John Paquet IIIBME 281 S01

02 October 2013

Apnea (“want of breath”) = a pause in breathing Narrower throat area When muscles in upper throat relax during sleep, airway

becomes blocked Results in repeating pattern of heavy snoring, a silent period,

and a gasp

Obstructive Sleep Apnea◦Most common kind of sleep-disordered breathing

Central Sleep Apnea◦ Imbalance of respiratory control centers in brain during sleep◦Controls fail to give signal to inhale, resulting in missed cycles

of breathing

Complex/Mixed Sleep Apnea◦Combination of obstructive and central

Each apnea can last from 10 seconds to minutes

5 to 30 or more apneas per hour

Affects around 18 million people in US, many of whom are unaware that they have the condition

Obesity

Large neck

Large tongue

Short lower jaw in comparison with upper jaw

Irritability and impatience Forgetfulness Drowsiness Headaches Increased risk of:◦High blood pressure◦Heart disease◦ Stroke

Continuous Positive Airway Pressure◦ Small machine delivers stream of pressurized air through tube

to mask Traditional CPAP machines require patient to input

desired pressure (determined from a sleep study) APAP automatically changes air pressure as necessary to minimize number of apneas◦Can even warm/humidify air and monitor breathing

Advantages:◦Better mood, better memory, higher alertness during day,

increased productivity, regular sleep patterns

Disadvantages:◦ Eye irritation, nasal congestion, dry or sore mouth◦ These can typically be remedied by humidification, keeping

CPAP equipment clean, and choosing the right mask

Mandibular advancement splint

Uvulopalatopharyngoplasty (UPPP or UP3)◦Removes excess tissue at back of throat

Base-of-tongue advancement

Maxillomandibular advancement

CPAP machines are far less expensive than surgery Even if apnea is cured, surgical procedures pose

potential risk of creating complications (i.e. via infection, nerve damage-TMD)

Dental appliances can be around the same cost or even cheaper than CPAP, but are less effective and only treat mild to moderate obstructive sleep apnea

CPAP is most common, effective, non-invasive treatment for patients with moderate to severe sleep apnea

"Nasal CPAP." Medline Plus. U.S. National Library of Medicine, n.d. Web. <http://www.nlm.nih.gov/medlineplus/ency/article/001916.htm>.

"Obstructive Sleep Apnea." Medline Plus. U.S. National Library of Medicine, n.d. Web. <http://www.nlm.nih.gov/medlineplus/ency/article/000811.htm>.

"Sleep Apnea." Wikipedia. Wikimedia Foundation, n.d. Web. <http://en.wikipedia.org/wiki/Sleep_apnea>.

"Sleep Apnea Facts." YourLungHealth.org - Sleep Apnea Facts. American Association for Respiratory Care, n.d. Web. <http://www.yourlunghealth.org/lung_disease/sleep_apnea/facts/>.