. Diagnosis and Workup (Pulmonary Function, Bronchoscopy and Imaging Anchored), 6. Severity, Staging and Risk Stratification
  154. [154]

    Kaw R, Michota F, Jaffer A et al.. “Unrecognized sleep apnea in the surgical patient: implications for the perioperative setting.” Chest (2006). PMID: 16424433 ↗

    L5REVIEW_NARRATIVECited in: 5. Diagnosis and Workup (Pulmonary Function, Bronchoscopy and Imaging Anchored), 12. Special Populations & Pregnancy
  155. [155]

    Lancaster LH, Mason WR, Parnell JA et al.. “Obstructive sleep apnea is common in idiopathic pulmonary fibrosis.” Chest (2009). PMID: 19567497 ↗

    L4OTHERCited in: 5. Diagnosis and Workup (Pulmonary Function, Bronchoscopy and Imaging Anchored)
  156. [156]

    Ahmed M, Patel NP, Rosen I. “Portable monitors in the diagnosis of obstructive sleep apnea.” Chest (2007). PMID: 17998370 ↗

    L5REVIEW_NARRATIVECited in: 5. Diagnosis and Workup (Pulmonary Function, Bronchoscopy and Imaging Anchored)
  157. [157]

    Flum DR, Belle SH, King WC et al.. “Perioperative safety in the longitudinal assessment of bariatric surgery.” The New England journal of medicine (2009). PMID: 19641201 ↗

    L2OTHERCited in: 5. Diagnosis and Workup (Pulmonary Function, Bronchoscopy and Imaging Anchored), 8. Long-term and Definitive Management, History and Evolution of Treatment, 11. Prognosis and Natural History, 12. Special Populations & Pregnancy
  158. [158]

    Baron KG, Alcántara C, López I et al.. “Protocol for Nuestro Sueño: A randomized trial of a couples-based intervention to improve PAP adherence and sleep health among Hispanic patients beginning positive airway pressure (PAP) and their partners.” Sleep medicine (2026). PMID: 42176392 ↗

    L5TRIAL_NONRANDOMCited in: 5. Diagnosis and Workup (Pulmonary Function, Bronchoscopy and Imaging Anchored)
  159. [159]

    Zafar A, Roman U, Haseeb A et al.. “Reliability of Home Sleep Apnea Test as a Diagnostic Modality in Children With Obstructive Sleep Apnea- a Systematic Review.” Pediatric pulmonology (2026). PMID: 42165382 ↗

    L2SR_OBSCited in: 5. Diagnosis and Workup (Pulmonary Function, Bronchoscopy and Imaging Anchored), 8. Long-term and Definitive Management, 10. Complications, 12. Special Populations & Pregnancy
  160. [160]

    Sung J, Chang R, Chen SN et al.. “Obstructive Sleep Apnea and Risk for Thromboembolic Complication Among Patients With Polycystic Ovary Syndrome: A Retrospective Cohort Study.” BJOG : an international journal of obstetrics and gynaecology (2026). PMID: 42248807 ↗

    L2COHORTCited in: 5. Diagnosis and Workup (Pulmonary Function, Bronchoscopy and Imaging Anchored), 8. Long-term and Definitive Management
  161. [161]

    Nishida T, Mittal R, Weinreb RN et al.. “Positive Airway Pressure and Long-Term Glaucoma Risk in Obstructive Sleep Apnea: A Cohort Study.” Ophthalmology. Glaucoma (2026). PMID: 42235822 ↗

    L2COHORTCited in: 5. Diagnosis and Workup (Pulmonary Function, Bronchoscopy and Imaging Anchored), 8. Long-term and Definitive Management
  162. [162]

    Pépin JL, Herquelot E, Denis H et al.. “Health Trajectories around Noninvasive Ventilation Initiation for Obesity Hypoventilation Syndrome.” Annals of the American Thoracic Society (2025). PMID: 40587365 ↗

    L2OTHERCited in: 5. Diagnosis and Workup (Pulmonary Function, Bronchoscopy and Imaging Anchored), 7. Acute Management and Exacerbation Rescue, 8. Long-term and Definitive Management
  163. [163]

    Chang JR, Akemokwe FM, Marangu DM et al.. “Obstructive Sleep Apnea Awareness among Primary Care Physicians in Africa.” Annals of the American Thoracic Society (2020). PMID: 31580702 ↗

    L4OTHERCited in: 5. Diagnosis and Workup (Pulmonary Function, Bronchoscopy and Imaging Anchored), 12. Special Populations & Pregnancy
  164. [164]

    Thomas S, Tharrington SG, Patel A et al.. “Racial and Ethnic Disparities in the Diagnosis and Treatment of Obstructive Sleep Apnea: A Systematic Review.” International journal of environmental research and public health (2026). PMID: 42196707 ↗

    L2SR_OBSCited in: 5. Diagnosis and Workup (Pulmonary Function, Bronchoscopy and Imaging Anchored)
  165. [165]

    Chiang JK, Kao HH, Chiang PH et al.. “Vitamin D Deficiency Is Associated with a Higher 5-Year Risk of Obstructive Sleep Apnea and CPAP Use in Older Adults: An Anchor-Based Network Meta-Analysis.” Medicina (Kaunas, Lithuania) (2026). PMID: 42195188 ↗

    L2SR_OBSCited in: 5. Diagnosis and Workup (Pulmonary Function, Bronchoscopy and Imaging Anchored)
  166. [166]

    Alahmadi HI. “Nocturnal hypoxemic burden in obesity hypoventilation syndrome compared to obstructive sleep apnea: a case-control study.” Sleep & breathing = Schlaf & Atmung (2026). PMID: 42366321 ↗

    L3CASE_CONTROLCited in: 5. Diagnosis and Workup (Pulmonary Function, Bronchoscopy and Imaging Anchored), 7. Acute Management and Exacerbation Rescue
  167. [167]

    Lavoie V, Pichard S, Bouchereau J et al.. “Pediatric sleep-disordered breathing in Pompe disease in the era of enzyme replacement therapy: A retrospective cohort study.” Molecular genetics and metabolism (2026). PMID: 42322896 ↗

    L4COHORTCited in: 5. Diagnosis and Workup (Pulmonary Function, Bronchoscopy and Imaging Anchored)
  168. [168]

