Sleep Apnea Essay

Sleep Apnea Essay
Sleep Apnea is a chronic sleep disorder causing shallow, infrequent or pauses in breathing.
According to the National Sleep Foundation, sleep apnea affects more than 18 million Americans
and is as common as type two diabetes. Common in both children and adults, there are three main
types of sleep apnea. The first is central apnea, followed by the most common form, obstructive
apnea and finally the combination of both, mixed/ complex apnea. Although these three types of
apnea have differing symptoms and treatments, they all share negative effects on the body and sleep
cycles. The quality of sleep is usually lower than normal, as the pauses in breathing can often bring
apnea patients from a deep to a shallow slumber, as the body's natural warning for oxygen. This lack
of deep sleep can also cause drowsiness and fatigue during the daytime in addition to eyesight
problems and reduced reaction times. Sleep apnea, occurring in both children and adults is higher in
prevalence in Hispanic and African–American men. Central Apnea occurs in patients that
experience repeated shallow or absent breathing from 10 to 30 seconds that occurs throughout the
duration of the night. This is caused by an imbalance in the brains respiratory controls, foregoing
inhalation and creating high levels of carbon dioxide in the blood stream. Patients with central apnea
also tend to experience a delayed response to monitor respiratory rates. Although the body may be
deprived of oxygen, there are no
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Cellular Respiration Essay
Respiration is the process of carrying of oxygen from the air to the cells in the tissues and the
carrying of carbon dioxide to the air and it is done through the act of ventilation. This function is
supported by the respiratory system, which comprises of airways, lungs and the respiratory muscles,
and works in concert with the cardiovascular system to carry gases to and from the tissues. This
respiratory activity is orchestrated by a system that has the sensors, effectors and the central
controller, which work together for efficient gas exchange i.e. consumption of O2 and elimination of
CO2, which ensures normal pH for appropriate functioning of enzymes and different proteins that
maintain cellular function (13). The central controller is ... Show more content on Helpwriting.net ...
Indirect action on the afferent, central and efferent neural pathway as well as direct action in the
lungs by these halogenated anaesthetic agents cause ventilator depression by overwhelming
peripheral chemoreceptor drive by suppressing the central nervous system as well as the function of
the intercostal muscles and diaphragm. In addition there is reduction in the bronchial smooth muscle
tone, detrimental effect in the mucociliary function and dilatation of pulmonary vasculature which
inhibits pulmonary vasoconstriction due to hypoxia

Sleep Apnea Outline
Description: A sleep disorder in which breathing is repeatedly stopping and starting do to the brain
not sending proper signals to the respiratory muscles, which are the muscles that help you breathe.
Symptoms:
incidents of stopped breathing during sleep
Concentrating difficulties
Abruptly waking up
Difficulty staying asleep
Excessive daytime sleepiness
abnormal breathing patterns while asleep
Chest pain occurring at night
Changes in mood
Morning headaches
Snoring (not as common)
Excessive fatigue
Shortness of breath
Difficulty staying asleep
Swallowing problems
Voice changes
Weakness or numbness throughout the body
Causes: The condition can develop in people who have a problem with the brainstem, which is the
part of the brain that controls breathing. Situations that can cause or lead to CSA include: issues that
involve the brainstem, such as encephalitis (brain infection), stroke, or conditions of the neck, injury
to the brainstem, obesity, neurological disorders (such as Parkinson's disease), and certain medicines
(for instance narcotic painkillers). "If the apnea is not associated with another disease, it is called
idiopathic central sleep apnea" (Central Sleep Apnea, Sept. 2017). ... Show more content on
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Long–term effects: If left untreated for a long time CSA can lead to high blood pressure, heart
failure, depression, stroke, weight gain, and diabetes.
Therapies and

The Field Of Critical Care
Introduction
The field of critical care is rapidly changing. It is important for anesthesiologists be knowledgeable
of these changes for providing care to critically ill patients in the perioperative period. The purpose
of this chapter is to provide update for clinicians on ICU issues relevant to clinical practice. Topics
which will be discussed include: modes of mechanical ventilation, renal replacement therapy,
antibiotic prophylaxis, nutritional support, sedation management, transport and transfer of care.
I. Modes of Mechanical Ventilation
Introduction
Most patients undergoing general anesthesia for surgical procedures require mechanical ventilation.
One of the biggest challenges facing clinicians providing mechanical ventilatory support today is
managing the balance between providing adequate gas exchange and avoiding lung injury associated
with positive pressure ventilation. Patients with respiratory failure need adequate tissue oxygenation
and acid–base balance; however, the lungs are fragile structures that can be injured by over–
distension, alveolar collapse and reopening, and high oxygen exposure. This challenge in providing
"lung protective ventilation" is made more difficult by the fact that lung injury is often
heterogeneous and thus what may benefit gas exchange in one region (e.g., higher pressure) may
worsen injury in another.
Modern anesthesia ventilators are becoming increasingly sophisticated provide high performances in
delivering accurately and

