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Sleep apnea and driving accidents

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Sleep apnea and driving accidents

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Sleep Apnea and Traffic Accidents: By Dr.K.O.Paulose. FRCS DLO
Consultant ENT Surgeon
Jubilee Hospital, Trivandrum,South India.
www.drpaulose.com www.snorefreesleep.com

Sleep Apnea and Traffic Accidents: By Dr.K.O.Paulose. FRCS DLO
Consultant ENT Surgeon
Jubilee Hospital, Trivandrum,South India.
www.drpaulose.com www.snorefreesleep.com

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Sleep apnea and driving accidents

  1. 1. SLEEP APNEA AND DRIVING ACCIDENTS Dr.K.O.Paulose FRCS DLO Consultant ENT Surgeon Jubilee Hospital, Trivandrum South India www.drpaulose.com,www.snorefreesleep.com
  2. 2. Avoid Falling Asleep While Driving Every year, over 100,000 accident deaths 2,500 deaths are caused by driver fatigue
  3. 3. RTA related Sleep debt
  4. 4. Sleep Apnea and Sleep Debt
  5. 5. Accidents more in early morning
  6. 6. Sleep Apnea can kill others too
  7. 7. Funeral Driving
  8. 8. Lack of sleep affects driver fatigue reaction time judgment and ability to concentrate
  9. 9. When Is It Most Likely To Happen? 1 pm and 4 pm and 2 am and 6 am.
  10. 10. Warning Signs of Drowsy Driving Yawning Inability to keep eyes open Drifting out of the lane Hitting rumble strips
  11. 11. What Can Be Done? Caffeine, stimulants and other tricks, loud music, washing face-temporary Avoid sleep debt- sleep 7-9 hrs/day Take Breaks-will allow you to stretch, move and wake up Pull over in a safe area to nap Awareness among patients, relatives, and Traffic police-DL The only long-lasting solution is to get adequate sleep.
  12. 12. Definition of Sleep Apnea Apnea is defined as a cessation of oronasal airflow of at least 10-30 seconds in duration When it occurs 30 or more times during a 7- hour period of nocturnal sleep. >10 episodes per night
  13. 13. Types of Sleep Apnea CSA- brain stem -bulbar polio stroke, a brain tumor, a viral brain infection OSA- upper airway obstruction Mixed- with chronic respiratory disease
  14. 14. Description of OSA Upper airway narrowing Loud snoring Wake up Gasping for air Fall back to sleep
  15. 15. Snoring and OSA can lead to divorce The spouse cannot sleep Separate bed room Marital discord Lack of sex drive EJD Infertility Lack of libido
  16. 16. Causes of OSA
  17. 17. Mechanism of Snoring and OSA
  18. 18. Symptoms of OSA Loud snoring Frequent cessation of breathing (apnea) during sleep. Choking sensation, Sudden awakenings Snorting or gasping for breath during sleeping Obese Extreme daytime sleepiness Problems concentrating Memory loss Poor judgment Personality changes such as irritation, depression lowest oxygen saturation (LSAT)>Hypoxia>Hypercarbia Pickwickian syndrome
  19. 19. Obesity OSA Diabetes
  20. 20. Snoring is not funny
  21. 21. Complications Social-relationship, accidents Pulmonary hypertension Hypertension, arrhythmias Type 2 Diabetes CVA
  22. 22. Diagnosis Good History: Talking to the patient and the spouse Questionnaire. Epworth Scale
  23. 23. Sleep Study or Polysomnogram (PSG) Home Sleep Study or Lab Diagnostic Overnight PSG EEG or electroencephalogram, EMG or electromyogram, EOG or electro-oculogram ECG or electrocardiogram Nasal Airflow Sensor Oximeter Snore Microphone and video recording
  24. 24. Sleep Lab Study
  25. 25. Treatment of Sleep Apnea Weight reduction, Diet, Exercise Avoiding sleep on one's back. Avoid alcoholic beverages, smoking , hypnotic or sedative drugs. Dental appliances, oral devices, and lower jaw adjustment devices Medical- Nasal decongestants, physostigmine, provilgil (increase daytime alertness) CSA-Mechanical ventilator CPAP -CPAP is not a cure, but a support measure
  26. 26. CPAP
  27. 27. CPAP in Children?
  28. 28. Surgical Treatment Hyoid Advancement Lingualoplasty-tongue reduction Mandibular osteotomy Nasal Surgery TS ADS in Children Somnoplasty( RF soft palate) Uvulopalatopharyngoplasty (UPPP) Tracheostomy- *last option
  29. 29. LASER ASSISTED UVULOPLASTY LAUP and LAPT: to cure snoring and sleep apnea Started doing Laser since 1996 More than 1000 cases since then
  30. 30. Laser Surgery as OPD Procedure Laser Surgery was done in OPD Patient discomfort Vasovagal Syncope Bad smell of burning tissue Complaints from neighboring clinics
  31. 31. OPD Set Up of Laser
  32. 32. Laser surgery Started in SUT Hospital 2007
  33. 33. Laser Team
  34. 34. Laser Surgeon
  35. 35. Anatomy of Throat
  36. 36. Anatomy of Nose
  37. 37. Elongated Uvula and Soft palate
  38. 38. LAUP in OPD
  39. 39. LAUP Procedure under LA
  40. 40. After LAUP
  41. 41. Snoring in Women
  42. 42. LAUP in Women
  43. 43. Laser surgery of Nose
  44. 44. Before LAUP
  45. 45. After LAUP
  46. 46. Laser Surgery Nose:LAPT
  47. 47. Laser Surgery Nose
  48. 48. Laser Surgery of Nose:polyps
  49. 49. Laser Septoplasty:LA
  50. 50. Laser cautery of Nose
  51. 51. Laser surgery Throat
  52. 52. Laser Surgery Tongue
  53. 53. Pre Op Endoscopy
  54. 54. Narrow Retro palatal Area
  55. 55. www.drpaulose.com www.snorefreesleep.com

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