Obstructive Sleep Apnea

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Obstructive Sleep Apnea

• Cal Knowles

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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

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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
• Its more common in older people and those who
  are obese and/or active smokers

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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 persons face,
  and the hose connects the two

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Pictures of a CPAP
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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

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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

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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

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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

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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)

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Conclusion

• The findings were that the CPAP is the most
  effective method due to its 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

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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/Sleep
  Apnea/SleepApnea_WhatIs.html
• http//www.medicinenet.com/sleep_apnea/article.htm