Osahs obstructive sleep apnoea hypopnoea syndrome
This presentation is the property of its rightful owner.
Sponsored Links
1 / 33

OSAHS Obstructive Sleep Apnoea Hypopnoea Syndrome PowerPoint PPT Presentation


  • 62 Views
  • Uploaded on
  • Presentation posted in: General

OSAHS Obstructive Sleep Apnoea Hypopnoea Syndrome. Liam Doherty Consultant Respiratory Physician, Bon Secours Hospital, Cork. Definition. OSAHS is characterized by recurrent episodes of partial or complete upper airway obstruction during sleep. Who cares?.

Download Presentation

OSAHS Obstructive Sleep Apnoea Hypopnoea Syndrome

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


OSAHSObstructive Sleep Apnoea Hypopnoea Syndrome

Liam Doherty

Consultant Respiratory Physician,

Bon Secours Hospital, Cork


Definition

OSAHS is characterized by recurrent episodes of partial or complete upper airway obstruction during sleep


Who cares?


Kaplan-Meier survival curve for cardiovascular death in CPAP treated and untreated patients.

Aaa

100

95

95

90

90

% surviving

85

85

Untreated group

N=61

N=61

p=0.009

CPAP group

80

80

N=107

75

75

0

25

50

75

100

time (months)

Doherty et al - CHEST 2005;


Who?


Who else?

  • Children

  • Cranio-facial abnormalities

    • Micrognathia, macroglossia

  • Neuro-muscular diesases

  • Syndromes

    • Downs, Prada-Willi, Treacher-Collins, Pierre-Rubin

  • Miscellaneous

    • Pregnancy, Renal failure, hypothyroid, CVA


How common?


The Occurrence of Sleep-Disordered Breathing among Middle-Aged Adults

Terry Young, Mari Palta, Jerome Dempsey, James Skatrud, Steven Weber, and Safwan Badr

1993;328:1230-1235

n=602


symptoms


Classical symptoms of OSAHS

  • Excessive daytime sleepiness

  • Heavy snoring

  • Witnessed apnoeas/nocturnal choking

    Other symptoms

  • Dyspepsia

  • Nocturia, Enuresis

  • Nightmares

  • Insomnia

  • Excess sweating


Assessing sleepiness

  • Epworth Sleepines Score (ESS)

  • Stanford Sleepiness Scale

  • Multiple Sleep Latency Test (MSLT)

  • Maintenance of Wakefulness Test (MWT)

  • Oxford Sleep Resistance test (OSLER)


Epworth Sleepiness ScaleUse the following scale to choose the most appropriate number for each situation:

0 = would never doze or sleep

1 = slight chance of dozing or sleeping

2 = moderate chance of dozing or sleeping

3 = high chance of dozing or sleeping

Situation-Chance of Dozing or Sleeping

  • Sitting and reading

  • Watching TV

  • Sitting inactive in a public place

  • Being a passenger in a motor vehicle for an hour or more

  • Lying down in the afternoon

  • Sitting and talking to someone

  • Sitting quietly after lunch (no alcohol)

  • Stopped for a few minutes in traffic while driving


Diagnostic tests

  • Polysomnography (PSG)

  • Limited sleep studies e.g. embletta

  • Overnight oximetry


EEG C4/A1 or C3/A2

EOG

Chin and anterior tibialis EMG

ECG

Blood Pressure

(optional)

Airflow

Saturations

Sonogram

Respitrace

rib

abdomen

Sum

PSG :- Montage


Diagnosis of OSA

  • Apnoea:- cessation of airflow > 10sec

  • Hypopnea:- > 30% reduction in airflow accompanied by > 4% drop in O2 saturations and/or an arousal.


Obstructive Sleep Apnoea


Diagnosis of OSA

  • AHI >5 mild

  • AHI 15-30 moderate

  • AHI >30 severe

    This must only be interpreted with symptoms i.e. Epworth Score, and cardiovascular risk factors e.g. Hypertension, IHD, CVA, arrhythmias


Treatment


Conservative

  • Lose weight

  • Reduce alcohol

  • Proper sleep hygiene

  • Sleep on side


Nasal CPAP therapy


Oral appliances

  • Tongue-retainers

  • Anterior mandibular displacement


Surgery

  • Septoplasty

  • Tonsillectomy

  • Polypectomy

  • Pharyngoplasty

  • UPPP (uvulo-palato-pharyngo-plasty)

  • Tracheostomy


Take home messages

  • Very common disorder (2-4% population)

  • Substantial morbidity and ?mortality

  • Diagnosis by sleep studies

  • Very easy to treat

  • On successful treatment, huge improvements in quality of life


“I want to die peacefully in my sleep like my Grandfather, not screaming in terror like the other passengers in his car”

Anonymous


  • Login