    Taranto-Montemurro L, Messineo L, Sands SA et al.. “The Combination of Atomoxetine and Oxybutynin Greatly Reduces Obstructive Sleep Apnea Severity. A Randomized, Placebo-controlled, Double-Blind Crossover Trial.” American journal of respiratory and critical care medicine (2019). PMID: 30395486 ↗

    L1RCTCited in: 6. Severity, Staging and Risk Stratification, 7. Acute Management and Exacerbation Rescue, 8. Long-term and Definitive Management, History and Evolution of Treatment, 11. Prognosis and Natural History
  169. [169]

    Xu H, Liu Y, Li C et al.. “Effects of Continuous Positive Airway Pressure on Neuroimaging Biomarkers and Cognition in Adult Obstructive Sleep Apnea: A Randomized Controlled Trial.” American journal of respiratory and critical care medicine (2025). PMID: 39998447 ↗

    L1RCTCited in: 6. Severity, Staging and Risk Stratification, 7. Acute Management and Exacerbation Rescue, 8. Long-term and Definitive Management, History and Evolution of Treatment
  170. [170]

    Strollo PJ, Farkas R, Taranto-Montemurro L et al.. “Aroxybutynin and atomoxetine (AD109) for obstructive sleep apnea: a randomized phase 3 trial (SynAIRgy).” American journal of respiratory and critical care medicine (2026). PMID: 42148495 ↗

    L1RCTCited in: 6. Severity, Staging and Risk Stratification, 7. Acute Management and Exacerbation Rescue, 8. Long-term and Definitive Management, History and Evolution of Treatment, 11. Prognosis and Natural History
  171. [171]

    Messineo L, Sands SA, Labarca G. “Hypnotics on Obstructive Sleep Apnea Severity and Endotypes: A Systematic Review and Meta-Analysis.” American journal of respiratory and critical care medicine (2024). PMID: 39042859 ↗

    L1SR_OBSCited in: 6. Severity, Staging and Risk Stratification
  172. [172]

    Strollo PJ, Soose RJ, Maurer JT et al.. “Upper-airway stimulation for obstructive sleep apnea.” The New England journal of medicine (2014). PMID: 24401051 ↗

    L4RCTCited in: 6. Severity, Staging and Risk Stratification, 7. Acute Management and Exacerbation Rescue, 8. Long-term and Definitive Management, History and Evolution of Treatment, 11. Prognosis and Natural History
  173. [173]

    Romero-Corral A, Caples SM, Lopez-Jimenez F et al.. “Interactions between obesity and obstructive sleep apnea: implications for treatment.” Chest (2010). PMID: 20202954 ↗

    L5REVIEW_NARRATIVECited in: 6. Severity, Staging and Risk Stratification
  174. [174]

    Suen C, Ryan CM, Mubashir T et al.. “Sleep Study and Oximetry Parameters for Predicting Postoperative Complications in Patients With OSA.” Chest (2018). PMID: 30359618 ↗

    L5REVIEW_NARRATIVECited in: 6. Severity, Staging and Risk Stratification, 7. Acute Management and Exacerbation Rescue, 10. Complications, 11. Prognosis and Natural History, 12. Special Populations & Pregnancy
  175. [175]

    Azzopardi M, Parsons R, Cadby G et al.. “Identifying Risk of Postoperative Cardiorespiratory Complications in OSA.” Chest (2024). PMID: 39134145 ↗

    L2OTHERCited in: 6. Severity, Staging and Risk Stratification, 7. Acute Management and Exacerbation Rescue, 11. Prognosis and Natural History
  176. [176]

    Rosa CFA, de Paula Soares CF, Cahali MB. “Which nocturnal hypoxemia parameters are associated with ambulatory blood pressure monitoring in adults with obstructive sleep apnea? A systematic review.” Sleep & breathing = Schlaf & Atmung (2026). PMID: 42397627 ↗

    L5SR_OBSCited in: 6. Severity, Staging and Risk Stratification, 7. Acute Management and Exacerbation Rescue
  177. [177]

    Chen D, Zhang X, Liu C et al.. “Correction: Association between obstructive sleep apnea syndrome and metabolic syndrome: a severity-stratified meta-analysis.” Frontiers in medicine (2026). PMID: 42422827 ↗

    L2SR_OBSCited in: 6. Severity, Staging and Risk Stratification
  178. [178]

    Cai P, Li B, Li Y et al.. “Association of peripheral NLRP3 inflammasome activation with prevalent and incident chronic kidney disease in patients with obstructive sleep apnea: a prospective study.” Sleep & breathing = Schlaf & Atmung (2026). PMID: 42377775 ↗

    L2COHORTCited in: 6. Severity, Staging and Risk Stratification, 11. Prognosis and Natural History
  179. [179]

    Hang LW, Finnsson E, Ágústsson JS et al.. “Association of Endotypic Traits and Their Interaction With Severity of Obstructive Sleep Apnea.” Respirology (Carlton, Vic.) (2026). PMID: 41813440 ↗

    L2OTHERCited in: 6. Severity, Staging and Risk Stratification
  180. [180]

    Vena D, Gell L, Messineo L et al.. “Physiological Determinants of Snore Loudness.” Annals of the American Thoracic Society (2024). PMID: 37879037 ↗

    L4OTHERCited in: 6. Severity, Staging and Risk Stratification
  181. [181]

    Schweitzer PK, Taranto-Montemurro L, Ojile JM et al.. “The Combination of Aroxybutynin and Atomoxetine in the Treatment of Obstructive Sleep Apnea (MARIPOSA): A Randomized Controlled Trial.” American journal of respiratory and critical care medicine (2023). PMID: 37812772 ↗

    L1RCTCited in: 7. Acute Management and Exacerbation Rescue, 8. Long-term and Definitive Management, History and Evolution of Treatment, 11. Prognosis and Natural History
  182. [182]

    Schwartz AR, Jacobowitz O, Mickelson SA et al.. “Three-Year Outcomes of Proximal Hypoglossal Nerve Stimulation in OSA.” Chest (2026). PMID: 41690459 ↗

    L2RCTCited in: 7. Acute Management and Exacerbation Rescue, 8. Long-term and Definitive Management, History and Evolution of Treatment
  183. [183]

    Khayat RN, Abraham WT, Patt B et al.. “In-hospital treatment of obstructive sleep apnea during decompensation of heart failure.” Chest (2009). PMID: 19567491 ↗

