sleep apnea
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Classification
- central sleep apnea
- cessation of airflow accompanied by the absence of respiratory effort
- obstructive sleep apnea
- cessation of airflow with continued respiratory effort
- mixed sleep apnea (most common)
- cessation of airflow that generally begins with no respiratory effort, but ends with increasing respiratory effort
- obstructive sleep apnea is predominant pattern
Epidemiology
- 2% of women & 4% of men age 30-60 years meet diagnostic criteria for sleep apnea syndrome
- 1/4-1/2 of patients have positional sleep apnea
- apnea episodes occur more frequently in supine position than lateral or prone position[8]
Pathology
- associated with adverse health effects & increased mortality
Clinical manifestations
- frequent episodes of apnea, hypopnea & symptoms of functional impairment
- frequent snoring
- frequent daytime sleepiness
- hypertension
- elevated body mass index (obesity)
- sleep apnea headache
- some patients may be asymptomatic
Diagnostic procedures
- sleep study (polysomnography)
- criterium:
- at least 30 episodes of apnea in a 7 hour sleep period
- criterium:
- out-of-center sleep study (home apnea monitoring)
- selected patients without cardiopulmonary disease
- see obstructive sleep apnea
Complications
- depression[9]
- increased risk of cognitive decline in older women[10]
- automobile accidents are 5-10 times more common in patients with sleep apnea
- increased risk of sudden cardiac death[11]
Management
- see obstructive sleep apnea
- central sleep apnea
- respiratory stimulants such as medroxyprogesterone
- mixed sleep apnea
- cardiac (atrial) pacing may reduce episodes of nocturnal apnea/hypopnea[7] {both central & obstructive sleep apnea}
More general terms
More specific terms
Additional terms
References
- ↑ Manual of Medical Therapeutics, 28th ed, Ewald & McKenzie (eds), Little, Brown & Co, Boston, 1995, pg 257
- ↑ Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed) Lippincott-Raven, Philadelphia, 1998, pg 749-50
- ↑ Journal Watch vol 19 #22, pg 177, Nov 15, 1999
- ↑ Netzer et al, Ann Intern Med 131:485, 1999
- ↑ Medical Knowledge Self Assessment Program (MKSAP) 11, 17 American College of Physicians, Philadelphia 1998, 2015
- ↑ Journal Watch 21(13):107, 2001 Barbe et al Ann Intern Med 134:1015, 2001 Pack & Maislin Ann Intern Med 134:1065, 2001
- ↑ 7.0 7.1 Journal Watch 22(6):47, 2002 Garrigue S et al, N Engl J Med 346:404, 2002 Gottlieb DJ, N Engl J Med 346:444, 2002
- ↑ 8.0 8.1 Mador MJ, Kufel TJ, Magalang UJ, Rajesh SK, Watwe V, Grant BJ. Prevalence of positional sleep apnea in patients undergoing polysomnography. Chest. 2005 Oct;128(4):2130-7. PMID: https://www.ncbi.nlm.nih.gov/pubmed/16236865
- ↑ 9.0 9.1 Peppard PE et al, Longitudinal association of sleep-related breathing disorder and depression. Arch Intern Med 2006, 166:1709 PMID: https://www.ncbi.nlm.nih.gov/pubmed/16983048
- ↑ 10.0 10.1 Yaffe K et al. Sleep-disordered breathing, hypoxia, and risk of mild cognitive impairment and dementia in older women. JAMA 2011 Aug 10; 306:613. PMID: https://www.ncbi.nlm.nih.gov/pubmed/21828324
Canessa N and Ferini-Strambi L. Sleep-disordered breathing and cognitive decline in older adults. JAMA 2011 Aug 10; 306:654 PMID: https://www.ncbi.nlm.nih.gov/pubmed/21828331 - ↑ 11.0 11.1 11.2 Shah BR et al Use of Stress Testing and Diagnostic Catheterization after Coronary Stenting: Association of Site-level Patterns with Patient Characteristics and Outcomes in 247,052 Medicare Beneficiaries. J Am Coll Cardiol. Published online June 5, 2013. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23727207 <Internet> http://content.onlinejacc.org/Onlinefirst.aspx
- ↑ NINDS Sleep Apnea Information Page https://www.ninds.nih.gov/Disorders/All-Disorders/Sleep-Apnea-Information-Page
- ↑ What Is Sleep Apnea? http://www.nhlbi.nih.gov/health/dci/Diseases/SleepApnea/SleepApnea_WhatIs.html