Idiopathic Interstitial Pulmonary Firosis ( Ipf ) Essay
Idiopathic interstitial pulmonary firosis (IPF) is considered the most common form of interstitial
lung disease (ILD). Its course is a progressive of and its cause is unknown. Idiopathic interstitial
pulmonary firosis a‫ٶ‬ect the gas exchange as it results in chronic inflmmation and progressive firosis
of lung parenchyma. Нe signs and symptoms of this disease consist of progressive dyspnea,
hypoxia, clubbing and crepitations at the lung bases [1]. IPF is a fatal lung disease; the natural
history is variable and unpredictable: Most patients with IPF demonstrate a gradual worsening of
lung function over years; a minority of patients remains stable or declines rapidly. Some patients
may experience episodes of acute respiratory worsening despite previous stability. НH
ATS/ERS/JRS/ALAT 2011 Revised Diagnostic Criteria Нe diagnosis of IPF is based on the absence
of a known cause of lung firosis computed tomography (CT) fidings and, in cases with CT
abnormalities that are not classical for IPF, the use of pathological criteria [2]. An 2‫ٹ‬FLDO
ATS/ERS/JRS/ALAT Statement IPF is defied as a specifi form of chronic, progressive firosing
interstitial pneumonia of unknown cause, occurring primarily in older adults, limited to the lungs,
and associated with the histopathologic and/or radiologic pattern of unspecifid interstitial
pneumonia (UIP) [3]. НH Diagnosis of IPF Requires 1. Exclusion of other known causes of
interstitial lung disease (ILD) Нe presence of a unspecifid interstitial

Sleep Apnea Disorder
Imagine that a person is sleeping and all of a sudden they wake up and are unable to breath. It is a
scary thing but this happens to millions of people each year. One of the causes of this is Sleep
Apnea. This paper will help identify the disorder of Sleep Apnea, its symptoms, causes, diagnosis
and treatment. Sleep Apnea affects a person's breathing while they sleep. According to the Mayo
Clinic there are three types of Sleep Apnea: Obstructive Sleep Apnea (OSA), Central Sleep Apnea
and Complex Sleep Apnea Syndrome. The most common is OSA. In OSA, the throat muscles relax
which in turn causes the airway to collapse causing shallowing breathing or lapses in breathing.
Central Sleep Apnea is caused by the brain not sending the proper signals to the muscles that control
breathing. Complex Sleep Apnea Syndrome is when a person has both OSA and Central Sleep
Apnea. The National Heart, Lung and Blood ... Show more content on Helpwriting.net ...
Most people do not realize that they have Sleep Apnea because it happens while they are sleeping. It
is usually the person's significant other that helps identify this disorder. In my case, my wife helped
identify my Sleep Apnea disorder. One morning she said that I was not breathing normal while I was
sleeping . The tipping point for me came when on two occasions I woke up from sleeping, I sat up in
bed and I couldn't breathe. This lasted for about 30 seconds. At that point I knew I had to go see the
doctor to find out what was going on. The doctor set up a sleep study for me. A common method to
diagnose sleep apnea is a sleep study. A sleep study is usually performed at a sleep center that
specializes in monitoring your sleep. Some of the things they will monitor are: sleep state, eye
movement, muscle activity, airflow, heart rate, respiratory effort, and blood oxygen levels. By
monitoring these things they can determine if you have sleep apnea and the severity of

Acute Respiratory Failure
Mechanical ventilation is the treatment for patients who show the sign of acute respiratory failure.
Patients would get acute respiratory distress from inadequate oxygenation or ventilation that
associated with hypoxemia without or with hypercapnia. Mechanical ventilation is used for these
patients based on when the patients' partial pressure of oxygen in arterial (PaO2) is less than 50 mm
Hg and partial pressure of carbon dioxide (PaCO2) greater than 50 mm Hg.1 Under normal
condition, when patients are breathing normal or spontaneous the diaphragm contracts on inhalation,
moving toward the abdomen, and the chest wall expands.1 As one can see breathing through
mechanical ventilation is fundamentally different from normal breathing. Therefore, ... Show more
content on Helpwriting.net ...
However, as some study suggested, for patients who can breaths spontaneously PC ventilation may
lower the work of breathing (WOB), and improve comfort to a greater extent than VC ventilation.1–
7 Therefore, using PCV over VCV can reduce the needed for sedative and neuromuscular blocking
agent. Other than that PCV and VCV can provide equally work for the patients. Consequently, it is
up to the clinician and institutional preference in the selection of PCV versus VCV ventilation.
However each of them has different setting, advantage and disadvantage of

Sleep Apnea Syndrome (SAS)
Getting restful sleep is vital. During sleep, blood pressure and body temperature changes, while
respiration and heart rate decreases. Sleep apnea syndrome (SAS) is defined by repeated
interruptions in breathing and / or reduced respiratory flow during sleep. The most common
symptoms include difficulty breathing, snoring, restless sleep, excessive daytime sleepiness,
frequent headaches, enlarged tonsils and large tongue volume, and irritability. Sleep apnea can be
mild, moderate or severe. If it's left untreated, sleeping apnea may lead to diabetes, stroke,
cardiovascular disease, high blood pressure, obesity or depression. One common treatment is the use
of sleep apnea devices.
Using sleep apnea devices as a way of treatment usually involves oxygen administration with
continuous positive pressure (CPAP), which works ... Show more content on Helpwriting.net ...
Well, it's recommended to stop smoking and to avoid the consumption of alcohol, caffeine and
sedatives. Obese and overweight people should lose weight in order to improve the quality of sleep.
Overweight individuals who lose even 10% of their weight can reduce sleep apnea.
The sleep apnea devices is a method of treatment that your doctor will prescribe after diagnosing the
condition, Other things you can try is to elevate the head of your bed 4 –6 inches to alleviate
snoring. Maintaining regular sleep hours and using a nasal dilator is extremely useful.
CPAP–Continuous Positive Airways Pressure is considered the most effective method of therapy.
CPAP involves the use of a ventilation device that provides pressurized air to prevent the airway
from collapsing. This method is indicated for the treatment of moderate and severe SAS. Patients
who feel uncomfortable wearing this device have other options: bi level PAP and AutoPAP or Oral
breathing devices that keep the tongue and jaw in an optimum position to maintain the airways open
during

