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  • 1. Baltimore Sleep and Wellness Center Sleep Disordered Breathing and Obstructive Sleep Apnea Blue Paper
  • 2. Prevalence of Sleep Disordered Breathing and Obstructive Sleep Apnea • Approximately 42 million American adults have Sleep Disordered Breathing (SDB) - T.Young NEJM 1993 ‣ 1 in 5 has mild Obstructive Sleep Apnea (OSA) and 1 in 15 has moderate to severe OSA. • 9% of women and 25% men in the middle-aged working population have OSA. - Marshall Sleep 2008 ‣ OSA defined as AHI ≥ 5 ‣ “Middle-aged” defined as 30-60-year-olds • ∼75% of severe SDB patients are not diagnosed - Young Sleep 2008
  • 3. Clinical Features of Sleep Apnea ✓ Excessive daytime sleepiness ✓ Short-term memory loss ✓ Loud snoring ✓ Nocturia ✓ Witnessed apneas ✓ Atrial fibrillation ✓ Nocturnal choking and coughing ✓ Gastroesophogeal reflux disease ✓ Restless sleep/heavy sweating ✓ Arrythmias ✓ Intellectual deterioration ✓ Impotence
  • 4. Sleep Apnea Risk Factors ✓ Obesity ✓ Anatomic abnormalities ✓ Male gender of the upper airway ✓ ✓ Increasing age Smoking ✓ ✓ Family History Endocrine and metabolic disorders ✓ Alcohol or sedative use
  • 5. Obesity Severity Levels Body Mass Index • BMI 25-29: Overweight - 30% of children/adolescents -NCHS 1999-2002 • BMI 30-35: Obese - 40% have OSA -Vgontzas et al. Arch Intern Med 1994 • BMI >35: Morbidly obese - 77-98% have OSA
  • 6. Sleep Apnea Prevalence in Comorbidities Percentage
  • 7. Sleep Apnea Prevalence in Comorbidities Percentage
  • 8. Sleep Apnea Prevalence in Comorbidities Percentage
  • 9. Sleep Apnea Prevalence in Comorbidities Percentage
  • 10. Sleep Apnea Prevalence in Comorbidities Percentage
  • 11. Sleep Apnea Prevalence in Comorbidities Percentage
  • 12. Sleep Apnea Prevalence in Comorbidities Percentage
  • 13. Sleep Apnea Prevalence in Comorbidities Percentage
  • 14. Sleep Apnea Prevalence in Comorbidities Percentage
  • 15. Sleep Apnea Prevalence in Comorbidities Percentage
  • 16. Untreated OSA Patients Have a Higher Recurrance of Atrial Fibulation
  • 17. CPAP May Improve Insulin Sensitivity