Obstructive sleep apnea

Intermittent absence of airflow through the mouth and nose during sleep. A serious and potentially life threatening disorder.

Manifestations:
loud, cyclic snoring
excessive daytime sleepiness, HA, irritability, restless sleep,
personality changes, depression, HTN, intellectual impairment, increases risk for heart failure

Risk Factors:
male, increasing age, obesity
large neck circumference
use of alcohol and CNS depressants

Treatments:
weight reduction, alcohol abstinence, improving nasal patency
avoid supine position for sleep
use of oral appliances designed to keep the mandible and tongue forward
tonsillectomy and adenoidectomy

CPAP/BiPAP - tx of choice
    • positive pressure generated by an air compressor and administered thru a tight-fitting nasal mask splints the pharyngeal airway, preventing collapse and obstruction
    • humidifier needed to prevent irritation and dryness
    • BiPAP delivers higher pressure during inspiration and lower pressure during expiration, providing less resistance to exhaling
    • continous usage at night
    • adequate fluid intake to maintain moist mucous membrane

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