Positive Airway Pressure Essay
Introduction
Positive airway pressure (PAP) is the standard treatment for patients with moderate–to–severe
obstructive sleep apnea (OSA); a sleep–related breathing disorder (SRBD) characterized by episodic
complete or partial upper airway occlusion during sleep.1 Over the past years, the relationship
between SRBD and cardiac arrhythmias have been thoroughly investigated.2–7 Previous studies
have shown that obstructive sleep apnea syndrome (OSAS) predisposes to clinically significant
nocturnal impairment of the cardiac autonomic function and such impairment correlated with the
severity of OSAS.8–11 The respiratory event–related cyclic hypoxemia and arousal characteristic of
OSA causes dysregulation in the autonomic nervous system (ANS) in the form of enhanced
sympathetic activity, such impairment is thought to be the substrate ... Show more content on
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Material and Methods
Study

Airway Assesment Of The Difficult Airway Before Manipulation
CHAPTER III
AIRWAY ASSESMENT IN TRAUMA PATIENTS Identification of the difficult airway before
manipulation is the Holy Grail of clinical management. It is the first step in preparing for patient
care. Selection of airway devices, techniques, and procedures all pivot on airway evaluation (Carin,
2008). Preoperative examination of the airway is essential. Identification of patients with a
potentially difficult airway before anesthesia allows time to plan an appropriate anesthetic
technique. Previous anesthetic records should always be consulted. However, a past record of
normal tracheal intubation is no guarantee against difficulty on subsequent occasions as airway
anatomy can be altered as in trauma affecting the airway. The presence of stridor or hoarse voice is
warning sign for the anesthetist. As it is impossible to identify all patients with a difficult airway
during preoperative assessment, the anesthetist must be prepared to manage the unexpected difficult
laryngoscopy (Alan et al,. 2001).
 Historical Indicators of Airway Difficulty: The intent of obtaining an airway history is to elicit
previously known factors indicating that airway management has been (and likely will be) difficult.
Any patient who is awake and capable of coherent conversation should be asked about prior
intubation and ventilation successes or failures. Some patients possess a Medic Alert bracelet
indicating a history of difficult intubation or ventilation and this can be useful in obtunded

Ineffective Airway Clearance Analysis
Ineffective airway clearance related to adventitious lung sounds, rhonchi auscultated bilaterally at
the patient's bases as evidence by CT scan displaying pleural effusion and basilar atelectasis. Y.B.'s
ability to clear his airway is ineffective due to his current disease state. His alveoli are deflated due
to pleural effusion. The pleural effusion is a result of blocked lymphatic drainage from the pleural
cavity, possible caused by malignant cells (Lewis, Dirksen, Heitkemper, Bucher, 2014). The goal
for Y.B. is to maintain a clear, open airway, and improvement in lung sounds before discharge.
Ensuring the patient uses the upright position, maintaining the head of the bead above 30o, will keep
his abdominal contents from inhibiting lung expansion. This intervention will be evaluated by
assessing lung sounds, pulse oximetry, assessing if Y.B. is using accessory muscles to breath, and a
chest X–ray. In the article titled, ... Show more content on Helpwriting.net ...
The purpose of this study was to analyze the accuracy of identifying characteristics of ineffective
airway clearance in an effort to minimize the severity of pulmonary complications (Pascoal et al.,
2015). Article states that adventitious breath sounds is a defining characteristic of ineffective airway
clearance, and properly positioning a patient during the postoperative period can be linked to
decreasing accumulation of secretions in the airway (Pascoal et al.,

REM Behavior Disorder (RBD)
REM behavior disorder (RBD) is a neurodegenerative brain disorder that causes abnormal sleep
phenomenon in which individuals act out their dreams. Individuals RBD have been observed flailing
their arms and legs as if defending themselves against imaginary enemies. In some severe cases,
people with RBD have gotten out of bed, driven cars, harmed themselves, and assaulted family
members. In one of the more frightening cases of RBD discussed during the lecture, a police officer
awoke with his gun pointed at a door, as if defending himself against an intruder. This disorder has
even been used, both successfully and unsuccessfully, in court as a murder defense. There are five
phases of sleep which are, stages 1, 2, 3, 4, and REM sleep or, rapid ... Show more content on
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During the 1930s there was extensive use of this technology in caring for victims of the polio
epidemic. These iron lungs were cumbersome, and provided little access to provide patient care.
Recent advancements however, have made negative pressure ventilation a viable option in non–
invasive mechanical ventilation. The modern iron lung consists of a flexible cuirass, or shell,
which is designed to fit over the anterior of the chest. On inspiration, a negative pressure helps to
pull the rib cage up and forward, increasing the space in the thoracic cavity, facilitating better air
flow and ventilation. Expiration is achieved by passive recoil. These latest devices offer many of the
same ventilatory modes as positive pressure vents do, as well as, high frequency chest wall
oscillation and cough assistance. The HFCWO assists patient in mobilizing secretions much the
same way the vest works in chest physiotherapy. The cuirass can also provide peep by providing a
continuous negative distending pressure baseline. This negative extrathoracic pressure provides a
new functional reserve capacity (FRC) from which the patient can breathe from. Biphasic cuirass
ventilation can also provide a positive pressure to assist in assist in exhalation. This positive phase
decreases the potential for large end expiratory lung volumes which may facilitate gas trapping or
barotrauma to compromised lung