    L1RCTCited in: 7. Acute Management and Exacerbation Rescue, 8. Long-term and Definitive Management, History and Evolution of Treatment, 11. Prognosis and Natural History
  184. [184]

    Schweitzer PK, Mayer G, Rosenberg R et al.. “Randomized Controlled Trial of Solriamfetol for Excessive Daytime Sleepiness in OSA: An Analysis of Subgroups Adherent or Nonadherent to OSA Treatment.” Chest (2021). PMID: 33631141 ↗

    L1RCTCited in: 7. Acute Management and Exacerbation Rescue, 8. Long-term and Definitive Management
  185. [185]

    Imadojemu VA, Mawji Z, Kunselman A et al.. “Sympathetic chemoreflex responses in obstructive sleep apnea and effects of continuous positive airway pressure therapy.” Chest (2007). PMID: 17494791 ↗

    L2RCTCited in: 7. Acute Management and Exacerbation Rescue
  186. [186]

    Chirinos JA, Gurubhagavatula I, Teff K et al.. “CPAP, weight loss, or both for obstructive sleep apnea.” The New England journal of medicine (2014). PMID: 24918371 ↗

    L1RCTCited in: 7. Acute Management and Exacerbation Rescue, 8. Long-term and Definitive Management, History and Evolution of Treatment
  187. [187]

    Messineo L, Gell L, Calianese N et al.. “Effect of Pimavanserin on the Respiratory Arousal Threshold from Sleep: A Randomized Trial.” Annals of the American Thoracic Society (2022). PMID: 35947827 ↗

    L1RCTCited in: 7. Acute Management and Exacerbation Rescue, 8. Long-term and Definitive Management, History and Evolution of Treatment
  188. [188]

    Christopher KL, Schwartz MD. “Transtracheal oxygen therapy.” Chest (2011). PMID: 21285058 ↗

    L5REVIEW_NARRATIVECited in: 7. Acute Management and Exacerbation Rescue, 8. Long-term and Definitive Management, 9. Respiratory Support, Procedures & Interventional Pulmonology (Specialty-Distinctive), 10. Complications
  189. [189]

    Stephens TN, Wang Y, Guo J et al.. “Evaluation of a sleep sound analysis smartphone app for home obstructive sleep apnea screening among community-dwelling Chinese adults with hypertension.” Sleep & breathing = Schlaf & Atmung (2026). PMID: 42412159 ↗

    L1RCTCited in: 7. Acute Management and Exacerbation Rescue, 8. Long-term and Definitive Management, History and Evolution of Treatment
  190. [190]

    Jiang Y, Wang Z, Wen H et al.. “Comparison of esketamine combined with dexmedetomidine versus propofol combined with midazolam on drug-induced sleep endoscopy: a randomized controlled trial.” BMC anesthesiology (2026). PMID: 42288726 ↗

    L1RCTCited in: 7. Acute Management and Exacerbation Rescue, 11. Prognosis and Natural History
  191. [191]

    Tong BK, Stewart GM, Dissanayake H et al.. “Feasibility and impact of personalized therapy for obstructive sleep apnea in patients with acute coronary syndrome: a pilot randomized controlled trial.” Pilot and feasibility studies (2026). PMID: 42243889 ↗

    L1RCTCited in: 7. Acute Management and Exacerbation Rescue, 11. Prognosis and Natural History
  192. [192]

    Zhao M, Wang L, Qin B et al.. “Efficacy and safety of atomoxetine combination therapy for obstructive sleep apnea: A meta-analysis of randomized placebo-controlled trials.” Sleep medicine (2026). PMID: 42269187 ↗

    L1SR_OBSCited in: 7. Acute Management and Exacerbation Rescue, 11. Prognosis and Natural History
  193. [193]

    Attaway AH, Mehra R, Zein JG et al.. “Nocturnal Hypoxemia Is Associated with Sarcopenia in Patients with Chronic Obstructive Pulmonary Disease.” Annals of the American Thoracic Society (2024). PMID: 38843487 ↗

    L2OTHERCited in: 7. Acute Management and Exacerbation Rescue
  194. [194]

    Gomes B, Esquinas AM, Alwajeeh FN. “Non-invasive ventilation in severe acute respiratory failure complicating Madelung's disease: a case series and management review.” Frontiers in medicine (2026). PMID: 42328573 ↗

    L4CASE_REPORTCited in: 7. Acute Management and Exacerbation Rescue
  195. [195]

    Parthasarathy S, Wendel C, Grandner MA et al.. “Peer-Driven Intervention for Care Coordination and Adherence Promotion for Obstructive Sleep Apnea: A Randomized, Parallel-Group Clinical Trial.” American journal of respiratory and critical care medicine (2025). PMID: 39441133 ↗

    L1RCTCited in: 8. Long-term and Definitive Management, 11. Prognosis and Natural History
  196. [196]

    Zinchuk AV, Chu JH, Liang J et al.. “Physiological Traits and Adherence to Sleep Apnea Therapy in Individuals with Coronary Artery Disease.” American journal of respiratory and critical care medicine (2021). PMID: 34156917 ↗

    L2RCTCited in: 8. Long-term and Definitive Management
  197. [197]

    Strollo PJ, Hedner J, Collop N et al.. “Solriamfetol for the Treatment of Excessive Sleepiness in OSA: A Placebo-Controlled Randomized Withdrawal Study.” Chest (2018). PMID: 30471270 ↗

    L1RCTCited in: 8. Long-term and Definitive Management
  198. [198]

    de Oliveira ACT, Martinez D, Vasconcelos LFT et al.. “Diagnosis of obstructive sleep apnea syndrome and its outcomes with home portable monitoring.” Chest (2009). PMID: 19201709 ↗

    L2RCTCited in: 8. Long-term and Definitive Management
  199. [199]

    Coruzzi P, Gualerzi M, Bernkopf E et al.. “Autonomic cardiac modulation in obstructive sleep apnea: effect of an oral jaw-positioning appliance.” Chest (2006). PMID: 17099011 ↗

    L4TRIAL_NONRANDOMCited in: 8. Long-term and Definitive Management
  200. [200]

