Obstructive Sleep Apnea Nice Guidelines

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.

OSA Screening Guidance for AMEs

*Music* *Airplane Sound Effect* Hello. Welcometo this update on Obstructive Sleep Apneascreening guidance for Aviation Medical Examiners. According to the Federal AirSurgeon, the new guidance willsignificantly improve the safety of the NationalAirspace System while

simultaneously improving pilothealth and career longevity. Today, I'll walk youthrough a triage function resulting in six possibledeterminations. But first, a littlehistory on this topic: In 2008 the NTSB providedrecommendations to the FAA to mitigate the safety riskof Obstructive Sleep Apnea. In response to theserecommendations, the FAA developed lectures onsleeprelated disorders

and in particularObstructive Sleep Apnea, to be delivered at alltraining events. Unfortunately, after fiveyears of awareness training, the number of pilotsidentified with OSA was virtually unchanged. It's important to note thatthe NTSB has recently placed OSA on their quot;Most Wantedquot;list for transportation safety improvements for 2015.

As a result, the FAA hasdeveloped new guidance to address thisgrowing concern. This tutorial outlines the processthat AMEs are expected to perform at eachpilot examination. The process is aresult of input given by industrystakeholders and medical practice guidelinesestablished by the American Academy ofSleep Medicine, or AASM.

AMEs will perform what isessentially a triage function screening and assigningpilots into one of six OSA groups while enteringexam results into AMCS. We do not expect theAME to perform a sleep medicine evaluation,nor do we encourage it. When performing the triage, itis important to keep in mind two principles. Number one: Apilot should not be denied or deferred unless the AMEbelieves he or she represents

an immediate safety hazard. This should be rare regardingOSA. And number two: No pilot willbe deferred based on Body Mass Index alone. Let's go over how anAME will assign pilots to the OSA groups. When examining pilots for OSA,AMEs should apply al judgment using criteriadeveloped by the AASM.

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