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.
Tonsillectomy and Adenoidectomy for OSA Anesthetic Considerations by Denise Chan MD
Tonsillectomy and Adenoidectomy for ObstructiveSleep Apnea: Anesthetic Considerations, by Denise Chan. Hello, my name is Denise Chan, and I'm a pediatricanesthesiologist at Boston Children's . Today, I'll be discussing important aspectsof taking care of children with obstructive sleep apnea syndrome in the perioperativesetting. Introduction. Now, first let's define what is obstructivesleep apnea syndrome. Well, it's a disorder of breathing during sleep, and it's characterizedby a few different things, according to the
American Thoracic Society. First of all, these patients have either prolongedupper airway obstruction, which is known as obstructive hypopnea, or intermittent completeobstruction, known as obstructive sleep apnea. And this occurs with or without snoring. Second, the patient exhibits moderate to severeoxygen desaturation. Third, normal ventilation is disrupted. And fourth, normal sleep patternsare disrupted. So these are the components of obstructive sleep apnea syndrome. Now, in children, obstructive sleep apneasyndrome is oftentimes caused by enlarged
adenoid or tonsillar tissue. And you can seein this illustration that the hypertrophied tonsils really do get in the way of normalairflow. So what do you expect to see in a patientwith this syndromeé First of all, you'll probably see snoring. They'll have difficulty breathingduring sleep, restless sleep, or even nightmares or night terrors. You may see excessive sweating.They may have nocturnal enuresis, or bedwetting, mouth breathing, pauses in breathing, or chronicrhinorrhea. More importantly, though, what is the significanceof having obstructive sleep apnea, and what are the consequences for the patienté Well,there are a number of problems that can occur.
Daytime somnolence patients have fallenasleep while driving older patients, of course and this can lead to motor vehicleaccidents; cognitive dysfunction, which leads to behavioral problems or problems with workor school performance; metabolic effects, such as insulin resistance, type 2 diabetesmellitus, or metabolic syndrome; or other metabolic effects, such as failure to thriveor stunted growth. Or if obstructive sleep apnea is more severeor left untreated, this could lead to cardiovascular morbidity, such as pulmonary or systemic hypertension,cor pulmonale, or stroke. Obstructive sleep apnea syndrome can even lead to death. Andit's been hypothesized to be a factor contributing
to SIDS, or Sudden Infant Death Syndrome.Diagnosis and al Features. In order to diagnose whether or not someonehas obstructive sleep apnea, you must first and foremost perform a thorough history andphysical exam. A sleep history screening for snoring should be a part of every child'sroutine health care visits. It's really unlikely that someone's goingto have obstructive sleep apnea if they don't snore. So if a child does snore, ask the parentsmore details about the sleep history. Does your child have difficulty breathing or stopbreathing during sleepé Or are you worried about their breathing at nighté Does yourchild sweat during sleepé Does your child
have restless sleepé Does he or she breathethrough his mouth while awakeé Has anyone in the family had obstructive sleep apneaor sudden infant death syndromeé Or does your child have behavioral problemsé When you examine the patient, you may noticecertain features that are suggestive of obstructive sleep apnea, such as a small, triangular chin,retrognathia, a high arched palate or a long soft palate, a long oval face, or, of course,large tonsils. There are also certain patients who are athigh risk for having obstructive sleep apnea. And these are patients with obesity; Downsyndrome; PraderWilli syndrome; certain neuromuscular
The structure of the eye Processing the Environment MCAT Khan Academy
When we thinkabout breathing problems at night, we could thinkabout the problem coming from three key areas. The first one being a problemarising from the brain and the brain being a key central organ that controls the respiratorycenters that help regulate the lungs so the brainis really important here. The second one being aproblem with upper airways
so if there's anyobstruction to the airways from the mouth and the nose to the lungs, that can cause a problem. And last, but not least,we can also have a problem with the lungs themselvesor the chest wall. Anything that stops thelungs from being able to expand out. So let us take each one ofthese things step by step
and let us start bylooking at the airways. So the main issue with the airways is that obstruction to the airways causes a significant problem interms of breathing at night. And if we consider the airthat goes in through our nose and in through ourmouth reaches our lungs, we have points at which thesoft tissues around our neck may potentially relax atnight and they may potentially
block this airflow intermittently. They may potentially cause an obstruction to this airflow. And when they cause anobstruction to this airflow, you may notice some snoring or gasping and this suggests that airflow is being stopped. That term is, for lack ofeffort, is called apnea,
and all that apnea really means is that there is an absence of airflow. So if the airways are obstructed, we can have something called obstructive sleep apnea. And this condition obstructive sleep apnea is actually very common. It gets worse as people get older.
These soft tissues blockthis airflow that we have and this condition actually results in a variety of daytimeand nighttime symptoms. So we actually mentioned some of the nighttime symptoms, righté We mentioned this can have snoring, gasping for air, and these kind of apneas, these kind of pauses,breaks in the breathing