Therapy And Increased Compliance While Using Nasal Pillows
Therapy and Increased Compliance While Using Nasal Pillows
Mae Cavalcanto
Linn State Technical College
Practical Nursing Program
Fundamentals of Nursing
Abstract
Sleep apnea is a sleep disorder that was previously considered to be a disorder of the aging
population. However, more and more young patients are being diagnosed with and treated for Sleep
Apnea. This group is comprised of groups of people with poor sleep hygiene (patients working shift
work, such as health care workers, service members, fire and rescue workers, etc) ResMed
(Headquartered in Germany) is a large supplier of CPAP (Continuous Positive Airway Pressure)
durable medical equipment. They conducted a study of 212 patients who were considering stopping
their prescribed CPAP therapy to see if changing to a different kind of mask (Nasal Pillow) would
change patients' minds about discontinuing their CPAP therapy.
Procedures
There were 5 specific groups of patients studied:
1. New CPAP users
2. Users already using a different type of nasal pillow mask (NASAL PILLOW MASK)
3. Established CPAP users
4. Users with low usage compliance
5. Users who were considering discontinuing their current CPAP therapy
Compliance was monitored by two methods, one being a traditional sleep lab, while the other was
having the data down loaded from the CPAP unit to be studied. CPAP units now have the ability to
be monitored remotely. The usage data on the unit is transmitted to a satellite. From the

Informative Essay On Sleep Apnea
If you have recently been diagnosed with sleep apnea and have done your research, then you will
know that treating your sleep apnea is essential, to prevent long term health risks. This page is
designed to inform you about all of the different sleep apnea treatment options available.
A summary of treatment options available for Sleep Apnea:
– CPAP (Continuous Positive Airway Pressure)
– Bilevel
– Oral Appliance Therapy
– Surgery
– Weight loss and lifestyle changes
CPAP Therapy
Continuous Positive Airway Pressure delivers a constant airflow to people while they are asleep to
prevent their airways from collapsing during the night. It is often the most prescribed and common
form of treatment. It is a pain free treatment, which may take some getting used to, but once you are
comfortable with using the CPAP therapy regularly, you will notice the benefits. You will begin
feeling less tired throughout the day and you and your partner will experience a much better quality
of sleep. Not forgetting that eventually, the rewards of treating your sleep apnea will put you less at
risk of developing any other serious health ... Show more content on Helpwriting.net ...
However, it is highly advisable that you would avoid this option as treatment as the risks outweigh
any benefits. The surgical treatments tend to be a painful option, which can cause long recovery
times, and carry the risk of more serious complications. It is not recommended, even by leading
healthcare professionals due to evidence suggesting that it is not as effective as CPAP therapy in
controlling the symptoms. Many people who have surgery are often going through the procedure
several times as it is not a permanent solution and through the amount of risk and pain involved, it is
best to avoid this method of treatment if possible. It is usually considered a last resort when all other
treatment options have failed, and if the condition severely affects your quality of

Obstructive Sleep Apnea
Obstructive sleep apnea (OSA) is when someone is experiencing episodes of cessation of breaths
during sleep because of their upper airway relaxing and obstructing air flow during sleep. The
episodes usually last for ten seconds or greater and is usually accompanied with a decreased oxygen
saturation. Although the airway is relaxed and obstructing airflow, the body (brain) is still
attempting to breathe. When breathing has resumed from its apneic state, there is usually a loud
gasping snore and or body jerking which can lead to restless sleep for the person with OSA and their
partner. According the National Heart Lung and Blood Institute more than twelve million people in
the United States have this clinical disorder. People who have OSA may be sleepy in the day and
experience subsequent disorders such as oxyhemoglobin desaturation, pulmonary hypertension,
right–sided heart failure, arrhythmias, myocardial infarction and diabetes. Proper diagnosing and
treatment of a person with OSA can yield optimal results thereby improving quality of life.
Some causes or risk factors of Obstructive Sleep Apnea are being overweight or obese, having a
large neck, having a narrow airway, high blood pressure, diabetes, being middle aged, and having a
genetic predisposition. Patients with OSA seem to have high cholesterol with an increase in LDL's
and a decrease in HDL's (good cholesterol (Nadeem R, 2014). Intermittent sleep or sleep deprivation
causes changes in the way the body metabolizes

Critique on the Nursing Article Critical care patients’...
This assignment aims to critically analyse a chosen nursing research article Critical care patients'
experience of the helmet continuous positive airway pressure by Dimech (2011) and was published
in the Journal of Nursing in Critical Care (JNCC). It will examine both the strengths and limitations
of the study by weighing various elements of the research undertaken and its value and implication
for nursing practice. It will use a critiquing tool by (Ryan, 2007) (see Appendix 1).
Evidence based practice (EBP) is to offer the best care possible to individual patients and use
professional judgement to determine nursing care in order to improve patient outcome and even save
lives (Moule and Hek, 2011). The Nursing and Midwifery Council ... Show more content on
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This article by Dimech is published in a peer–reviewed journal (JNCC). Which means it is being
reviewed by experts in the field. Palatnik (2012) stated that Nursing in Critical Care is a peer review
journal that presents the latest practical clinical and professional information in a clear, concise,
hands–on approach, which critical care nurses can use in day–to–day practice. Also, the study was
undertaken within an acute NHS Foundation Trust which means it is relevant to can be used to
improve practice within NHS Trust.
The title of the article is effectively worded to ensure that readers correctly understand the nature of
the research and whether it is relevant to them as justified by (Marshall, 2005). Also, Polit et al.,
(2010) stated that title is an important means in ascertaining the research design used as it may
feature a research question that is to be answered, or a hypothesis to be proven. In this case, the title
of this article made a clear identification of the patient lived experience of helmet CPAP. Perhaps the
title could have identified that the study was conducted only on male patients even though this was
unintentional.
The author was suitably qualified to undertake the study based on his qualification and experience in
critical care. However, this is his first published work which makes him a novice researcher. Robson
(2011) stated that it can be challenging and complicated to conduct a reliable

