SLEEP APNEA Juan A Albino MD FCCP Village
SLEEP APNEA Juan A. Albino, MD, FCCP Village Sleep Lab 751 -4955 October, 2007
Thank You !!! l Debbie Hurtt, Rotary Club l Phillip Ratliff, AWAKE Group (753 -8773) l Heather Ellington, Office Manager l John Crawford, Technical Director l Thomas Chaput, Sleep Technologist l Miyoshi Scott, Nurse l Brigette Hayes, Receptionist
Common Sleep Disorders l Insomnia: wants to sleep but cannot l Sleep Deprivation: does not want to sleep but can; problem of sleep quantity l SLEEP APNEA: sleepy during day, snores at night because of obstruction in throat; problem of sleep quality l Restless Legs Syndrome: leg discomfort, relieved by movement that hinders sleep
Good Sleep Hygiene: Basics l Regular times for sleeping and awakening l Maintain bedroom dark, quiet, cool l Use bed only for sleep and sex l Avoid late daytime naps l Avoid at night: alcohol, caffeine, nicotine l Sleep around 7 to 8 hours every night l Prudent exercise and eating l Avoid stressful situations at bednight
Restless Legs Syndrome l Leg discomfort, worse at night, relieved by movement, affects 5 -10% of population l Familial, begins in childhood l Associated with iron deficiency, drugs, Periodic Limb Movements of Sleep l Easily treatable with medicines l Restless Legs Syndrome Foundation, June K. Wharton (259 -0979)
Sleep Deprivation l Disasters: Exxon Valdez, Challenger Space Shuttle, Chernoble Nuclear Plant, Commuter plane crash in Kentucky l 33% of fatal truck accidents l 10% of fatal car accidents l Impairment the same whether: drunk, sleep deprived (<4 -6 hrs. ), sleep apnea l Must be taken seriously: sleep 8 hours l Leads to obesity and diabetes
Insomnia: Acute or Chronic l l l l Insomnia: inability to get to sleep, stay asleep, wakes up early, with daytime impairment Acute Insomnia (<4 weeks): stress, illness Sleep medicines work well in acute stage Chronic Insomnia: >4 weeks, often years Treat basic problem: >60% psychological Psychotherapy and behavioral therapy better than medicines, not easy to treat Psychologists, Psychiatrists, PCP
Sleep Apnea: Risk Factors l l l l Affects: 4 to 5% of population: common Family history, Sleep maintenance insomnia Obesity: 80 % of sleep apnea patients; central (visceral, apples) obesity Increasing age, Male gender Large tonsils / adenoids in children Small mandible, large neck Smoking, alcohol, sedatives, nasal allergies
Sleep Apnea: Consequences l l l l During night: snoring, snorting, gasping, difficult or stops breathing, wife worries During day: sleepy, tired, depressed, irritabile, impotent, forgets, sometimes few complaints More accidents: work, home, motor vehicle Higher death rates with severe sleep apnea Hypertension, Congestive Heart Failure Heart Attacks, Strokes, Atrial Fibrillation Promotes Obesity and Diabetes Problems: at night, during day, risk factor
Obstructive Sleep Apnea What is OSA? • Cessation of airflow with ongoing respiratory effort • NORMAL SNORING SLEEP APNEA
Sleep Apnea: Treatment l l l Behavioral: Weight Loss, Sleep Position (Sleep on side, head raised), Oxygen, Avoid sedatives CPAP: proven therapy, needs motivation: widely available, 70%: patients adapt well Surgery: tracheostomy, tonsillectomy, pull forth mandible or tongue Bariatric Surgery: banding, bypass (Bob Eisenhauer 259 -1485; Lewis Jones 753 -3459) Dental appliances: also pull forth mandible or tongue; expertise necessary
Treatment Options: CPAP Treatment -CPAP treatment – Positive pressure keeps airway open – 100% effective CPAP therapy
Summary: Sleep Apnea l l l l Very common and dangerous Easily diagnosed and treated Benefits of treatment: sleep better at night, also Feel better during the day: less sleepiness and fatigue, more energy, less accidents Reduce risk factor for heart disease and strokes Control better: obesity, diabetes, hypertension Bed partner sleeps better: less noise and less worry (but dog is scared of CPAP)
Websites l l l National Sleep Foundation: sleepfoundation. org American Sleep Apnea Association: sleepapnea. org Restless Legs Syndrome Foundation: rls. org National Center on Sleep Disorders: healthfinder. gov/orgs/HR 2536. htm Commercial: My. Resmed. com Commercial: Respironics. com
Books l l l The Promise of Sleep by William Dement Sleeping Well by Michael Thorpy No More Sleepless Nights by Peter Hauri A Woman’s Guide to Sleep Disorders by Meir H. Kryger Restless Legs Syndrome by Robert H. Yoakum Say Good Night to Insomnia by Gregg D. Jacobs
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