    Lorenzi-Filho G, Cruz FCSG, Queiróz DBC et al.. “Effects of Continuous Positive Airway Pressure on Central and Peripheral Blood Pressure in Patients with Uncontrolled Hypertension and Obstructive Sleep Apnea: The Randomized Controlled MORPHEOS Clinical Trial.” Annals of the American Thoracic Society (2025). PMID: 39879540 ↗

    L1RCTCited in: 8. Long-term and Definitive Management, History and Evolution of Treatment
  201. [201]

    Tsou PY, Alex RM, Redline S et al.. “Pathophysiological Traits in Pediatric Obstructive Sleep Apnea. Associations with Patient Characteristics and Responses to Therapy: A Secondary Analysis of the CHAT Clinical Trial.” Annals of the American Thoracic Society (2025). PMID: 40720163 ↗

    L2RCTCited in: 8. Long-term and Definitive Management, History and Evolution of Treatment, 12. Special Populations & Pregnancy
  202. [202]

    Shah R, Patel N, Emin M et al.. “Statins Restore Endothelial Protection against Complement Activity in Obstructive Sleep Apnea: A Randomized Clinical Trial.” Annals of the American Thoracic Society (2023). PMID: 36912897 ↗

    L1RCTCited in: 8. Long-term and Definitive Management, History and Evolution of Treatment
  203. [203]

    Murase K, Tanizawa K, Minami T et al.. “A Randomized Controlled Trial of Telemedicine for Long-Term Sleep Apnea Continuous Positive Airway Pressure Management.” Annals of the American Thoracic Society (2020). PMID: 31689141 ↗

    L1RCTCited in: 8. Long-term and Definitive Management, History and Evolution of Treatment
  204. [204]

    Fridriksson B, Berndtson M, Hamnered H et al.. “Beneficial Effects of Early Intervention Telemedicine-based Follow-Up in Sleep Apnea: A Randomized Controlled Multicenter Trial.” Annals of the American Thoracic Society (2023). PMID: 37463309 ↗

    L1RCTCited in: 8. Long-term and Definitive Management, History and Evolution of Treatment
  205. [205]

    Lichtblau M, Schwarz EI, Ulrich T et al.. “Effect of an Overnight Stay at 2,500 Meters on Nocturnal Hypoxemia and Sleep-disordered Breathing in Patients with Pulmonary Vascular Disease: A Randomized Clinical Trial.” Annals of the American Thoracic Society (2025). PMID: 40085143 ↗

    L1RCTCited in: 8. Long-term and Definitive Management, History and Evolution of Treatment, 10. Complications
  206. [206]

    Chowdhuri S, Quan SF, Almeida F et al.. “An Official American Thoracic Society Research Statement: Impact of Mild Obstructive Sleep Apnea in Adults.” American journal of respiratory and critical care medicine (2016). PMID: 27128710 ↗

    L1REVIEW_NARRATIVECited in: 8. Long-term and Definitive Management, 10. Complications
  207. [207]

    Cade BE, Chen H, Stilp AM et al.. “Genetic Associations with Obstructive Sleep Apnea Traits in Hispanic/Latino Americans.” American journal of respiratory and critical care medicine (2016). PMID: 26977737 ↗

    L2OTHERCited in: 8. Long-term and Definitive Management
  208. [208]

    Efune PN, Nakonezny PA, Pinales P et al.. “Effect of neuromuscular blockade on opioid consumption in high-risk children undergoing adenotonsillectomy: A randomized-controlled trial.” Journal of clinical anesthesia (2026). PMID: 42107449 ↗

    L1RCTCited in: 8. Long-term and Definitive Management, History and Evolution of Treatment, 10. Complications
  209. [209]

    Kung SC, Shen YC, Wang HM et al.. “Investigating the effects of CPAP/BiPAP therapy on cognitive function and reaction time in patients with obesity hypoventilation syndrome.” Respiratory physiology & neurobiology (2026). PMID: 42150628 ↗

    L1RCTCited in: 8. Long-term and Definitive Management, History and Evolution of Treatment
  210. [210]

    Gupta AK, Narula V, Sharma S et al.. “Comparative effectiveness of Mandibular advancement devices and Continuous positive airway pressure in adults with obstructive sleep Apnea: A systematic review and meta-analysis.” Sleep medicine (2026). PMID: 42287974 ↗

    L1SR_OBSCited in: 8. Long-term and Definitive Management
  211. [211]

    Moffa A, Nardelli D, Iafrati F et al.. “What do patients want for their sleep apnea? A systematic review of treatment choice and preference drivers.” Sleep & breathing = Schlaf & Atmung (2026). PMID: 42274931 ↗

    L2SR_OBSCited in: 8. Long-term and Definitive Management
  212. [212]

    Zhang Y, Wang J, Zhang J et al.. “Comparative efficacy of positive airway pressure-based combination therapy in comorbid insomnia and sleep apnea: A systematic review and network meta-analysis.” Sleep medicine reviews (2026). PMID: 42107468 ↗

    L1SR_OBSCited in: 8. Long-term and Definitive Management
  213. [213]

    Tseng JJ, Wang JJ, Lin MC et al.. “Long-term health outcomes of pediatric obstructive sleep apnea: A 10-year multicenter cohort study.” Sleep medicine (2026). PMID: 42127725 ↗

    L2COHORTCited in: 8. Long-term and Definitive Management, 12. Special Populations & Pregnancy
  214. [214]

    Cunningham TJ, Kishore D, Guo M et al.. “The Effect of Obstructive Sleep Apnea on Sleep-dependent Emotional Memory Consolidation.” Annals of the American Thoracic Society (2023). PMID: 36250951 ↗

    L4OTHERCited in: 8. Long-term and Definitive Management
  215. [215]

    Berry RB, Kouchi K, Bower J et al.. “Triazolam in patients with obstructive sleep apnea.” American journal of respiratory and critical care medicine (1995). PMID: 7842205 ↗

    L1RCTCited in: History and Evolution of Treatment
  216. [216]

    Mulloy E, McNicholas WT. “Theophylline in obstructive sleep apnea. A double-blind evaluation.” Chest (1992). PMID: 1541143 ↗

    L1RCTCited in: History and Evolution of Treatment
  217. [217]

    Collop NA. “Medroxyprogesterone acetate and ethanol-induced exacerbation of obstructive sleep apnea.” Chest (1994). PMID: 8082361 ↗

    L1RCTCited in: History and Evolution of Treatment
  218. [218]

