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Obstructive Sleep Apnoea


The prevalence of OSA in middle aged and older people is high but does not always produce symptoms or require treatment.

OSA, defined as an apnoea hypopnea index > 15 events per hour on a sleep study, affects ~20% of the population, while simple snoring which is highly prevalent affects 30% of the adult population (See Presentation & Risk Factors)1, 2 The prevalence of obstructive sleep apnoea syndrome (OSAS) - defined as AHI ≥ 5 events per hour combined with symptoms e.g. excessive daytime sleepiness (International Classification of Sleep Disorders (ICSD-3) criteria) - affects 2-5% of the general middle-aged population. The Australian MAILES study reported that 14% of men had moderate-severe OSA while 2% of men had OSA and excessive daytime sleepiness.3

Of Note, the prevalence of OSA in the general population, especially in older adults (ages 65-79 years), based on the standard criteria of an apnoea-hypopnoea index (AHI) cut-off of ≥ 5, is very high. Therefore the a priori chance of a positive diagnosis of OSA is high. OSA per definition does not compel medical treatment as a large proportion of people with OSA, based on AHI ≥ 5 are asymptomatic. As such, people with OSAS, i.e. AHI > 15 or > 30 when aged 65 years old or more, with daytime sleepiness symptoms and/or cardiometabolic comorbidities and/or impact of OSA on their quality of life, will likely benefit most from medical treatment.

OSA costs the Australian community an estimated $26 billion annually including direct health costs, cardiovascular complications and loss of productivity.4


AHI - Apnoea-Hypopnoea Index
BBTi - Brief Behavioural Therapy for Insomnia
BMI - Body Mass Index (kg/m2)
BQ - Berlin Questionnaire
CBTi - Cognitive Behavioural Therapy for Insomnia
CELL - Coblation Endoscopic Lingual Lightening
COPD - Chronic Obstructive Pulmonary Disease
CVA - Cerebrovascular Accident
CPAP - Continuous Positive Airway Pressure
CSA - Central Sleep Apnoea
DASS - Depression Anxiety Stress Scale
DBAS - Dysfunctional Beliefs and Attitudes about Sleep
DBP - Diastolic Blood Pressure
DIMS - Difficulties Initiating and/or Maintaining Sleep
DISE - Drug-Induced Sleep Endoscopy
DISS - Daytime Insomnia Symptom Scale
ENT - Ear Nose and Throat
ESS - Epworth Sleepiness Scale
FOSQ - Functional Outcomes of Sleep Questionnaire
FSH - Follicle-Stimulating Hormone
FTP - Friedman Tong Position
GP - General Practitioner
HANDI - RACGP Handbook of Non-Drug Interventions
HGNS - Hypoglossal Herve Htimulation
ISI - Insomnia Severity Index
K10 - Kessler Psychological Distress Scale
MAD - Mandibular Advancement Device
MAS - Mandibular Advancement Rplint
MBS - Medicare Benefits Schedule
MMA - Maxillomandibular Advancement Surgery
MRA - Mandibular Repositioning Appliance
ODI - Oxygenation Desaturation Index
OSA - Obstructive Sleep Apnoea
PLMD - Periodic Limb Movement Disorder
PT - Positional Therapy
PTSD - Post-Traumatic Stress Disorder
PSG - Polysomnography
QSQ - Quebec Sleep Questionnaire
REM - Rapid Eye Movement
RFTB - Radiofrequency Thermotherapy of the Tongue Base
SBP - Systolic Blood Pressure
SCI - Sleep Condition Indicator
SE - Sleep Efficiency
SF36 - Short-Form (36) Health Survey
SMILE - Submucosal Minimally Invasive Lingual Excision
SNRIs - Serotonin-Norepinephrine Reuptake Inhibitors
SOL - Sleep Onset Latency
SSRI - Selective Serotonin Reuptake Inhibitors
TFTs - Thyroid Function Tests
TIB - Time In Bed
TORS - Transoral Robotic Surgery
TST - Total Sleep Time
UPPP - Uvulopalatopharyngoplasty
WASO - Wake After Sleep Onset

Quick links


  1. Heinzer R, et al. Prevalence of sleep-disordered breathing in the general population: the HypnoLaus study. Lancet Respir Med 2015;3(4):310-8
  2. Adams R, et al. High prevalence of undiagnosed OSA in a community sample of men aged 40 years and over. Sleep Biol Rhythms 2012;Suppl 1:62
  3. Carol Lang, et al. Associations of Undiagnosed Obstructive Sleep Apnea and Excessive Daytime Sleepiness With Depression: An Australian Population Study. J Clin Sleep Med 2017;13(4):575-82
  4. Asleep on the job- Costs of inadequate sleep in Australia. Sleep Health Foundation, August 2017