Premature Lungs Essay
Premature neonates or preterm babies refer to the neonates that are born before 37 weeks of
gestation are over. Given that most of the body organs are not completely developed at this stage,
the neonates have a high risk of developing many complications at birth. A good example of these
organs is the lungs, which completely mature by week 36 of gestation. Therefore, neonates born at
37th weeks are likely to have immature lungs that are associated with respiratory problems such as
respiratory distress syndrome, pneumonia, and apnea of prematurity. Respiratory distress syndrome
(RDS) develops as a consequence of the lung's inability to produce enough surfactant necessary for
maintaining the air spaces in the lungs in an open state. As a ... Show more content on
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According to DiBlasi, even in animal models, the conventional methods cause inflammation of the
lungs and sometimes cause injure to the lungs.1 These techniques also cause redundancy in alveolar
growth and also affect the efficacy of surfactant produced in the animal lung.1 This is a good signal
that these techniques may have serious consequences in the neonate. One of the adverse effects of
invasive and mechanical ventilation is ventilator–induced lung injury.1 This complication is defined
by the presence of polytrauma (excessive tidal volume) and shear injury to the airways, a condition
known as atelectrauma.1 Insertion of the endotracheal tube into the lungs through the airways also
causes injury to the lungs and the airways, a condition known as endotrauma.1
Insertion of the endotracheal tube through the airways is also a painful procedure that may need the
neonate to be sedated first. According to DiBlasi, insertion of the tube may also cause acute airway
injury, emergencies, an infestation of the airway with bacteria, reduced ciliary function and
increased resistance to airflow that may result to increased work of breathing (WOB) energy
required for breathing.1 Another common complication associated with a conventional method is
bronchopulmonary dysplasia.2 This is usually a serious condition, and may progress to a condition
that resembles chronic asthma later in the child's life.2 According

Obstructive Sleep Apnea And Effects On Blood Pressure Essay
Continuous Positive Airway Pressure in Those with Obstructive Sleep Apnea and the Effects on
Blood Pressure
One issue faced daily in primary care is the incidence of hypertension. This disease impacts
approximately 25% of the adult population in the world. Risk factors for hypertension include
genetics, poor diet, obesity, sedentary lifestyle, and other disease processes. In addition, obstructive
sleep apnea (OSA) has been recognized as an additional risk factor in the development of
hypertension according to European and US guidelines (Pepin et al, 2014). According to Ohio State
physicians Magalang and Valentine, (2015), there are possibly ten million people who have resistant
hypertension, and most of those have OSA. In contrast, the National Sleep Foundation explains that
sleep apnea affects more than 18 million people (Sleepapnea.org, n.d.). These numbers are
staggering. A diagnosis of obstructive sleep apnea increases a patient's chances of developing
hypertension. With this information in mind, it is prudent to recognize the correlation between
treating obstructive sleep apnea with CPAP therapy and the benefits of this therapy in regards to
blood pressure. Keeping in mind that many patients with sleep apnea have hypertension, questions
remain regarding treatment options. Today, many patients use more than two medications in order to
decrease their blood pressures; unfortunately, this does not always work (Magalang Valentine,
2015). If it is our duty as

Infective Airway Diseases
Mechanical ventilation in Infective airway diseases
Introduction
Nearly 50% of patients with infective airway diseases are at an increased risk of developing Acute
Lung Injury or Acute Respiratory Distress Syndrome (ALI/ARDS). Endotracheal intubation may be
lifesaving in these situations, as they allow provision of adequate tissue oxygenation, reduce the
respiratory muscle effort and avert hemodynamic embarrassment. Over the last 20 years, many
clinical evidences have highlighted the harmful consequences of invasive mechanical ventilation
such as Ventilator associated pneumonia (VAP) and excessive mechanical stress leading to
perpetuation of lung injury.
Unavailability of robust clinical data fails to provide enough evidence–based data on ... Show more
content on Helpwriting.net ...
Does prone positioning affect 1) gas exchange or 2) outcome in sepsis related ALI, and 3) should
prone positioning be used for patients with ARDS requiring potentially injurious levels of FIO2 or
plateau pressure?
Recommendation:
In facilities with adequate experience, prone positioning should be considered in patients requiring
potentially injurious levels of FIO2 or plateau pressure who are not at high risk for adverse
positional changes.
6. Is there a defined fluid management strategy in sepsis–related ALI/ ARDS?
Recommendation:
Avoid administration of fluids in excess of those amounts needed to maintain appropriate vital organ
perfusion. Consider use of colloids in hypoproteinemic patients with ALI/ ARDS.
7. Are corticosteroids indicated in the 1) prevention, 2) early treatment (exudative phase), or 3) late
treatment (fibroproliferative phase) of sepsis induced

Nur504 Week 5 Collaborative Learning Community: Ebp...
NUR504 Week 5 Collaborative Learning Community: EBP Literature Latest
Click Link Below To Buy:
http://hwcampus.com/shop/nur504–week–5–clc–ebp–literature–latest/
This is a CLC assignment.
Follow the instructions provided in CLC Assignment: Evidence–Based Project (EBP).
Utilize the Synthesis Table, Table of Evidence and EBA Project Evaluation Tool to complete your
CLC assignment. Submit these documents for this weeks CLC assignment.
While APA format is not required for the body of this assignment, solid academic writing is
expected and in–text citations and references should be presented using APA documentation
guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
This assignment ... Show more content on Helpwriting.net ...
2008 Gosseling, R.
2000 Joris, J.
1997 Ebeo, C.
2002 Westwood K.
2007 Leech, C
2007 Freitas, E.
2007 Overend, R.
2001 Sungur, M.
2007 Bourne, R.
2007 El Solh
2006 National Guideline Clearing House
2004
Levels of Evidence I II II II III VII I I VII IV III I
Design Systematic Review RTC RCT RCT Observational Study–Non Randomized Case
Report RTC Systematic Review Expert Comment Retrospective
Quantitative Prospective Control Trial NGC/AHRQ Guideline
Evidence does not support IS in prevention of PPCs X X X X
Evidence supporting use of IS to prevent PPCs X
Evidence Supporting Use of NIPPV to Prevent PPCs X X X X X X X
NIPPV/BiPAP Treatment 12/4
12–24hrs Post–op

