Obstructive sleep apnea
About Obstructive sleep apnea
Obstructive sleep apnea (OSA) is a disease characterize by obstructive apneas, hypopneas, and/or respiratory effort-related arousals that result from recurrent collapse of the upper airway during sleep.
This article reviews the epidemiology, clinical presentation, diagnostic method, and consequences of OSA. The pathophysiology and treatment of OSA are separately discusse.
Modvigil 200(Provigil) and Modalert 200 is use to treat excessive sleepiness in patients with narcolepsy and
residual sleepiness in certain cases of sleep apnea. Scientists believe the drug affects the sleep-wake centers
in the brain. The most common side effect is a headache.
FACTORS OF RISK AND ASSOCIATED CONDITIONS
Many clinical risk factors, including the following, are connect with OSA.
The prevalence of obstructive sleep apnea (OSA) grows from early adulthood through the sixth and seventh decades, and then seems to level.
Male sex — OSA is generally two to three times more prevalent in men than in women, but the risk seems to be comparable until women reach perimenopause and postmenopause.
Obesity – The risk of OSA is strongly correlate with the body mass index (BMI). In one research, a 10% increase in weight was related with a 6-fold increase in OSA risk. In another research, moderate to severe OSA (apnea-hypopnea index [AHI] 15) was present in 11% of normal-weight guys, 21% of overweight males (BMI 25 to 30 kg/m2), and 63% of obese males (BMI >30 kg/m2). Similarly, in females, OSA was present in 3 percent of normal-weight patients, 9 percent of overweight patients, and 22 percent of obese patients. 90 percent of those with obesity hypoventilation syndrome (OHS) also have OSA; OHS is describe separately.
Observable symptoms
The majority of people with OSA report daytime tiredness, or their bed partner reports loud snoring, gasping, choking, snoring, or breathing pauses during sleep (table 1). Often, these symptoms are identified during the examination of another complaint, during health maintenance, or during preoperative screening.
Daytime drowsiness: Daytime drowsiness is a frequent symptom of OSA. During the alertness phase of the sleep-wake cycle, sleepiness is the inability to stay completely awake and aware. Afternoon drowsiness may be underappreciate due to its subtle onset and persistent nature. The patient could use phrases like exhaustion, tiredness, low energy, or poor concentration. Focused questioning of the patient and their loved ones or bed partner generally discloses a pattern of feeling drowsy or falling asleep during dull, inactive, or monotonous circumstances.
For instance, the patient may confess to falling asleep often while reading, watching television, or even driving a car. Nevertheless, unpleasant or inappropriate sleep occurrences may be report (eg, at religious services, listening to lectures, or driving). Due to the fact that daytime drowsiness may be camouflage by activity, it is crucial to examine patient behavior outside of the office. Also, patients should always be questione about activities, such as coffee usage, that may disguise tiredness. In conjunction with their complaint of daytime drowsiness, patients often have nonrestorative sleep (i.e., they do not awaken feeling refreshed) and nocturnal restlessness.
Insomnia maintenance: Insomnia maintenance accompanied by recurrent awakenings might warrant evaluation of OSA. Roughly one-third of OSA patients report sleeplessness rather than excessive daytime drowsiness. This condition is more prevalent among women.
Some patients may present with symptoms of related illnesses and consequences, such as neuropsychiatric symptoms, postoperative hypoxemia, or nocturnal cardiovascular events, such as chest discomfort owing to angina pectoris or palpitations due to atrial fibrillation.
Diagnosis
Deciding between full- and split-night studies — While full-night studies are the gold standard, split-night studies are often use because, in the majority of cases, they can offer an accurate assessment of disease severity and determine the proper amount of PAP in a single night for the vast majority of patients. When informed of their testing alternatives, the majority of patients choose a split-night regimen owing to its convenience and the ability to begin treatment immediately after the test. Split-night PSG also reduces health care expenditures, avoids scheduling delays, and does not seem to have a negative impact on patient compliance, despite the reduced time available for patient education throughout the night. If clinically appropriate, clinical practice guidelines also advocate using a split-night diagnostic procedure rather than a full-night diagnostic strategy for PSG to diagnose OSA.
Visit: Techk Crunch
