Management of Obstructive Sleep Apnea (OSA) Across the Care Continuum: An Interdisciplinary Narrative Review
Abstract
Background: Obstructive Sleep Apnea (OSA) is a highly prevalent yet critically underdiagnosed disorder affecting nearly 1 billion adults globally. It represents a major public health burden, significantly increasing the risk of hypertension, atrial fibrillation, heart failure, stroke, and perioperative complications. Despite its systemic impact, OSA management remains fragmented, with poor coordination between primary care, diagnostic services, therapeutic support, and surgical specialties. Aim: This narrative review synthesizes evidence from 2010-2024 on integrated, multidisciplinary care models for OSA across the entire patient journey, from community screening to long-term management and perioperative safety. Methods: A comprehensive literature search of PubMed, Scopus, CINAHL, and Web of Science was conducted. Thematic analysis integrated findings from sleep medicine, cardiology, anesthesiology, primary care, and nursing literature. Results: Evidence strongly supports that coordinated care pathways—featuring systematic screening in primary care, efficient diagnostic testing, nurse-led titration and adherence programs, and proactive perioperative risk stratification—significantly improve diagnostic rates, positive airway pressure (PAP) adherence, cardiovascular outcomes, and reduce postoperative complications. The failure to integrate these disciplines leads to diagnostic delays, poor treatment adherence, and preventable morbidity. Conclusion: OSA must be managed as a chronic cardiovascular and perioperative risk condition, not an isolated breathing disorder. Effective care requires dismantling silos through standardized protocols, shared electronic health record tools, and dedicated interdisciplinary sleep teams to optimize patient outcomes and health system efficiency.
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Authors
Copyright (c) 2024 Fahd Sari K. Alsharari, Sattam Aali Alotaibi, Qoot Naif Ayad Alotaibi, Nasser Saad Hamed Aldossary, Wegdan Husain Ali Mubaraki, Yusra Ali Alatawi, Yousef Jamman Alharbi, Weam Ali Esmael Mobarky, Doaa Salim Hamid Alabsi, Ali Mousa Mobarki, Dr. Othman Mohammed Almousa, Hanan Ahmad Alghamdi
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