What is Obstructive Sleep Apnea?
- Syndrome that results from a repetitive pharyngeal narrowing and collapse during sleep
What are some OSA Systemic Effects?
- Myocardial Ischemia/Infaraction
- Congestive Heart Failure
- Cerebrovascular Accidents
Observed cessation of inspiratory effort for greater than 10 seconds during sleep...leads to oxygen desaturation
> 30% reduction in airflow for > or equal to 10 from baseline with > 4% 02 desaturation
What is the cause of Snoring (noisy breathing - rhoncus)?
Vibration of the uvula and osft palate against the posterior wall of the oropharynx
How does one arrive to the AHI value?
Apnea + Hypopnea Index...
Apnea + Hypopnea Index which is calculated by adding the number of apneas to the hypopneas divided by the number of hours of sleep
What value is synonmymous with AHI?
Respiratory Disturbance Index
What does RERA stand for?
Respiratory Effort Related Arousals
What are some OSA Risk Factors?
- Obesity present in 60-90% of OSA patients
- Gender: male:female ratio 2-3:1
- Nasal Obstruction
- Craniofacial abnormalities
- Mandibular retrognathia
- Narrowed, tapered, and short max arch
- Long soft palate
- Mallampati grade III or IV
- Tonsillar hypertrophy
- Neck circumference
- Increase Snoring
What are some OSA symptoms?
- Loud snoring
- EDS (daytime sleepiness)
- Sleep fragmentation
- Mental deterioration
- Reduced sleep latency
What are some different tests for Obstructive Sleep Apnea?
- Epworth Sleepiness Scale
- Multiple Sleep Latency Test
- Polysomnography (PSG)
What AHI value must you have to be diagnosed with OSA?
- Daytime sleepiness
- Witnessed noctural apneas
- Awakening with choking
- Breath holding
What are the values for a normal AHI, Mild OSA, Moderate OSA, and Severe OSA?
- Classified by number of apneic/hypopneic episodes per hour
- AHI < 5 Normal
- AHI > or equal to 5 < 15 = Mild OSA
- AHI > or equal to 15 < or equal to 30 = Moderate OSA
- AHI > 30 = Severe OSA
What are some Non-Surgical OSA Treatments?
- Weight loss/behavior modification
- Drug therapy
- Continuous Positive Airway Pressure (Gold Standard)
- Dental appliance
What OSA classifications are Dental Appliances Indicated?
Dental devices are indicated in snoring and mild-moderate OSA patients after medical evalution and referral
What are some Surgical treatment for OSA?