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Editorials |

Treatment of Sleep Apnea : Unmet Needs

Peretz Lavie, PhD
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Affiliations: Haifa, Israel 
 ,  Dr. Lavie is the head of the Sleep Research Laboratory, Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology.

Correspondence to: Peretz Lavie, PhD, Israel Institute of Technology, Sleep Research Laboratory, Gutwirth Building, Technion City, Haifa 32000, Israel; e-mail: plavie@tx.technion.ac.il



Chest. 1999;116(6):1501-1503. doi:10.1378/chest.116.6.1501-a
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Judging by the number of publications and amount of media exposure allocated to sleep apnea syndrome, it is obvious that the awareness of sleep apnea as a major public health problem is no longer restricted to a small group of sleep specialists. Cognizance of the syndrome and its consequences has diffused to larger and larger circles of the medical community. The wide prevalence of the syndrome, its strong association with cardiovascular morbidity and mortality, and the relative ease by which diagnosis can be made have greatly influenced this process. In view of the fact that only 7 to 18% of the estimated 12 to 15 million persons having sleep apnea in the United States have had their conditions diagnosed so far,1 it can be safely predicted that the number of cases of sleep apnea diagnosed annually will be greatly accelerated in the coming years. Suitable diagnosis and treatment of such a large number of patients is not an easy task. In recent years, continuous positive airway pressure (CPAP) has become the main treatment modality in sleep apnea. There is convincing evidence that effective CPAP treatment can alleviate daytime and nighttime symptoms of the syndrome, such as sleepiness and fatigue, intellectual deterioration, and restless sleep.25 Furthermore, studies have been carried out demonstrating that CPAP treatment can reduce diurnal and nocturnal BP values, as well as waking levels of sympathetic nerve activity,67 and can acutely reduce plasma noradrenalin levels.8 Recently, this treatment was shown to be more effective in lowering BP than a sham CPAP treatment.9

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