    Brownell LG, West P, Sweatman P et al.. “Protriptyline in obstructive sleep apnea: a double-blind trial.” The New England journal of medicine (1982). PMID: 6750396 ↗

    L1RCTCited in: History and Evolution of Treatment
  219. [219]

    Simantirakis EN, Schiza SE, Chrysostomakis SI et al.. “Atrial overdrive pacing for the obstructive sleep apnea-hypopnea syndrome.” The New England journal of medicine (2005). PMID: 16354893 ↗

    L2RCTCited in: History and Evolution of Treatment
  220. [220]

    Garrigue S, Bordier P, Jaïs P et al.. “Benefit of atrial pacing in sleep apnea syndrome.” The New England journal of medicine (2002). PMID: 11832528 ↗

    L2RCTCited in: History and Evolution of Treatment
  221. [221]

    Kaneko Y, Floras JS, Usui K et al.. “Cardiovascular effects of continuous positive airway pressure in patients with heart failure and obstructive sleep apnea.” The New England journal of medicine (2003). PMID: 12660387 ↗

    L1RCTCited in: History and Evolution of Treatment
  222. [222]

    Brown KM, Malow BA. “Pediatric Insomnia.” Chest (2016). PMID: 26378738 ↗

    L5REVIEW_NARRATIVECited in: History and Evolution of Treatment, 12. Special Populations & Pregnancy
  223. [223]

    Fernández-Barriales M, López de Luzuriaga M, Lafuente-Ibáñez de Mendoza I et al.. “Controlled Prospective Evidence of Rapid Maxillary Expansion Efficacy in Pediatric Obstructive Sleep Apnea: A Systematic Review Update.” Journal of clinical medicine (2026). PMID: 42074778 ↗

    L1SR_OBSCited in: History and Evolution of Treatment
  224. [224]

    Mendelson WB. “Sleepiness and hypertension in obstructive sleep apnea.” Chest (1992). PMID: 1555460 ↗

    L2OTHERCited in: History and Evolution of Treatment
  225. [225]

    Sorajja D, Gami AS, Somers VK et al.. “Independent association between obstructive sleep apnea and subclinical coronary artery disease.” Chest (2008). PMID: 18263678 ↗

    L2OTHERCited in: History and Evolution of Treatment
  226. [226]

    Guilleminault C, Motta J, Mihm F et al.. “Obstructive sleep apnea and cardiac index.” Chest (1986). PMID: 3948544 ↗

    L4OTHERCited in: History and Evolution of Treatment
  227. [227]

    Kaw R, Pasupuleti V, Walker E et al.. “Postoperative complications in patients with obstructive sleep apnea.” Chest (2011). PMID: 21868464 ↗

    L2OTHERCited in: History and Evolution of Treatment, 12. Special Populations & Pregnancy
  228. [228]

    Fank F, Artismo RS, Rocha AR et al.. “Effects of combined exercise and sleep hygiene on obstructive sleep apnea severity in older adults: a randomized controlled trial.” Sleep medicine (2026). PMID: 42025100 ↗

    L1RCTCited in: History and Evolution of Treatment
  229. [229]

    Malhotra A, Schwartz AR, Lovett E et al.. “Proximal Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea in the OSPREY Study : A Randomized Controlled Trial.” Annals of internal medicine (2026). PMID: 42008810 ↗

    L1RCTCited in: History and Evolution of Treatment
  230. [230]

    Peker Y, Glantz H, Thunström E et al.. “CPAP does not modify exercise-derived autonomic responses in nonsleepy patients with coronary artery disease and obstructive sleep apnea.” Sleep medicine (2026). PMID: 41980537 ↗

    L1RCTCited in: History and Evolution of Treatment
  231. [231]

    Andrews ND, El Ahdab J, Pascoe M et al.. “What's leak got to do with it? Association of mask leak and positive airway pressure adherence from the homepap study.” Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine (2026). PMID: 41963755 ↗

    L1RCTCited in: History and Evolution of Treatment
  232. [232]

    Al-Rawi NH, Elsayed W, Al-Bayati SF et al.. “Artificial intelligence applications in CBCT-based assessment of craniofacial airway volume and shape in sleep-disordered breathing: a systematic review.” PeerJ (2026). PMID: 42328666 ↗

    L2SR_OBSCited in: History and Evolution of Treatment
  233. [233]

    Birnbaum S. “Pulse oximetry: identifying its applications, coding, and reimbursement.” Chest (2009). PMID: 19265093 ↗

    L5OTHERCited in: 9. Respiratory Support, Procedures & Interventional Pulmonology (Specialty-Distinctive)
  234. [234]

    Shen H, Xu Y, Zhang Y et al.. “Efficacy of pulmonary rehabilitation in patients with chronic obstructive pulmonary disease and obstructive sleep apnea; a randomized controlled trial.” Journal of rehabilitation medicine (2024). PMID: 39318173 ↗

    L1RCTCited in: 9. Respiratory Support, Procedures & Interventional Pulmonology (Specialty-Distinctive)
  235. [235]

    Erturk N, Celik A, Kahraman Yaman S et al.. “Expiratory muscle strength training reduces oxidative stress and systemic inflammation in men with obstructive sleep apnea syndrome: a double-blinded, randomized parallel trial.” Sleep (2024). PMID: 39297486 ↗

    L1RCTCited in: 9. Respiratory Support, Procedures & Interventional Pulmonology (Specialty-Distinctive)
  236. [236]

    Neumannova K, Hobzova M, Sova M et al.. “Pulmonary rehabilitation and oropharyngeal exercises as an adjunct therapy in obstructive sleep apnea: a randomized controlled trial.” Sleep medicine (2018). PMID: 30292081 ↗

    L1RCTCited in: 9. Respiratory Support, Procedures & Interventional Pulmonology (Specialty-Distinctive)
  237. [237]

    Jurado-García A, Molina-Recio G, Feu-Collado N et al.. “Effect of a Graduated Walking Program on the Severity of Obstructive Sleep Apnea Syndrome. A Randomized Clinical Trial.” International journal of environmental research and public health (2020). PMID: 32878112 ↗

    L1RCTCited in: 9. Respiratory Support, Procedures & Interventional Pulmonology (Specialty-Distinctive)
  238. [238]

