Obstructive Sleep Apnea - Transcript
Obstructive sleep apnea (OSA) is an increasingly common
disorder of repeated upper airway collapse during sleep,
leading to oxygen desaturation and disrupted sleep (Do,
Wilson & Floyd, 2016). Loud snoring, gasping during
sleep, obesity, and enlarged neck circumference are
predictive clinical features. OSA is defined as the
presence of at least 5 episodes of apnea or hypopnea per
hour during sleep, but individuals with OSA may have as
many as 15 apneic episodes in 1 hour, with as many as
200–400 episodes occurring during 6–8 hours of sleep.
Obstructive sleep apnea (OSA) is a highly prevalent
disease that remains underdiagnosed and undertreated.
Nearly 30 million adults in the United States have
OSAOSA affects at least 4% of men and 2% of women,
and possibly a much higher percentage of the population.
Risk for OSA increases with age, and occurs 2–3 times
more often in individuals who are over 65 years of age or
older. OSA affects African American adults more than
White adults. Due to tonsillar hypertrophy, 1–2% of
children between the ages of 4 and 6 years experience
OSA. Sleep breathing disorders might be undiagnosed in
92% of males and 80% of females. It is estimated that
diagnosing and treating every patient in the U.S. who has
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, OSA would produce an annual economic savings of
$100.1 billion.
Pathophysiology Current understanding of the
pathophysiologic basis of the disorder suggests that
during awake, the small airway and neuromuscular
compensate to keep the pharynx open. Once sleep onset,
loss of neuromuscular compensation with loss of
pharyngeal muscle activity causing the airway to collapse,
which contributes to episodes of apnea or hypopnea,
leading lack of oxygenation in the brain causing it to
increase the ventilation process, and arouse the person.
The recurrent pattern of sleep interruption followed by
restored breathing continues on during sleep cycle.
Pathogenesis: Predisposing factors are Small upper
airway lumen Unstable respiratory control Low arousal
threshold Small lung volume Dysfunctional upper airway
dilator muscles.
Risk Factors Age > 40 years Male sex Obesity Cigarette
smoking Disease processes - Hypothyroidism,
hypertension, acromegaly, heart disease Nasopharyngeal
structural abnormalities - deviated septum, nasal polyps
Neurologic syndromes- muscular dystrophy, cerebral palsy
Rheumatoid arthritis due to subluxation of the cervical
vertebrae) Menopause Consumption of alcohol or use of
sedatives before bedtime.
Signs and Symptoms and Clinical Presentation The three
cardinal symptoms of OSA are snoring, sleepiness, and
significant other reported episodes of apnea During sleep
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