Obstructive Sleep Apnea

What is Obstructive Sleep Apnea

disorder of breathing during sleep that causes repeated complete or partial airway collapse (apnea or hypopnea)
→ accompanied by increased sympathetic tone leading to elevated blood pressure and heart rate
→ the upper airway is less rigid and collapses in sleep apnea because of this

Which structures are more susceptible to collapse

Semi-rigid areas: retropalatal and retroglossal oropharynx

What does the genioglossus do and pharyngeal constrictors do?

Genioglossus - protrudes the tongue

Pharyngeal constrictors - form lateral pharyngeal walls

Loss of tone in either of these can cause these things to close off during sleep → retropalatal and retroglossal oropharynx will close off during sleep

What is the pathogenesis of obstructive sleep apnea

When you sleep, your breathing rate will decrease causing an increase in PaCO2
→ in patients with sleep apnea, they have abnormal upper airways which will cause airway collapse
→ this leads to to further hypoxia and hypercapnia, leading to arousal by our chemoreceptors

What are the eight risk factors for OSA?

STOP BANG - having 3-4 is intermediate risk, anything above that is high risk
→ Snoring
→ tired
→ Observed Apneas
→ Pressure (Elevated)
→ BMI > 35
→ Age > 50
→ Neck Circumference > 40
→ Gender Male

How is OSA related to cardiovascular disease

OSA is related to cardiovascular disease and atrial fibrillation- increases risk
→ increased sympathetic activity during sleep
→ patients with OSA often have hypertension and also have pulmonary hypertension (hypoxemic constriction)