Thesis Sleep Apnea

It is the most common type of sleep-disordered breathing and is characterized by recurrent episodes of upper airway collapse during sleep.These episodes are associated with recurrent oxyhemoglobin desaturations and arousals from sleep.

Obstructive sleep apnea (OSA)—also referred to as obstructive sleep apnea-hypopnea (OSAH)—is a sleep disorder that involves cessation or significant decrease in airflow in the presence of breathing effort.The most recent guidelines from the American Academy of Sleep Medicine (AASM Weekly Update 9/26/2013) updated the definitions of the terms for scoring hypopneas (recommended and acceptable), as follows: An RERA is an event characterized by increasing respiratory effort for 10 seconds or longer leading to an arousal from sleep but one that does not fulfill the criteria for a hypopnea or apnea.The criterion standard to measure RERAs is esophageal manometry, as the AASM recommends.However, esophageal manometry is uncomfortable for patients and impractical to use in most sleep centers.A reliable and valid way to measure RERAs is with the use of a nasal cannula and pressure transducer.With either method, the respiratory disturbance index (RDI) is greater than 5 and the normal RDI cutoff is greater than 15.Obstructive apneas and hypopneas are typically distinguished from central events.Sleepiness is one of the potentially most morbid symptoms of sleep apnea, owing to the accidents that can occur as a result of it.OSA is a very important diagnosis for physicians to consider because of its strong association with and potential cause of the most debilitating medical conditions, including hypertension, cardiovascular disease, coronary artery disease, insulin-resistance diabetes, depression, and, as mentioned, sleepiness-related accidents.The standard indications for such testing apply to all patients, with or without OSA.Treatment of OSA partly depends on the patients’ severity of sleep-disordered breathing.

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