Obstructive sleep apnea

What is OSA

Episodes of partial or complete collapse of the airway and decrease in O2

Most common structure attributed to OSA

Base of tongue

Patient more likely to have OSA

DM, postmenopausal, heart disease, obesity

Risk factors

Nasal congestion, thickened lateral pharyngeal walls, facial malformations, craniofacial, upper airway abnormalities

Upper airway abnormalities

Short mandible, craniofacial base is wide, adenoid or tonsillar structures are wide

Patient with OSA have increased risk for

Hypertension, cardiac arrhythmia, HR and stroke

Anatomical factors in older adults

Fat deposits, muscle dysfunction, loss of teeth

Clinical manifestations

Loud snoring that is frequently accompanied by breathing cessation for 10 seconds or longer followed by a loud snore that wakes them

Night time OSA manifestations

Snoring, not breathing, fragmented sleep, gasping, snorting, insomnia, nocturia night sweats

Daytime OSA manifestations

Excessive sleepiness, headaches waking up, irritability/moody, fatigue, inability to concentrate, libido decreased

What does a PSG measure

Patients episodes of sleep apnea

Complications of OSA

Memory loss, stroke, heart attack, diabetes, lung hypertension, headache, arrhythmia, hypertension

Environmental role of the nurse

Dim the lights and draw curtains or keep door slightly closed

Therapies to ensure good management of OSA

CPAP, BiPAP, MAD

Medications

Modafinil, protriptyline

Modafinil job

Reduces daytime sleepiness, inhibits dopamine reuptake

Protriptyline job

Increases respiratory drive, improves upper airway muscle tone