2 out of 3 hrs X X Intraoperative 3hrs post–op 48 hrs post extubation 5 on out of 6 hrs
BiPAP S/T–D
Obese Related Surgery X X X
Hip X X X Obese patients X (OSA surgery)
Abdominal Surgery X X X X X
Thoracic Area/Cardiac X X X
QRTC= quasi–experimental –nonrandomized controlled trials CD=cross–over design CS=case
series PCS= prospective cohort study RCS=retrospective case series MA=meta–analysis
NIPPV=Noninvasive positive pressure ventilation BiPAP=Bi–level positive airway pressure
hrs=hours
NUR–504: Table of Evidence Study 1 Study 2 Study 3 Study 4 Study 5
Author
Study title
Research Questions

Continuous Positive Airway Pressure (CPAP)
CPAP and APAP Before talking about the Resmed S9 device features, let's understand something
more about its use. In cases of sleep apnea syndrome of severe entity, the reference therapy is based
on the use of a nocturnal ventilation named CPAP. Such medical treatment is customized based on
medical history, medical examination and results of polysomnography. CPAP (Continuous Positive
Airway Pressure) is the personalization of the pressure ventilator, or a series of tests and
examinations to determine the minimum effective operating pressure. Along with it are done
experimenting with various masks to allow the patient to choose the most effective and comfortable
form. These tests are essential to ensure maximum comfort to the patient and to minimize the most
common disorders related to breathing through a mask, such as irritation and nasal congestion. ...
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The CPAP consists of a small ventilator, from a pipe and a nasal mask or nose buccal. Of course, all
these elements are chosen and carefully calibrated, using a procedure defined titration, depending on
the patient and the characteristics of his nocturnal respiratory pathology. The greater the attention
given to the patient and the medical personnel's experience at this stage, the higher the patient
treatment compatibility. Auto CPAP (APAP), is a CPAP is the ability to automatically vary the
pressure in response to variation of flow (apneas/hypopneas or limitation) or snoring intensity. Has a
preferential use in patients with poor compliance to treatment with CPAP or in patients with OSAS
with apneas/hypopneas present in only limited periods (such as in close and exclusive association
with REM). Resmed S9

Essay on Treatment of a Thick Mucus Found in the Lung
The thick mucus in the lungs resulting from the disease causes repeated infections and tissue
damage apart from airway obstruction. This is why a fundamental part of the treatment is to clear
this mucus.
Physiotherapy can be used to clear the mucus as a daily therapy and usually commencing as soon as
the diagnosis of CF is made, and more frequently during exacerbations.
It has been scientifically proved that physiotherapeutic airway clearance techniques have great
effects on the patients, however it may result unpleasant, uncomfortable and time–consuming.
Keeping the airways clean of secretions helps preventing pulmonary infections and improving the
lung function.
These physiotherapeutic techniques are ... Show more content on Helpwriting.net ...
It can be sometimes accompanied by percussion or vibrations
Forced Expiration Technique: Forced expiratory manoeuvre causing compression and narrowing of
the airways, it helps moving secretion from smaller to larger airways from where they can be cleared
more easily
This Cycle would consist in the following procedure:
The cycle is repeated several times.
Positioning
The position of the patient during the airway clearance techniques is going to have an important
effect on the results.
Postural drainage: Also called gravity assessed positioning, consists in using different body
positions to help the drainage of secretions from specific areas of the lungs and also helps to
increase the air movement or ventilation to different parts of the lungs. It is usually associated to
percussion technique. Different positions apply to babies, older children and adults, but the
physiotherapist will recommend the best positions for each patient.

Percussion and vibration
These techniques help loosen and mobilize secretions.
Percussion: Also

What´s Sleep Apnea?
Sleep Apnea
Sleep apnea is a condition in which breathing pauses during sleep. When you have sleep apnea, you
move out of deep sleep and into light sleep. As a result, you do not sleep well and your body does
not get the rest it needs. If sleep apnea is not treated, it can lead to:
High blood pressure.
Coronary artery disease.
An inability to achieve or maintain an erection (impotence) in men.
Worsening thinking abilities.
There are three kinds of sleep apnea:
Obstructive sleep apnea. This kind is caused by a blocked airway.
Central sleep apnea. This kind happens when the part of the brain that controls breathing does not
send the correct signals to the muscles that control breathing.
Mixed sleep apnea.

The Causes Of Premature Neonates
Introduction
Premature neonates or preterm babies refer to the neonates that are born before 37 weeks of
gestation are over. Given that most of the body organs are not completely developed at this stage,
the neonates have a high risk of developing many complications at birth. A good example of these
organs is the lungs, which completely mature by week 36 of gestation. The surfactant production
does not begin until 20 weeks of gestation age; at this stage of gestation surfactant only present in
small amount and in immature form. The mature surfactant production begins approximately after
35 weeks of gestation age. Even though the lung has mature surfactant at this stage it is not
completely capable of respiratory function. Therefore, ... Show more content on Helpwriting.net ...
However, even if these methods have managed to reduce mortality in preterm infants, they are
associated with serious adverse effects that may be fatal or contribute to chronic conditions later in
life of the patient.
According to DiBlasi, even in animal models, the conventional methods cause inflammation of the
lungs and sometimes cause injure to the lungs.1 These techniques also cause redundancy in alveolar
growth and also affect the efficacy of surfactant produced in the animal lung.1 This is a good signal
that these techniques may have serious consequences in the neonate. One of the adverse effects of
invasive and mechanical ventilation is ventilator–induced lung injury.1 This complication is defined
by the presence of polytrauma (excessive tidal volume) and shear injury to the airways, a condition
known as atelectrauma.1 Insertion of the endotracheal tube into the lungs through the airways also
causes injury to the lungs and the airways, a condition known as endotrauma.1
Insertion of the endotracheal tube through the airways is also a painful procedure that may need the
neonate to be sedated first. According to DiBlasi, insertion of the tube may also cause acute airway
injury, emergencies, an infestation of the airway with bacteria,

