Sleep Apnea

      CPAP Machines For Sale and your humble, virtual respiratory therapist are here to support you.  Allow me to provide you with a measured dose of patient education, I swear, it’s painless.  Let’s start at the beginning, with a few simple definitions and ramp up to a basic understanding of obstructive sleep apnea (OSA).  Sleep apnea is formally defined as repeated episodes of complete cessation of airflow for periods lasting 10 seconds or longer.  There are three types of sleep apnea, obstructive, central and mixed.
    
     OSA is by far the most common clinical form and is estimated to affect up to 5% of the general population, a frequency similar to that of diabetes.  Risk factors include increased age, upper body obesity (neck > 16.5in.), and nose or throat problems.  Consumption of large meals prior to bedtime, alcohol consumption, sleep medication and sleeping position contribute to the disorder.  The primary cause of OSA is a small or unstable pharyngeal airway due to soft tissue factors.  If the throat is too narrow, or the muscles of the tongue and soft palate relax too much, the airway can become completely blocked.
   
     When the obstructed airway reduces or cuts off the oxygen supply, the brain eventually detects the gas reduction and alerts the body to wake up to a lighter level of sleep to breathe.  The OSA patient then falls back into a deeper sleep, the airway collapses and again becomes obstructed, and the cycle repeats throughout the night.  The adverse cardiopulmonary consequences of OSA include cardiac arrhythmia, hypertension, mycardial infarct and stroke. Daytime sleepiness, morning headaches, anxiety, restlessness, irritability, memory loss, inability to focus, depression and overall diminished quality of life are commonly reported symptoms.
    
     OSA can cause the patient to stop breathing several hundred times during the night, sometimes for as long as a minute or two in duration.  Hypopneas are significant decreases in airflow, without a complete cessation.  The number of events of apnea and hypopnea per hour of sleep is referred to the apnea-hypopnea index.  An AHI of greater than 30 is prevalent in those patients diagnosed with moderate to severe sleep apnea, while an AHI of less than 5 considered normal.  Some patients with chronic obstructive pulmonary disease (COPD) also have coexisting OSA, a combination known as overlap syndrome.  In central sleep apnea (CSA), occuring in 10-15% of sleep disordered patients, the airway is not blocked, but the patient has a ventilatory pattern that is best described as periodic breathing, an increasing and decreasing in respiratory rates and volumes.  Mixed apnea is a combination of both OSA and CSA.
    
     When sleep apnea is suspected, an overnight polysomnogram (PSG), monitored by a sleep technologist should be obtained for a clinical diagnosis. In a sleep lab study, the technologist records physiological signals to determine whether airway closure occurs during sleep and to what extent the closure disturbs sleep continuity and cardiopulmonary function.

     Enough already.  No need to be obsessive here.  Breathe.  We can do this.

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