Oxygenation: Sleep Apnea

Sleep Apnea : pathophysiology

What is it?

breathing disorder caused by a narrowing of the upper airway that impairs normal ventilation during sleep

Sleep apnea can include a complete/ partial airway obstruction blocked by?

soft palate, tongue, uvula

Apnea is the reduction or cessation of

breathing while sleeping unofficially with

10-20 seconds of breathing pauses followed by a loud snore or awakening

how many apneic episodes per hour is diagnostic?

5 or more

Apnea increases what & decreases what?

blood CO2 levels (cus not expelling out) & decrease in blood PH (acidotic)

RISK FACTORS 6

• obesity #1 & diabetes’s

• hypertension (ox to tissue)

• cig smoking (mucous pro damage to alveoli)

• men 14% women 5%

• thick neck M17inch W16inch

• enlarged tongue, uvula, tonsils, adenoids

SIGNS & SYMPTOMS 7

1. snoring

2. gasping during sleep

3. frequent awakenings

4. irritability

5. morning headaches

6. daytime drowsiness

7. 5 or more apneic episodes per hour lasting 10-20 seconds each

DIAGNOSTIC TESTS S t o p B a n g

snoring

tired

observed

pressure

bmi

age

neck size

gender male?

Polysomnogram- sleep study measures

• airflow

• blood ox levels

• HR

• breathing patterns

• eye/leg movement

• eeg used to monitor brain waves associated with NREM & REM

NONPHARMACOLOGIC THERAPY:

• weight reduction

• avoid alc ( cus depressant)

• smoking

• AVOID SPINE POSITION FOR SLEEP

• CPAP(relieve apneic episodes)

• BIPAP( less pressure during exhalation more during inhalation)

What are the 3 surgery’s for Sleep Apnea

1. tonsillectomy

2. adenoidectomy

3. partial remove of soft palate, uvula, PLat phargyno wall (UPPP)

Surgery options usually considered ONLY IF

nonpharm therapies not tolerated or effective