OSA Today - What's New With Sleep Apnea


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Presentation made via webinar, courtesy of the American Thoracic Society on March 15, 2011 as a part of Sleep Disorders Week at the ATS.

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  • Welcome and thank you all for attending our webinar – OSA Today – courtesy of the American Thoracic Society. We are partnering with them during sleep disorders week at the ATS. For more information about ATS visit them at their web site – thoracic.org
  • In the next twenty minutes or so I want to set the stage with a brief review, talk about ways to diagnose and treat sleep apnea and conclude with some information about the ASAA.
  • The field of sleep research is learning more and more about the physiological responses to sleep and lack of sleep. This diagram maps some bodily responses to the changing light and dark cycle. Notice that the blood pressure rises in morning and reaches is highest point in the early evening. From there is starts to dip. Body temperature also starts fall from its high point of the day. Melatonin, the sleep inducing hormone, starts working in the evening and stops as we are starting the day.
  • 30 degree reverse Trendelenburg's position
  • OSA Today - What's New With Sleep Apnea

    1. 1. OSA Today What’s New in Sleep Apnea? <ul><li>Edward Grandi, Executive Director </li></ul><ul><li>American Sleep Apnea Association </li></ul><ul><li>Sleep Disorders Week at ATS </li></ul><ul><li>March 15, 2011 </li></ul>
    2. 2. Objectives <ul><li>A Brief Review </li></ul><ul><li>Diagnostic Options </li></ul><ul><li>Treatment Options – Now & Future </li></ul><ul><li>About the ASAA </li></ul>
    3. 3.
    4. 4. Normal Sleep Interrupted
    5. 5.
    6. 6.
    7. 7.
    8. 8.
    9. 9. Signs, Symptoms, and Risk Factors <ul><li>Loud Chronic Snoring </li></ul><ul><li>Witnessed Pauses in Breathing </li></ul><ul><li>BMI Greater than 30 </li></ul><ul><li>Large Neck Size ( > 17″ men, > 16 ″ women) </li></ul><ul><li>Excessive Daytime Sleepiness </li></ul><ul><li>Insomnia </li></ul><ul><li>Nocturia </li></ul><ul><li>Hypertension </li></ul><ul><li>Type 2 Diabetes </li></ul>
    10. 10. OSA Consequences <ul><ul><li>CNS Effects </li></ul></ul><ul><ul><li>Cognitive impairment </li></ul></ul><ul><ul><li>Motor vehicle accidents </li></ul></ul><ul><ul><li>Impaired quality of life </li></ul></ul><ul><li>Cardiovascular Effects </li></ul><ul><ul><li>Systemic Hypertension </li></ul></ul><ul><ul><li>Pulmonary Hypertension </li></ul></ul><ul><ul><li>Nocturnal arrhythmias </li></ul></ul><ul><ul><li>Coronary artery disease and congestive heart failure </li></ul></ul><ul><ul><li>TIA/Stroke </li></ul></ul><ul><ul><li>Death </li></ul></ul><ul><li>Metabolic Effects </li></ul><ul><ul><li>Insulin Resistance/diabetes </li></ul></ul><ul><ul><li>Metabolic syndrome </li></ul></ul>
    11. 11.
    12. 12. Diagnostics
    13. 13. Treatment Options for OSA <ul><li>Lifestyle Changes </li></ul><ul><li>Oral Appliances </li></ul><ul><li>Positive Airway Pressure </li></ul><ul><li>Surgery </li></ul><ul><li>Alternatives </li></ul>Mild Moderate Severe AHI > 5 & < 15 AHI >15 & <30 AHI >30
    14. 14. Lifestyle Changes <ul><ul><li>Weight Loss </li></ul></ul><ul><ul><li>Stop Smoking </li></ul></ul><ul><ul><li>Reduce Or Eliminate Alcohol Intake </li></ul></ul><ul><ul><li>Reduce Or Eliminate Sedatives </li></ul></ul><ul><ul><li>Positional Therapy </li></ul></ul>
    15. 15. Positional Therapy
    16. 16.
    17. 17. Oral Appliance Therapy <ul><ul><li>Tongue-Retaining Device </li></ul></ul><ul><ul><li>Mandibular-Advancement Device </li></ul></ul><ul><ul><ul><li>Fixed </li></ul></ul></ul><ul><ul><ul><li>Adjustable </li></ul></ul></ul>
    18. 18. Positive Airway Pressure Therapy <ul><ul><li>Continuous </li></ul></ul><ul><ul><li>Bi-level </li></ul></ul><ul><ul><li>Auto-titrating </li></ul></ul><ul><ul><li>Assistive Servo Ventilation </li></ul></ul>In real estate it is location, location, location. When it comes to successfully treating OSA it is the mask, the mask, the mask.
    19. 19. Surgery <ul><ul><li>Minor Surgery </li></ul></ul><ul><ul><ul><li>Correcting Deviated Septum </li></ul></ul></ul><ul><ul><ul><li>Removing Turbinate </li></ul></ul></ul><ul><ul><ul><li>Pillar Procedure </li></ul></ul></ul><ul><ul><ul><li>Hyoid And Tongue Procedures </li></ul></ul></ul><ul><ul><li>Major Surgery </li></ul></ul><ul><ul><ul><li>Uvulopalatopharyngoplasty (UPPP) </li></ul></ul></ul><ul><ul><ul><li>Maxillomandibular Advancement (MMA) </li></ul></ul></ul><ul><ul><ul><li>Tracheostomy </li></ul></ul></ul>
    20. 20. New/Future Options
    21. 21. Alternative Therapies
    22. 22. Take Away Messages… <ul><li>Diagnostics – variety of devices to choose from, with slowly increasing acceptance by the payors (insurers) </li></ul><ul><li>Treatments – Oral appliances, coming on strong; creative minds thinking outside the box with– Provent, Aura 6000, Ampakine. </li></ul><ul><li>Treatments II – What’s old is new again – didgeridoo, acupuncture, vocal lessons. </li></ul>
    23. 24. The American Sleep Apnea Association is the leading organization for education, support, and advocacy on sleep apnea. Our web site – www.sleepapnea.org – provides a wealth of information on all aspects of the disease. We sponsor a network of support groups operating under the name A.W.A.K.E. and online at www.apneasupport.org where patients help other patients. Facebook – www.facebook.com/sleepapneaassn
    24. 25. Thank you for your attention Are there any questions? Contact information: Edward Grandi 202-293-3650 [email_address]