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Being obstructive in sleep apnoea: more of a drive than a load problem?
  1. Yuan-Ming Luo1,
  2. Michael I Polkey2
  1. 1 State Key Laboratory of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical College, Guangzhou, China
  2. 2 NIHR Respiratory BRU, Royal Brompton Hospital and National Heart and Lung Institute, London, UK
  1. Correspondence to Dr Yuan-Ming Luo, State Key Laboratory of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical College, Guangzhou, 510120, China; yuanmingluo9431{at}

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Obstructive sleep apnoea (OSA) is characterised by recurrent episodes of complete or partial obstruction of the upper airway during sleep. OSA syndrome (OSAS) is used when OSA is associated with symptoms such as excessive daytime sleepiness, anxiety and depression. OSAS is a common condition which is associated with several comorbidities. The prevalence of OSA and OSAS has increased globally over the past decade reflecting an increased prevalence of obesity. Currently, the mainstay of treatment for OSAS is continuous positive airway pressure (CPAP) applied via a nasal mask. CPAP therapy has a strong evidence base and has recently been endorsed in the UK by the National Institute of Clinical Excellence, yet it is seldom greeted by patients with enthusiasm and adherence rates in clinical practice remain suboptimal.1 Thus, there is great interest in alternative therapies for OSAS which entails understanding the underlying pathophysiology.

Absent airflow, apnoea and the related phenomenon of reduced airflow (hypopnea) causing arousal and sleep fragmentation is the hallmark of OSAS, yet the mechanism underlying apnoea in OSA remains unclear. Clinically, obstructive events …

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  • Contributors Y-ML and MIP contribute equally to the paper.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.

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