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Sleep-Related Respiratory Disorders

Adult Obstructive Sleep Apnea: Pathophysiology and Diagnosis
• Sleep-Related Respiratory Disorders • Jul 28 07

Obstructive sleep apnea (OSA) is a highly prevalent disease characterized by recurrent episodes of upper airway obstruction that result in recurrent arousals and episodic oxyhemoglobin desaturations during sleep. Significant clinical…


 

Therapy for Obstructive Sleep Apnea
• Sleep-Related Respiratory Disorders • Oct 05 06

The first step in OSA therapy involves a search for reversible factors that worsen sleep-disordered breathing (

Fig. 67-6). For example, OSA patients should avoid ethanol and sedative…


 

Who Requires Treatment?
• Sleep-Related Respiratory Disorders • Oct 05 06

The spectrum of clinical disorders related to sleep-induced upper airway obstruction is illustrated in

Fig. 67-5. Unfortunately, we lack good prospective studies characterizing the long-term clinical consequences of simple…


 

Other Disorders Associated with Sleep-Disordered Breathing
• Sleep-Related Respiratory Disorders • Oct 05 06

About 5% of OSA patients have chronic alveolar hypoventilation with elevated arterial carbon dioxide tension while awake (

see Fig. 67-4). These patients have the so-called pickwickian…


 

Diagnosis of Obstructive Sleep Apnea
• Sleep-Related Respiratory Disorders • Oct 05 06

When OSA is suspected, polysomnography is indicated to establish the diagnosis. Standardized overnight polysomnography performed in a sleep laboratory by a trained technician is recommended as the best diagnostic approach. Polysomnography involves…


 

Risk Factors for Obstructive Sleep Apnea
• Sleep-Related Respiratory Disorders • Oct 05 06

Important risk factors for OSA include obesity, male gender, and upper airway structural abnormalities (

Fig. 67-4). The majority of OSA patients are overweight, with more than…


 

Pathophysiology of Obstructive Sleep Apnea
• Sleep-Related Respiratory Disorders • Oct 05 06

In OSA patients, upper airway obstruction during sleep occurs in the pharynx behind the soft palate or tongue base. We do not fully understand why OSA patients experience frequent pharyngeal occlusion during…


 

Clinical Evaluation of potential Sleep Apnea patients
• Sleep-Related Respiratory Disorders • Oct 05 06

It is important to take a good sleep history in any patient with risk factors or clinical features suggesting the possibility of OSA (

see Fig.…


 

Consequences of Sleep-Disordered Breathing
• Sleep-Related Respiratory Disorders • Oct 05 06

Although occasional apneas and hypopneas during sleep may be normal, prolonged exposure to frequent apneas and hypopneas results in clinical problems that define the OSA syndrome. The clinical sequelae in OSA (

 

Normal Sleep and Respiration
• Sleep-Related Respiratory Disorders • Oct 05 06

Many neurophysiologic changes occur during sleep. Normal sleep has complex architecture, with several stages of non-REM sleep alternating with periods of REM sleep. Each sleep stage is defined by characteristic electrophysiologic patterns. Normal…


 

Definitions: Apnea and Hypopnea
• Sleep-Related Respiratory Disorders • Oct 05 06

Apnea is commonly defined as airflow cessation for at least 10 seconds. Apneas may be central, mixed, or obstructive (

Fig. 67-1). During central apneas, no effort is made…


 
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