Cpap Anatomy
Carter Alford EMT–Paramedic to Paramedic Course 07/21/15 Instructor– Wesley Carter Continuous
Positive Airway Pressure–CPAP Continuous Positive Airway Pressure or CPAP as it is known, uses
forced air to keep a patients airway open. It has common uses that most people are familiar with
such as sleep apnea. But it also used in emergency and hospitals routinely to treat sicknesses such as
congestive heart failure. In this essay I will give a brief history on CPAP, a basic overview of its
anatomy and the some of the many uses of CPAP and health benefits. Dr. Collin Sullivan in the
1980's began testing his idea of continuous positive pressure or forced air through the nasal and oral
airway. He began testing this idea to help alleviate patients who had chronic obstructed airways so
that a tracheotomy was not the only option. The first machine used was a vacuum motor with plastic
tubes and silicone sealant. The first patient that Dr. Collin Sullivan treated experienced relief
immediately. This propelled the research and by 1985 Philips Respironics released the first
commercial CPAP device. The first self–sealing CPAP device came out in the 1990's with the
Bubble Mask. ... Show more content on Helpwriting.net ...
It begins with a small motor that provides forced humidified air down a small tube. There is next a
long sealed flexible tube that is connected from the motor to the actual CPAP mask. The CPAP mask
is a mask that either fits just over the patients nose or completely over the patients mouth. It has a
strong but flexible strap that fits around the back of the patients head to keep the mask firmly placed
over the patient's nose of mouth. The mask lastly has a soft self–sealing rim around the edge of the
mask to provide a form fit on the patient's mouth or nose. Overall it is a simple design that has such
a huge health impact on a large population of

Effectiveness Of Scenario Based Learning During Training...
The Effectiveness of Scenario–Based Learning in Training Healthcare Worker: Literature Review
The effect of innovations within the healthcare industry lead to many scientific and technical
changes in health care delivery. To cope with these changes, there necessitate to prepare and train
health care workers to improve employees ' knowledge and the quality of care and. Limited clinical
experience with new mode of mechanical ventilation such as Airway Pressure Released Ventilation
mode make its implementation difficult in real critical world. Adequate staff training time and
offsite support services and backup from ventilator manufactures are essential to improve employees
' knowledge and skills. My research topic seeks to investigate the effectiveness of scenario–based
learning in training healthcare practitioners for the use of APRV. Airway Pressure Released
Ventilation (APRV) was first introduced by Dr. Christine Stock and Dr. John Downs, in late 1980s.
The APRV application was originally used as a rescue therapy to manage ARDS patients who have
difficulty in oxygenation.{40} The Drager Evita was the first ventilator provide APRV. Other ICU
ventilator manufacturers incorporated APRV mode with different terminology. Such as, the Maquet
Servoi refers to APRV as Bi–vent; the Puritan Bennett 840 uses the term Bi–level; the Cardinal
AVEA uses Bi–phasic; and Hamilton G5 refers to APRV as DouPAP.{13} Airway Pressure Released
Ventilation is a form of nonconventional mode of

Obstructive Sleep Apnea Essay
Do you get elbowed, and told to roll over in the middle of the night? Do you wake up in the morning
exhausted? It's possible that you could have a severe and potentially fatal disorder called Obstructive
Sleep Apnea. OSA can affect anyone; from infants to adults, the healthy and physically fit, and the
obese. The cause of OSA can come from a single or multiple airway abnormalities. You can be born
with OSA, or it can develop over time. As a whole; it's a degree of airway blockage at the back of
your throat. You may have tissue enlargement, throat muscle relaxation or a combination of both.
When we sleep, the airway will narrow or closes off. The airway anatomy involved are the
pharyngeal tonsil or commonly referred to as adenoid, the soft palate, uvula, palatine tonsils, tongue,
and your third tonsil called the lingual tonsil. If someone becomes obese or when your neck
circumference increase they are at higher risk of OSA due to fat deposits that accumulate around the
upper airway. Women that are going through menopause that gains weight could end up with OSA.
The use of alcohol and sedatives will also relax your throat muscles. Smokers are more likely to
have OSA due to an increased amount of inflammation and ... Show more content on
Helpwriting.net ...
The procedure is called laser ablation uvulopalatopharyngoplasty. It's when the soft palate, tonsils,
adenoids, lingual tonsils, and uvula are surgically removed or burned off. This operation should
successfully stop the throat structures from vibrating or obstructing the airway. More extreme
measures would be weight–loss surgery, Maxillomandibular advancement; jaw repositioning by
moving it forward from the remainder of your facial bones, which will enlarge the space behind the
tongue, soft palate, making obstruction less likely. A tracheostomy is the only other treatment if all
else has failed and you have severe, life–threatening sleep

