Obstructive Sleep Apnea versus Central Sleep Apnea
Obstructive sleep apnea is when the airwaybecomes narrowed or obstructed and you're making the effort to breathe but we do notsee any flow in air movement coming from your nose or mouth. Where central sleep apnea occurswhere your brain forgets to tell your body to breathe. If we're looking at it from avery simplistic term and so we do not see the drive to breathe. So the first step isto come into the and be seen by one of our physicians in the sleep medicine .We'll go through a questionnaire and try to determine what risk factors we think you havefor sleep apnea such as obesity, snoring, daytime sleepiness and then if we think thatyou have a high risk for meeting those criteria
then we would set you up for a sleep studyeither in your home to do an overnight sleep study or in our laboratory, depending on yoursituation. The CPAP can be used to treat both conditions and, in some patients, that isenough. However, there are some patients that have more complex types of central sleep apneathat require more complicated types of machines to treat that condition. Obstructive sleepapnea actually has been linked to a lot of other problems such as high blood pressureand then, you know, difficulty functioning during the day. If it goes untreated for along period of time there's an increased risk of early heart problems and those types ofthings.
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
What Is Sleep Apnea
Hey there sleepy heads, Julia here for Dnews. According to the National Sleep Foundationsnoring affects 90 million Americans. So you're probably not the only one sleeping on thecouch tonight. When you sleep most of your muscles relax.Including those in your mouth, throat and airways. If these become too relaxed, theycan get in the way of your breathing. As you try to suck more air through the narrowedairways, these muscles can vibrate, making sounds like an airplane or lawnmower. Although it might be annoying to your sleepingbuddy, snoring seems mostly harmless. Yet
several studies linked the night time maladyto some pretty nasty healthy effects. One study published in the journal Laryngoscope,found that snoring might lead to a thickening of the arteries in the heart. Snoring canalso lead to headaches and even decline in memory. Not to mention if you wake up yourpartner, snoring could get you into some relationship trouble. But is your snoring so bad you wake yourselfupé You might suffer from sleep apnea. Half of those 90 million I mentioned earlier mightbe suffering from Obstructive Sleep Apnea (OSA). Apnea means literally â€œwithout breathâ€�.Like the name suggests, this type of sleep
disorder can cause the airways to completelyclose. Sufferers actually stop breathing when they sleep! This lack of oxygen wakes peopleup with a snort or gasp. While waking up a bunch of times in the middleof the night leaves you tired the day, Sleep Apnea can also lead to a host of other problems. One large study was published in the journalAmerican Journal of Respiratory and Critical Care Medicine. The study found that patientswith severe apnea have a 30% higher risk of developing diabetes than those with almostno apnea. And patients with mild or moderate apnea had a 23% increased risk of developingdiabetes.
Another study published in the journal Journalof al Sleep Medicine surveyed a group of patients for 20 years! The researchersfound that, even after controlling for smoking and other lifestyle factors, people with moderateto severe obstructive sleep apnea were four times more likely to die, nearly four timesmore likely to have a stroke, three times more likely to die from cancer, and 2.5 timesmore likely to develop cancer. Lack of oxygen to the brain is never a goodthing. One study published in the journal Cerebral Blood Flow and Metabolism, foundthat the immediate effects of sleep apnea on the brain were similar to the effects ofa stroke!
Okay okay, have I scared you enoughé Sorryabout that. So currently one of the best treatments for sleep apnea remains the cumbersome CPAPmachine. CPAP stands for quot;continuous positive airway pressurequot;. Basically, if you can'tguess from that name, the machine creates pressure on your airways so those soft tissuesdon't get in the way of your breathing. The exact pressure depends on the patientand decided by a physician. But you breathe easier and pretty much stop snoring. While the whole getup includes a face mask,that goes into your nose and over your head, it definitely helps. Some studies publishedin the journal Sleep found that using a CPAP
machine improves blood pressure and even restoresbrain tissue after a year of use! So while it might be awkward, it could actually addyears to your life. So wanna found out if your snoring is dangerousor just dang annoyingé Well there's an app for that, designed by researchers at the Universityof Washington. ApneaApp uses sound waves to monitor breathing. The app acts kind of likea bat, emitting sonar to track breathing patterns. According to its makers, the app can detectsleep apnea as well as tests 98% of the time. The app is only designed foruse on android phones. Sorry hipsters, you'll just have to wait.