    Soler X, Gaio E, Powell FL et al.. “High Prevalence of Obstructive Sleep Apnea in Patients with Moderate to Severe Chronic Obstructive Pulmonary Disease.” Annals of the American Thoracic Society (2015). PMID: 25871443 ↗

    L2OTHERCited in: 9. Respiratory Support, Procedures & Interventional Pulmonology (Specialty-Distinctive)
  239. [239]

    Gupta S, Kumar R, Gupta NK et al.. “Effect of high flow nasal cannula versus conventional nasal cannula oxygen therapy in patients undergoing endobronchial ultrasound-guided transbronchial needle aspiration.” Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace (2025). PMID: 39968686 ↗

    L1RCTCited in: 9. Respiratory Support, Procedures & Interventional Pulmonology (Specialty-Distinctive)
  240. [240]

    Arwas N, Goldbart A, Aviram M et al.. “Flexible bronchoscopy in pediatric patients with Down syndrome: A case-control study of the indications, findings, and complications.” Pediatric pulmonology (2023). PMID: 36811243 ↗

    L3CASE_CONTROLCited in: 9. Respiratory Support, Procedures & Interventional Pulmonology (Specialty-Distinctive)
  241. [241]

    Lima E, Nakamura MAM, Genta PR et al.. “Improving Airways Patency and Ventilation Through Optimal Positive Pressure Identified by Noninvasive Mechanical Ventilation Titration in Mounier-Kuhn Syndrome: Protocol for an Interventional, Open-Label, Single-Arm Clinical Trial.” JMIR research protocols (2020). PMID: 32795996 ↗

    L5TRIAL_NONRANDOMCited in: 9. Respiratory Support, Procedures & Interventional Pulmonology (Specialty-Distinctive)
  242. [242]

    Commesso EA, Paoletti MF, Kezirian EJ. “Hypoglossal Nerve Stimulation Respiratory Lead Migration: MAUDE Database Review and Case Report.” OTO open (2025). PMID: 40511388 ↗

    L4CASE_REPORTCited in: 9. Respiratory Support, Procedures & Interventional Pulmonology (Specialty-Distinctive)
  243. [243]

    Zhang Q, Qin Z, Hu R et al.. “A rare early-onset neonatal case of Birk-Barel syndrome presenting severe obstructive sleep apnea: a case report.” Frontiers in medicine (2023). PMID: 37358997 ↗

    L4CASE_REPORTCited in: 9. Respiratory Support, Procedures & Interventional Pulmonology (Specialty-Distinctive)
  244. [244]

    Liang H, Hou Y, Wei H et al.. “Supraglottic jet oxygenation and ventilation assisted fiberoptic intubation in a paralyzed patient with morbid obesity and obstructive sleep apnea: a case report.” BMC anesthesiology (2019). PMID: 30894124 ↗

    L4CASE_REPORTCited in: 9. Respiratory Support, Procedures & Interventional Pulmonology (Specialty-Distinctive)
  245. [245]

    Berger K, Braverman G, Siltumens A et al.. “Care of the Patient with Interstitial Lung Disease Perioperatively.” Current rheumatology reports (2026). PMID: 42059971 ↗

    L5REVIEW_NARRATIVECited in: 9. Respiratory Support, Procedures & Interventional Pulmonology (Specialty-Distinctive)
  246. [246]

    De Jong A, Molinari N, Terzi N et al.. “Early identification of patients at risk for difficult intubation in the intensive care unit: development and validation of the MACOCHA score in a multicenter cohort study.” American journal of respiratory and critical care medicine (2013). PMID: 23348979 ↗

    L2TRIAL_NONRANDOMCited in: 10. Complications
  247. [247]

    Ulrich S, Fischler M, Speich R et al.. “Sleep-related breathing disorders in patients with pulmonary hypertension.” Chest (2008). PMID: 18339776 ↗

    L4TRIAL_NONRANDOMCited in: 10. Complications
  248. [248]

    García-Sánchez A, Villalaín-Rodes I, Jaureguizar A et al.. “Continuous Positive Airway Pressure Effect on Progression of Retinal Disease in Patients with Sleep Apnea and Nonproliferative Diabetic Retinopathy: A Randomized Clinical Trial.” Annals of the American Thoracic Society (2024). PMID: 37793101 ↗

    L1RCTCited in: 10. Complications
  249. [249]

    Gozal D, Kheirandish-Gozal L. “Cardiovascular morbidity in obstructive sleep apnea: oxidative stress, inflammation, and much more.” American journal of respiratory and critical care medicine (2007). PMID: 17975198 ↗

    L5REVIEW_NARRATIVECited in: 10. Complications
  250. [250]

    Mason RH, Ruegg G, Perkins J et al.. “Obstructive sleep apnea in patients with abdominal aortic aneurysms: highly prevalent and associated with aneurysm expansion.” American journal of respiratory and critical care medicine (2010). PMID: 20622036 ↗

    L3OTHERCited in: 10. Complications, 13. Prevention, Screening & Surveillance
  251. [251]

    Lagravinese G, Santacesaria P, Castellana G et al.. “EEG patterns and cognitive outcomes in chronic respiratory disorders: a systematic review.” Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology (2026). PMID: 42349048 ↗

    L2SR_OBSCited in: 10. Complications
  252. [252]

    Rebibo L, Tropeano AI, Vilfaillot A et al.. “Same-day discharge sleeve gastrectomy in France on the last decade: a nationwide cohort study on safety and patient selection.” Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery (2026). PMID: 42270484 ↗

    L2COHORTCited in: 10. Complications, 11. Prognosis and Natural History
  253. [253]

    Li Y, Zhang R, Li N et al.. “The impact of dexmedetomidine on postoperative delirium in obstructive sleep apnea patients (DPOD-OSA): study protocol for a prospective randomized controlled trial.” Trials (2026). PMID: 42144647 ↗

    L5TRIAL_NONRANDOMCited in: 10. Complications
  254. [254]

    Collaco JM, McGrath-Morrow SA. “Respiratory Phenotypes for Preterm Infants, Children, and Adults: Bronchopulmonary Dysplasia and More.” Annals of the American Thoracic Society (2018). PMID: 29328889 ↗

    L5REVIEW_NARRATIVECited in: 10. Complications, 12. Special Populations & Pregnancy
  255. [255]

