Lack of sleep affectsdriver fatiguereaction timejudgment and abilityto concentrate
When Is It Most Likely To Happen?1 pm and 4 pmand 2 am and 6am.
Warning Signs of Drowsy DrivingYawningInability to keep eyes openDrifting out of the laneHitting rumble strips
What Can Be Done?Caffeine, stimulants and other tricks, loud music,washing face-temporaryAvoid sleep debt- sleep 7-9 hrs/dayTake Breaks-will allow you to stretch, move andwake up Pull over in a safe area to napAwareness among patients, relatives, and Trafficpolice-DLThe only long-lasting solution is to get adequatesleep.
Definition of Sleep ApneaApnea is defined as a cessation of oronasalairflow of at least 10-30 seconds in durationWhen it occurs 30 or more times during a 7-hour period of nocturnal sleep.>10 episodes per night
Types of Sleep ApneaCSA- brain stem -bulbar polio stroke, abrain tumor, a viral brain infectionOSA- upper airway obstructionMixed- with chronic respiratory disease
Description of OSAUpper airway narrowingLoud snoringWake upGasping for airFall back to sleep
Snoring and OSA can lead to divorceThe spouse cannotsleepSeparate bed roomMarital discordLack of sex driveEJDInfertilityLack of libido
Symptoms of OSALoud snoringFrequent cessation of breathing (apnea) during sleep.Choking sensation, Sudden awakeningsSnorting or gasping for breath during sleepingObeseExtreme daytime sleepinessProblems concentratingMemory lossPoor judgmentPersonality changes such as irritation, depressionlowest oxygen saturation(LSAT)>Hypoxia>HypercarbiaPickwickian syndrome
DiagnosisGood History: Talking to the patientand the spouseQuestionnaire. Epworth Scale
Sleep Study or Polysomnogram (PSG) Home Sleep Study or LabDiagnostic Overnight PSGEEG or electroencephalogram,EMG or electromyogram,EOG or electro-oculogramECG or electrocardiogramNasal Airflow SensorOximeterSnore Microphone and video recording
Treatment of Sleep ApneaWeight reduction, Diet, ExerciseAvoiding sleep on ones back.Avoid alcoholic beverages, smoking , hypnotic orsedative drugs.Dental appliances, oral devices, and lower jawadjustment devicesMedical- Nasal decongestants, physostigmine,provilgil (increase daytime alertness)CSA-Mechanical ventilatorCPAP -CPAP is not a cure, but a support measure