INTRODUCTION: Obstructive sleep apnoea (OSA) is common in Singapore, with moderate to severe OSA affecting around 30% of residents. These consensus statements aim to provide scientifically grounded recommendations for the management of OSA, standar-dise the management of OSA in Singapore and promote multidisciplinary collaboration. METHOD: An expert panel, which was convened in 2024, identified several areas of OSA management that require guidance. The expert panel reviewed the current literature and developed consensus statements, which were later independently voted on using a 3-point Likert scale (agree, neutral or disagree). Consensus (total ratings of agree and neutral) was set a priori at ≥80% agreement. Any statement not reaching consensus was excluded. RESULTS: The final consensus included 49 statements that provide guidance on the screening, diagnosis and management of adults with OSA. Additionally, 23 statements on the screening, diagnosis and management of paediatric OSA achieved consensus. These 72 consensus statements considered not only the latest clinical evidence but also the benefits and harms, resource implications, feasibility, acceptability and equity impact of the recommendations. CONCLUSION The statements presented in this paper aim to guide clinicians based on the most updated evidence and collective expert opinion from sleep specialists in Singapore. These recommendations should augment clinical judgement rather than replace it. Management decisions should be individualised, taking into account the patient's clinical characteristics, as well as patient and caregiver concerns and preferences.
Humans ; Sleep Apnea, Obstructive/diagnosis* ; Singapore ; Consensus ; Adult

Orthognathic surgery has been used regularly to treat dentofacial deformities. The surgical procedures affect both the facial appearance as well as the posterior airway space (PAS). Our current literature indicates that setback procedures produce an inferior repositioning of the hyoid bone and posterior displacement of the tongue and the soft palate. These movements cause anteroposterior and lateral narrowing of the PAS. Most authors agree that these effects are permanent. The PAS changes in turn produce an adaptive posturing, with an increased craniocervical angle to open up the PAS. Even though most patients do not display snoring and obstructive sleep apnoea (OSA) post-surgery, there is certainly an increased possibility in patients with already compromised airways. Therefore, patients who are undergoing orthognathic surgery should be screened for excessive daytime somnolence, snoring, increased body mass index (BMI) and medical conditions related to OSA and sent for an overnight polysomnography (PSG) if OSA is suspected. Then the proposed treatment plan may be modified according to the risk of potential airway compromise or even to improve it. Conversely, advancement of the maxilla and mandible causes widening of the airway in both the anteroposterior and lateral dimensions. This effect would translate to better airflow and decreased airway resistance. This is supported by the evidence showing high success rates when orthognathic surgery, especially maxillomandibular advancement (MMA), is utilised to treat OSA.
Airway Obstruction ; etiology ; surgery ; Cephalometry ; Humans ; Malocclusion ; complications ; pathology ; surgery ; Malocclusion, Angle Class II ; surgery ; Malocclusion, Angle Class III ; surgery ; Mandibular Advancement ; Oral Surgical Procedures ; Osteotomy ; Treatment Outcome