Snoring Obstructive Sleep Apnea and Treatment Animation
Snoring and sleep apnea.In normal breathing, air enters the nostrils and goes through the throat and the tracheato the lungs. In people who snore this airway is partiallyobstructed by excess tissue of the throat, such as large tonsils, large soft palate ortongue. Another common cause of obstruction is the dropping of the tongue into the throatdue to over relaxation of tongue muscles during sleep. Air currents competing throughnarrow spaces in the throat cause the soft palate essentially a piece of soft tissuehanging in the throat to vibrate. This vibration is the source of the noise we hear when someoneis snoring.
Sleep apnea happens when the airway is completelyobstructed, no air can go through and the person stops breathing. This cessation ofbreathing triggers the brain to respond by waking up the person just enough to take abreath. This repeats itself again and again during the course of the night and may resultin sleep deprivation. Snoring and mild sleep apnea may be treatedwith a mandibular advancement device. This device is designed to move the lower jaw andthe tongue slightly forward and thus making the space in the back of the throat larger.
Central Sleep Apnea Treatment Obstructive Sleep Apnea
Central Sleep Apnea TreatmentObstructive Sleep Apnea.
ESC TV 2015 Congress by Topic Heart Failure
The study is called SchlaHF XT, which means sleep and heart failure We were able to rule out sleep apnea in only 25 % of the patients so that is meaning that 75 % of the patients will have sleeplessness or breathing of one or other type or severity and about half of them are, let us sayroughly 45 %, will present with moderate to severe obstructive or central sleep apnea we see that with including now HFPAF patients into the registry, we see much more obstructive sleep apnea compared tocentral sleep apnea before sleep breathing disorder is very prevalent in heart failure either HFRAFand HFPAF
it is, all the data out say that it has a prognostic impact, you can treat it and I think my key messages is, screen your patients for prevalence of sleep disorder breathing and look for data out there iftreatment changes anything in prognostic prognosis of them or quality of life, and we have to clearly differentiate I think at that point, from obstructive andcentral sleep apnea In SERVEHF, 1 325 systolic heart failure patients presenting with central sleep apnea were randomised to receive either adaptive servoventilation or medicalmanagement alone, median followup was 31 months
We found actually there was no difference in outcome at all and surprisingly, which has taken both respiratory physicians and cardiologists completely by surprise we found an increase inmortality, and if you look at cardiovascular mortality it was up 34 %,so not only does it not make any difference to the patients with systolicheart failure but it actually increases the risk of them dying, so this is a realgamechanger trial, really important All of the available patients who wererandomised in trials, we put those patients together from individual patient dataand so we were able to do something that
has not been done before which is to lookat age as a continuous variable and look at the benefits of betablockerscompared to placebo across all ages and gender and what we found was that patients who were older got exactly the same benefit from beta blockers as youngerpatients, if they were in sinus rhythm with an absolute risk reduction ofaround 4 % whether you are 50 or whether you are 75, looking at the results for gender, women had less mortality as you would expect but actually again they got exactly the same benefit that men got from beta blockers, so this suggestsvery importantly that the practice that
seems to be out there that women andolder patients get less beta blockers is something that we should not do, andreinforces the need for all of these patients to get guidelines' recommendedtreatments The ESC heart failure longterm registry is a general registry under the European observational research programme of the ESC, and the aim is to know theepidemiology and management of adult patients with heart failure in ESC countries orMediterranean countries
this registry has started in 2011, so far we have enrolled more than 24 000 patients from 31 ESC countries and 320 active centres participating, according to KaplanMeier survival curves the mortality at one year is 23.6 % for acute heart failure patients and around 6 % for chronic heart failure patients mortality for acute heart failure is still high while mortality for chronic heart failure is lower and this might reflect that there have been no new therapies in the last years for the