Obstructive Sleep Apnea

1. Obstructive Sleep Apnea Cal Knowles

2. What is Obstructive Sleep Apnea? • Obstructive Sleep Apnea (OSA) is a sleeping disorder that causes a person to stop breathing for a span of seconds • In OSA, the airway narrows as the muscles relax during sleep, reducing the amount of oxygen in the blood • Sleep apnea can lead to more severe health problems like cardiovascular disease, high blood pressure, diabetes, and/or a stroke

3. Information on OSA • It is believed that 1 in 15 Americans (roughly 20 million) have sleep apnea • It is also believed that 80-90 percent of these people are unaware that they have it • Symptoms are loud snoring, restless sleep, and sleepiness during the day • It’s more common in older people and those who are obese and/or active smokers

4. Continuous positive airway pressure treatment • The CPAP is a machine that is a common treatment for those experiencing OSA • The CPAP is composed of a flow generator, a hose, and an interface • The flow generator provides airflow, the interface is a mask placed on the person’s face, and the hose connects the two

5. Pictures of a CPAP

6. How the CPAP treatment works • The user is provided with a constant stream of compressed air • The pressure from the air keeps the airway open lessening/preventing the number of sleep apnea episodes • It is the pressure, not the actual airflow that forces the airway to stay open • The air pressure is measured in cm per water, and most patients use a range from 6 to 14 cm per water

7. Disadvantages to the CPAP • Many are reluctant to try this method at first due to the inconvenience of the mask, hose, and machine • The air pressure also causes some patients to experience nasal congestion or a runny nose, and it may take a few weeks to adjust to the machine • The disadvantages are mainly because of comfort reasons, and there are really no serious side effects

8. Other methods of treatment • About half of those diagnosed with OSA decide to use the CPAP machine • One alternative is nasal surgery; however, this method has a very low success rate (under 10 percent) and is usually performed so the patient can be fitted with a more convenient nasal mask for the CPAP • Nasal ventilation has very little impact on sleep apnea, and that is why it yields such low success rates

9. Minimally invasive surgery for alternative treatment • Radiofrequency surgery uses high frequency electrical currents and is applied to the soft palate, the tongue, and or/the tonsils • All 6 of the subjects for this method saw an improved score on their Epworth sleepiness scale from pre surgery to post surgery • Soft palate implants is another method, where cylinders of polyester yarn are inserted into the soft palate • All 7 of these subjects had an improved score on the Epworth sleepiness scale

10. Invasive surgery methods for alternative treatment • The invasive surgery methods include: pharyngeal procedures (80 percent experienced improvement), tongue base procedures (33), supraglottic procedures (85), multi-level surgery (51.5), maxillofacial surgery (90), tracheostomy (96)

11. Conclusion • The findings were that the CPAP is the most effective method due to it’s non-invasiveness and lack of side effects • The minimally-invasive techniques as well as the maxillofacial surgery were the next best methods due to the efficiency of success compared to the minimal amount of invasiveness • The tongue based surgery, as well as the tracheotomy were both given the lowest rating for effectiveness due to the low success rates for the tongue based surgery, and the highly invasive manner and rare necessity for the tracheotomy

12. Sources • Maurer, Joachim. "Update on surgical treatment for sleep apnoea" Swiss Medical Weekly 132 (2009): 624-629 • http://www.sleepapnea.org/ • http://www.nhlbi.nih.gov/health/dci/Diseases/SleepApnea/SleepApnea_WhatIs.html • http://www.medicinenet.com/sleep_apnea/article.htm