    May AM. “Sleep-disordered Breathing and Inpatient Outcomes in Nonsurgical Patients: Analysis of the Nationwide Inpatient Cohort.” Annals of the American Thoracic Society (2023). PMID: 37748082 ↗

    L2OTHERCited in: 10. Complications
  256. [256]

    Manthous CA, Mokhlesi B. “Avoiding Management Errors in Patients with Obesity Hypoventilation Syndrome.” Annals of the American Thoracic Society (2016). PMID: 26512908 ↗

    L5OTHERCited in: 10. Complications
  257. [257]

    Ayas NT, Laratta CR, Coleman JM et al.. “Knowledge Gaps in the Perioperative Management of Adults with Obstructive Sleep Apnea and Obesity Hypoventilation Syndrome. An Official American Thoracic Society Workshop Report.” Annals of the American Thoracic Society (2018). PMID: 29388810 ↗

    L5OTHERCited in: 10. Complications
  258. [258]

    Pepin JL, Herquelot E, Denis H et al.. “Mortality impact of long-term home non-invasive ventilation in COPD patients with versus without obstructive sleep apnea.” Annals of the American Thoracic Society (2026). PMID: 41915562 ↗

    L2OTHERCited in: 10. Complications
  259. [259]

    Fitriana F, Hariri F, Sng JHT et al.. “Midface Advancement Surgery and Its Effects on Upper Airway Function and Obstructive Sleep Apnea Status in Children With Syndromic Craniosynostosis: A Systematic Review.” The Journal of craniofacial surgery (2026). PMID: 42228493 ↗

    L5SR_OBSCited in: 10. Complications, 12. Special Populations & Pregnancy
  260. [260]

    Cakmak Demir S, Batman A, Yazici D et al.. “Association of High-Risk Obstructive Sleep Apnea with Microvascular Complications in Adults with Type 1 Diabetes Mellitus: A Case-Control Study.” Journal of clinical medicine (2026). PMID: 42074704 ↗

    L3CASE_CONTROLCited in: 10. Complications
  261. [261]

    Moioli D, Cesana G, Ciccarese F et al.. “Single Anastomosis Sleeve Ileal Bypass Could Be the Future of Redo Surgery? A Single-Center Cohort Study.” Journal of laparoendoscopic & advanced surgical techniques. Part A (2026). PMID: 42120341 ↗

    L2COHORTCited in: 10. Complications
  262. [262]

    Gonçalves SC, Martinez D, Gus M et al.. “Obstructive sleep apnea and resistant hypertension: a case-control study.” Chest (2007). PMID: 18079220 ↗

    L3CASE_CONTROLCited in: 11. Prognosis and Natural History
  263. [263]

    Bhattacharjee R, Kheirandish-Gozal L, Spruyt K et al.. “Adenotonsillectomy outcomes in treatment of obstructive sleep apnea in children: a multicenter retrospective study.” American journal of respiratory and critical care medicine (2010). PMID: 20448096 ↗

    L2COHORTCited in: 12. Special Populations & Pregnancy
  264. [264]

    Kheirandish-Gozal L, Bandla HP, Gozal D. “Montelukast for Children with Obstructive Sleep Apnea: Results of a Double-Blind, Randomized, Placebo-Controlled Trial.” Annals of the American Thoracic Society (2016). PMID: 27439031 ↗

    L1RCTCited in: 12. Special Populations & Pregnancy
  265. [265]

    Panyarath P, Goldscher N, Pamidi S et al.. “Positive Airway Pressure Treatment of Obstructive Sleep Apnea-Hypopnea in Hypertensive Disorders of Pregnancy: A Pilot Randomized Proof-of-Concept Clinical Trial.” Annals of the American Thoracic Society (2024). PMID: 38252423 ↗

    L1RCTCited in: 12. Special Populations & Pregnancy
  266. [266]

    Ievers-Landis CE, Redline S. “Pediatric sleep apnea: implications of the epidemic of childhood overweight.” American journal of respiratory and critical care medicine (2006). PMID: 17158283 ↗

    L5REVIEW_NARRATIVECited in: 12. Special Populations & Pregnancy
  267. [267]

    Hornero R, Kheirandish-Gozal L, Gutiérrez-Tobal GC et al.. “Nocturnal Oximetry-based Evaluation of Habitually Snoring Children.” American journal of respiratory and critical care medicine (2017). PMID: 28759260 ↗

    L2OTHERCited in: 12. Special Populations & Pregnancy
  268. [268]

    Gozal D, Capdevila OS, Kheirandish-Gozal L. “Metabolic alterations and systemic inflammation in obstructive sleep apnea among nonobese and obese prepubertal children.” American journal of respiratory and critical care medicine (2008). PMID: 18276939 ↗

    L3OTHERCited in: 12. Special Populations & Pregnancy
  269. [269]

    Kheirandish-Gozal L, Bhattacharjee R, Kim J et al.. “Endothelial progenitor cells and vascular dysfunction in children with obstructive sleep apnea.” American journal of respiratory and critical care medicine (2010). PMID: 20203242 ↗

    L3OTHERCited in: 12. Special Populations & Pregnancy
  270. [270]

    Tarasiuk A, Greenberg-Dotan S, Simon-Tuval T et al.. “Elevated morbidity and health care use in children with obstructive sleep apnea syndrome.” American journal of respiratory and critical care medicine (2006). PMID: 17038661 ↗

    L3OTHERCited in: 12. Special Populations & Pregnancy
  271. [271]

    Kim J, Bhattacharjee R, Khalyfa A et al.. “DNA methylation in inflammatory genes among children with obstructive sleep apnea.” American journal of respiratory and critical care medicine (2011). PMID: 22077067 ↗

    L3OTHERCited in: 12. Special Populations & Pregnancy
  272. [272]

    Khalyfa A, Gharib SA, Kim J et al.. “Transcriptomic analysis identifies phosphatases as novel targets for adenotonsillar hypertrophy of pediatric obstructive sleep apnea.” American journal of respiratory and critical care medicine (2010). PMID: 20093640 ↗

    L3OTHERCited in: 12. Special Populations & Pregnancy
  273. [273]

    Dayyat E, Kheirandish-Gozal L, Sans Capdevila O et al.. “Obstructive sleep apnea in children: relative contributions of body mass index and adenotonsillar hypertrophy.” Chest (2009). PMID: 19225059 ↗

    L3OTHERCited in: 12. Special Populations & Pregnancy
  274. [274]

