Continuous professional development: elevating sleep and breathing disorder education in Europe

Abstract

Sleep and breathing disorders are highly prevalent, representing a growing subspecialty of respiratory medicine. The term sleep disordered breathing (SDB) encompasses a range of conditions characterised by abnormal breathing during sleep, from chronic or habitual snoring, to frank obstructive sleep apnoea (OSA) or, in some cases, central sleep apnoea (CSA) and hypoventilation syndromes. OSA is the commonest form of SDB, leading to many potential consequences and adverse clinical outcomes, including excessive daytime sleepiness, impaired daytime function, metabolic dysfunction, and an increased risk of cardiovascular disease and mortality [1]. The estimated reported prevalence of moderate-to-severe SDB (≥15 events·h−1) was 23.4% in women and 49.7% in men, and the prevalence of symptomatic OSA was 9% and 13%, respectively [2]. However, in some populations, the prevalence of OSA is substantially higher, such as in patients been evaluated for bariatric surgery (estimated range 70-80%), in patients who have had a transient ischaemic attack or stroke (estimated range 60-70%) and in patients with cardiometabolic disease [3-6]. Limited data have been reported on CSA and non-obstructive sleep-related hypoventilation, which have received considerable interest in the sleep field within the past 10 years. Even if their prevalence was noted to be quite low relative to the prevalence of OSA [7], they are quite common in specific subpopulations [8-10]. Unquestionably, considerable progress has been made in past decades regarding basic science, and technical, clinical and therapeutic aspects of SDB. Furthermore, as sleep is essential for general health, SDB is important for general health as well. The field is still evolving and additional research to improve the diagnostic accuracy of simplified screening tools is needed to ensure that patients with SDB are accurately identified. However, the task of routine screening, assessment and management of SDB is particularly challenging. Inconsistencies in the diagnosis and management of SDB emphasise the need for standards in practice with special knowledge and expertise for medical practitioners managing respiratory sleep patients [11]. Moreover, in an era of evolving precision medicine, personalising therapeutic applications should be established on patient individualisation, correctly identifying their clinical profile and needs.