OBSTRUCTIVE SLEEP APNEA

Description

  • condition where breathing stops involuntarily for brief periods of time
  • the normal flow of air is repeatedly stopped throughout the night

Symptoms

  1. noisy and laboured breathing
  2. repeated short periods where breathing is interrupted by gasping or snorting
  3. loud snoring
  4. headaches that are difficult to treat
  5. feeling disgruntled (grumpy)
  6. forgetfulness
  7. drowsiness
  8. Nocturia
  9. insomnia
  10. Daytime fatigue/tiredness
  11. Decreased vigilance
  12. Morning confusion
  13. Personality and mood changes, including depression and anxiety

Causes

  1. OSA is more likely to occur in older people
  2. overweight
  3. taking medicines with a sedative effect
  4. having an unusual inner neck structure
  5. alcohol and smokin
  6. menopause in women
  7. nasal congestion
  8. family history

Types

  1. Obstructive sleep apnea
  2. Central sleep apnea
  3. Mixed sleep apnea

Risk factors

  • children with large tonsils and adenoids
  • men with a collar size of 17 inches or more
  • women with a collar size of 16 inches or more
  • large tongue, which can block the airway
  • retrognathia, which is when your lower jaw is shorter than your upper jaw
  • a narrow palate or airway that collapses more easily

Diagnostic Tests

  • Polysomnogram
  • Pulse Oximetry
  • Arterial Blood Gas (ABG)
  • “electromyography (EMG) – this monitors muscle tone recordings of movements in your chest and abdomen recordings of airflow through your mouth and nose”
  • electrocardiography (ECG)
  • electroencephalograhy (EEG)

Treatments

  • continuous positive airway pressure (CPAP) device.
  • Nasal Decongestants
  • weight loss
  • Bilevel Positive Airway Pressure (BiPAP or BPAP)
  • positional therapy
  • surgery
  • Conservative therapy
  • Pharmacotherapy
  • Mandibular advancement device (MAD)
  • soft palate implants

Medication

  • modafinil
  • armodafinil
  • Acetazolamide
  • medroxyprogesterone,
  • fluoxetine
  • protriptyline

Lifestyle Management

  • limiting your alcohol consumption
  • avoid smoking
  • avoiding sedative medications and sleeping tablets
  • weight loss
  • Restriction of body positions during sleep (avoid supine position)
  • Sleeping in an upright position for markedly obese patients
  • Avoiding sleep deprivation