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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.

Published in: Health & Medicine, Business
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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,
  2. 2. Avoid Falling AsleepWhile DrivingEvery year, over 100,000 accidentdeaths2,500 deaths are caused by driverfatigue
  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 affectsdriver fatiguereaction timejudgment and abilityto concentrate
  9. 9. When Is It Most Likely To Happen?1 pm and 4 pmand 2 am and 6am.
  10. 10. Warning Signs of Drowsy DrivingYawningInability to keep eyes openDrifting out of the laneHitting rumble strips
  11. 11. 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.
  12. 12. 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
  13. 13. Types of Sleep ApneaCSA- brain stem -bulbar polio stroke, abrain tumor, a viral brain infectionOSA- upper airway obstructionMixed- with chronic respiratory disease
  14. 14. Description of OSAUpper airway narrowingLoud snoringWake upGasping for airFall back to sleep
  15. 15. Snoring and OSA can lead to divorceThe spouse cannotsleepSeparate bed roomMarital discordLack of sex driveEJDInfertilityLack of libido
  16. 16. Causes of OSA
  17. 17. Mechanism of Snoring and OSA
  18. 18. 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
  19. 19. Obesity OSA Diabetes
  20. 20. Snoring is not funny
  21. 21. ComplicationsSocial-relationship, accidentsPulmonary hypertensionHypertension, arrhythmiasType 2 DiabetesCVA
  22. 22. DiagnosisGood History: Talking to the patientand the spouseQuestionnaire. Epworth Scale
  23. 23. 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
  24. 24. Sleep Lab Study
  25. 25. 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
  26. 26. CPAP
  27. 27. CPAP in Children?
  28. 28. Surgical TreatmentHyoid AdvancementLingualoplasty-tongue reductionMandibular osteotomyNasal SurgeryTS ADS in ChildrenSomnoplasty( RF soft palate)Uvulopalatopharyngoplasty (UPPP)Tracheostomy- *last option
  29. 29. LASER ASSISTED UVULOPLASTYLAUP and LAPT: to cure snoring andsleep apneaStarted doing Laser since 1996More than 1000 cases since then
  30. 30. Laser Surgery as OPD ProcedureLaser Surgery wasdone in OPDPatient discomfortVasovagal SyncopeBad smell of burningtissueComplaints fromneighboring 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.