3.
Muscles of pharynx are relaxed during sleep and
cause partial obstruction
Breathing against partial obstruction causes
vibration of soft palate , tonsillar pillars and base of
tongue - sound
Mechanism
14.
PATHOPHYSIOLOGY:
Apnea during sleep causes hypoxia and retention of
co2 leading to pulmonary constriction – congestive
heart failure, bradycardia and cardiac hypoxia
leading to left heart failure – sudden death.
Due to frequent arousal – sleep fragmentation , day
time sleepiness.
OSA
15.
Daytime sleepiness
Morning headache
Fatigue
Memory loss
Depression
loss of libido
symptoms
16.
Pt bed partner
h/o should include snoring during sleep , gasping .
Choking , apnoeic events and sweating .
h/o any daytime sleepiness , fatigue , irritability ,
memory loss , impotence , morning headaches,
Use of any alcohol, sedatives, caffeine intake , mouth
breathing .
Clinical evaluation
17.
Body mass index
Collar size
Complete head and neck examination
Mullers manoeuvre: endoscope is passed – nose –
inspire vigorously with nose and mouth closed –
level of pharyngeal obstruction can be found
Systemic examination
examination
18.
Polysomnography: gold standard
EEG
ECG
EOM – for rolling of eye movements
Pulse oximetry
Nasal and oral airflow
Bp
Sleep position
19.
Change of lifestyle
Positional therapy : avoid supine
Intra oral devices : alters position of mandibule or
tongue to open airway and relieve snoring and sleep
apnea
Treatment
