Physiotherapy-based Interventions for the Management of Obstructive Sleep Apnea: A Comprehensive Review

and overall quality of life. 6It has been suggested that OSA is a multifactorial disorder resulting from pathophysiological mechanisms such as anatomical compromise, pharyngeal dilator muscle dysfunction, lowered arousal threshold, ventilatory control instability, and/or reduced lung volume. 7Sleep-related reduced ventilatory drive and neuromuscular factors combined with anatomic risk factors are likely to play an important role in upper airway obstruction during sleep. 2 Various risk factors for OSA are given in Table 1.Diagnosis involves clinical evaluation, validated screening questionnaires, and confirmation through polysomnography. 1 IntroductIonObstructive sleep apnea (OSA) is a chronic sleep disorder characterized by recurrent partial or complete upper airway obstruction during sleep, leading to reduced airflow, oxygen desaturation, and sleep fragmentation despite ongoing respiratory effort. 1 These events contribute to negative intrathoracic pressure, hypoxia, and hypercapnia, resulting in cardiovascular, metabolic, and neurocognitive impairments.OSA is an independent risk factor for conditions such as hypertension, myocardial infarction, heart failure, stroke, diabetes, and metabolic syndrome, thereby increasing overall morbidity and mortality. 2,3bstructive sleep apnea is increasingly being recognized as a significant emerging public health concern worldwide, including India.In India, a large-scale study utilizing level I polysomnography and the American Academy of Sleep Medicine (AASM) 2012 criteria reported a 30.5% prevalence of moderate-to-severe OSA among healthy volunteers. 4Severity of OSA determined using the apneahypopnea index (AHI). 5he classic signs and symptoms of OSA include loud snoring, gasping or choking during sleep, witnessed apneas, and excessive daytime sleepiness.Individuals with OSA may also experience a tendency to fall asleep in inappropriate situations (e.g., while driving or attending lectures), along with impaired concentration, neurocognitive dysfunction, fatigue, morning headaches, nocturia, decreased libido, attention deficits, irritability, and depression.These symptoms result in reduced work efficiency