Sleep Apnea
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Basics
Description
- Disorder characterized by cessation of breathing during sleep:
- Defined as apneic episodes >10 s with brief EEG arousals or >3% oxygenation desaturation
- Risk factors:
- Obesity (strongest risk factor)
- Male
- >40 yr of age
- Upper airway anomalies
- Myxedema (hypothyroidism)
- Alcohol/sedative abuse
- Smoking
- Associated illness:
- Various dysrhythmias, particularly atrial fibrillation and bradyarrhythmia
- Right and left heart failure
- MI
- Stroke
- Motor vehicle accidents
- Hypertension poorly controlled by medical therapies
Epidemiology
- Affects about 15% of males and 5% of females
- Prevalence has increased due to higher rates of obesity
- 80% of moderate or severe cases undiagnosed in middle-aged adults
Etiology
3 classifications of sleep apnea:- Obstructive (84%) is due to upper airway closure despite intact respiratory drive:
- Also known as Pickwickian syndrome
- Pharyngeal airway is narrowed
- Central (0.4%) is due to lack of respiratory effort despite patent upper airway
- Complex (15%) is due to a combination of obstructive and central sleep apnea
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Basics
Description
- Disorder characterized by cessation of breathing during sleep:
- Defined as apneic episodes >10 s with brief EEG arousals or >3% oxygenation desaturation
- Risk factors:
- Obesity (strongest risk factor)
- Male
- >40 yr of age
- Upper airway anomalies
- Myxedema (hypothyroidism)
- Alcohol/sedative abuse
- Smoking
- Associated illness:
- Various dysrhythmias, particularly atrial fibrillation and bradyarrhythmia
- Right and left heart failure
- MI
- Stroke
- Motor vehicle accidents
- Hypertension poorly controlled by medical therapies
Epidemiology
- Affects about 15% of males and 5% of females
- Prevalence has increased due to higher rates of obesity
- 80% of moderate or severe cases undiagnosed in middle-aged adults
Etiology
3 classifications of sleep apnea:- Obstructive (84%) is due to upper airway closure despite intact respiratory drive:
- Also known as Pickwickian syndrome
- Pharyngeal airway is narrowed
- Central (0.4%) is due to lack of respiratory effort despite patent upper airway
- Complex (15%) is due to a combination of obstructive and central sleep apnea
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