    Verhulst SL, Aerts L, Jacobs S et al.. “Sleep-disordered breathing, obesity, and airway inflammation in children and adolescents.” Chest (2008). PMID: 18689597 ↗

    L3OTHERCited in: 12. Special Populations & Pregnancy
  275. [275]

    Sharma SK, Kumpawat S, Banga A et al.. “Prevalence and risk factors of obstructive sleep apnea syndrome in a population of Delhi, India.” Chest (2006). PMID: 16840395 ↗

    L2OTHERCited in: 12. Special Populations & Pregnancy
  276. [276]

    Yao J, Jin T, Huang A et al.. “Tympanocentesis or not? A prospective cohort study for obstructive sleep apnea children in conjunction with asymptomatic otitis media with effusion.” Frontiers in medicine (2026). PMID: 42205832 ↗

    L2COHORTCited in: 12. Special Populations & Pregnancy
  277. [277]

    Qin J, Zhang J, Ge M et al.. “Associations of Preoperative HMGB-1 and Systemic Immune-Inflammation Index with Short-Term Behavioral Improvement After Adenotonsillectomy in Children with OSAHS.” Journal of inflammation research (2026). PMID: 42199628 ↗

    L2TRIAL_NONRANDOMCited in: 12. Special Populations & Pregnancy
  278. [278]

    Wang R, Dong Y, Weng J et al.. “Associations among Neighborhood, Race, and Sleep Apnea Severity in Children. A Six-City Analysis.” Annals of the American Thoracic Society (2017). PMID: 27768852 ↗

    L3OTHERCited in: 12. Special Populations & Pregnancy
  279. [279]

    Izci Balserak B, Pien GW, Prasad B et al.. “Obstructive Sleep Apnea Is Associated with Newly Diagnosed Gestational Diabetes Mellitus.” Annals of the American Thoracic Society (2020). PMID: 32040334 ↗

    L3OTHERCited in: 12. Special Populations & Pregnancy
  280. [280]

    Goswami U, Ensrud KE, Paudel ML et al.. “Vitamin D Concentrations and Obstructive Sleep Apnea in a Multicenter Cohort of Older Males.” Annals of the American Thoracic Society (2016). PMID: 26845389 ↗

    L4OTHERCited in: 12. Special Populations & Pregnancy
  281. [281]

    Li Q, Zhong Q, Kong X et al.. “Allergic rhinitis in children in relation to sleep breathing disorders: a meta-analysis.” International journal of pediatric otorhinolaryngology (2026). PMID: 42302637 ↗

    L1SR_OBSCited in: 12. Special Populations & Pregnancy
  282. [282]

    Zhang J, Zhang Y, Li H. “Risk factors for residual obstructive sleep apnea after adenotonsillectomy in children: A single-center retrospective cohort study.” American journal of otolaryngology (2026). PMID: 42349273 ↗

    L3COHORTCited in: 12. Special Populations & Pregnancy, 13. Prevention, Screening & Surveillance
  283. [283]

    Cano-Valls A, Martinez Monblan MA, Carro-Fernández E et al.. “NURSE-Led Care in Patients Undergoing Catheter Ablation for Atrial Fibrillation: The NURSECAT-AF Randomized Trial.” Circulation. Arrhythmia and electrophysiology (2026). PMID: 41744095 ↗

    L1RCTCited in: 13. Prevention, Screening & Surveillance
  284. [284]

    Ward SA, Storey E, Naughton MT et al.. “Obstructive sleep apnea and cerebral small vessel disease in community-based older people: an aspirin in reducing events in the elderly imaging substudy.” Sleep (2025). PMID: 39301859 ↗

    L2RCTCited in: 13. Prevention, Screening & Surveillance
  285. [285]

    Mauries S, Rolland B, Mallevays M et al.. “Conditions of sleep restoration after smoking cessation: A systematic review.” Sleep medicine reviews (2024). PMID: 39893864 ↗

    L5SR_OBSCited in: 13. Prevention, Screening & Surveillance
  286. [286]

    Adal O, Mamo ST, Belay AE et al.. “The prevalence of asthma and its predictor among patients presetting in Ethiopian public hospitals: systematic review and meta-analysis, 2024.” Therapeutic advances in respiratory disease (2024). PMID: 39235440 ↗

    L1SR_OBSCited in: 13. Prevention, Screening & Surveillance
  287. [287]

    Garabedian C, Sénat MV, Sananès N et al.. “[Preexisting diabetes: Expert consensus from the College of French Gynecologists and Obstetricians and from the French Society of Diabetology].” Gynecologie, obstetrique, fertilite & senologie (2025). PMID: 41365423 ↗

    L1GUIDELINECited in: 13. Prevention, Screening & Surveillance
  288. [288]

    Cho J, Kim JH, Kim YH et al.. “Obstructive Sleep Apnea Screening and Effects of Surgery in Acromegaly: A Prospective Study.” Endocrinology and metabolism (Seoul, Korea) (2024). PMID: 38918903 ↗

    L2COHORTCited in: 13. Prevention, Screening & Surveillance
  289. [289]

    Strausz S, Agafonova E, Tiullinen V et al.. “Genetic Analysis of Obstructive Sleep Apnea and Its Relationship with Severe COVID-19.” Annals of the American Thoracic Society (2024). PMID: 38330144 ↗

    L2OTHERCited in: 13. Prevention, Screening & Surveillance
  290. [290]

    Donovan LM, Wai T, Spece LJ et al.. “Sleep Testing and Mortality in a Propensity-matched Cohort of Patients with Chronic Obstructive Pulmonary Disease.” Annals of the American Thoracic Society (2023). PMID: 37579136 ↗

    L3OTHERCited in: 13. Prevention, Screening & Surveillance
  291. [291]

    . “[Guidelines for the diagnosis and treatment of obstructive sleep apnea in adults (2025)].” Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases (2026). PMID: 41820035 ↗

    L1GUIDELINECited in: 13. Prevention, Screening & Surveillance
  292. [292]

    Cheung E, Shang Y, Kong L et al.. “Performance of obstructive sleep apnea screening questionnaires in hospitalized patients with heart failure.” Sleep medicine (2026). PMID: 42413232 ↗

    L4OTHERCited in: 13. Prevention, Screening & Surveillance

Revision History

All updates applied to this page

Loading revisions…