Cystic Fibrosis Literature Review
Cystic fibrosis (CF) is a multisystem disease: the major clinical manifestations are related to
respiratory disease. Clinical manifestations of CF are retention of sputum, reduced exercise capacity,
and breathlessness. Physical therapy involves a range of interventions (e.g. airway clearance,
physical therapy), which have an overall aim of reducing progression of CF. In this article, different
techniques were discussed in an effort to reduce cystic fibrosis progression. Current measures being
utilized were mentioned such as auscultation; incentive spirometer; pulse oximeter, and sputum
weight or volume, as well as the less frequently use measures such as radio aerosol clearance;
arterial blood gas; cough frequency, breathlessness, sputum culture,

Dyspnea And Asthma Case Study
CC: Followup dyspnea and asthma. History of Present Illness: Mr. Goldstein is here for followup of
his pulmonary function tests, CT scan, and sleep study. He states that his dyspnea is improved after
initiation of Advair HFA. He still is complaining of some fatigue, shortness of breath and general
malaise. The thyroid function testing was grossly abnormal and he is being evaluated by Core
Physician Endocrinology in the next one to two months. Otherwise, he states his cough is markedly
improved. He is still using tobacco products, roughly one pack daily and he does have a CPAP
machine at home, however has not initiated any therapy for his OSA. Medications: 1. Gabapentin. 2.
[___1:32_] 3. Lorazepam. 4. Zolpidem. 5. Ranitidine. 6. Sumatriptan.

Sleep Apnea Treatment Options
Sleep Apnea Treatment Options
By Bob Shaughnessy | Submitted On May 18, 2011
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Available Sleep Apnea Treatment Options
Various treatment options are available for treating this sleep disorder. Sleep apnea causes chronic
sleep deprivation resulting from periodic breathing pauses that can last more than 10 seconds and
occur as many as 50 times per hour. These breathing pauses frequently jolt one from sleep, making
sleeping ... Show more content on Helpwriting.net ...
Continuous Positive Airway Passage which is prescribed for OSA can also be prescribed to treat
CSA.
Bi–level Positive Airway Pressure which supplies greater air pressure when one inhales and less air
pressure when exhaling can also be effective in treating CSA.
Adaptive Servo–Ventilation – this makes use of a computer to monitor breathing patterns and
creates increased air pressure if breathing becomes abnormal. This is one of the latest and probably
more successful sleep apnea treatment options for CSA.
Sleep apnea is a serious medical condition that causes millions of people to suffer. From the social
consequences of snoring to the reduced work productivity caused by lack of sleep to the industrial
and highway accidents caused by lack of concentration and drivers falling asleep at the wheel, the
costs associated with sleep apnea are in the billions of dollars. Fortunately, people do not have to
suffer in vain. There are many successful options available for sleep apnea treatment.
Is sleep apnea or snoring ruining your life or your relationship? Sleep apnea is a serious medical
condition that affects millions of people. You don't have to feel guilty any longer but you do need to
take

Effect Of Innovation Within The Healthcare Industry
The effect of innovations within the healthcare industry leads to many scientific and technical
changes in healthcare delivery. To cope with these changes, there necessitate to prepare and train
healthcare workers to improve employees ' knowledge and the quality of care. Limited clinical
experience with new mode of mechanical ventilation, such as Airway Pressure Released Ventilation
mode, make its implementation difficult in real critical world. Adequate staff training time, offsite
support services, and backup from ventilator manufacturers are essential to improve employees '
knowledge and skills. My research topic seeks to investigate the effectiveness of scenario–based
learning in training healthcare practitioners in the use of APRV. Airway Pressure Released
Ventilation (APRV) was first introduced by Dr. Christine Stock and Dr. John Downs, in the late
1980s. The APRV application was originally used as a rescue therapy to manage ARDS patients who
have difficulty in oxygenation.{40} The Drager Evita was the first ventilator provide APRV. Other
ICU ventilator manufacturers incorporated APRV mode with different terminology. Such as, the
Maquet Servoi refers to APRV as Bi–vent; the Puritan Bennett 840 uses the term Bi–level; the
Cardinal AVEA uses Bi–phasic; and Hamilton G5 refers to APRV as DouPAP.{13} Airway Pressure
Released Ventilation is a form of nonconventional mode of ventilation that based on open–lung
principle.{13} It is a time triggered, pressure limited, and

Infective Airway
Introduction: Mechanical ventilation (MV) strategies in Infective Airway Diseases (IAD) are an
important area of concern for an intensivist or clinician.
Objective: To evaluate MV strategies in IAD based on literature survey.
Method: Literature survey on 'Mechanical Ventilation' and 'Infective Airway Disease' was
undertaken using PubMed MEDLINE search. Methodological filters were applied to limit
retrieval to evidence based clinical data. Incomplete methodology, results in abstract form, duplicate
publications were excluded. Data extraction forms were piloted and used to obtain uniform quality
of data. Data presented as recommendations (Grade A B) using a narrative approach.
Results Conclusion: Bibliographic 'human' databases accessed ... Show more content on
Helpwriting.net ...
Patients with shock, altered mental status, or increased airway secretions should not be treated with
NIPPV. NIPPV is indicated in patients with sepsis–induced ALI/ARDS with a normal mental status
who are likely to recover within 48–72 hrs.[4,5]
3. What is the role of MV in acute respiratory failure (ARF) related to lung infection or sepsis?
Recommendation:
The early placement of an endotracheal tube is justified to limit the work of breathing, protect the
threatened airway, or prevent cardio–respiratory arrest. Common indications for institution of
mechanical ventilation may include profound tachypnea (respiratory rate 40), fatigue or failure of
respiratory muscles (use of accessory muscles), refractory hypoxemia on high levels of inspired
FiO2, compromised cardiac performance, life–threatening metabolic acidosis, and altered mental
status.[6]
4. Should 'permissive hypercapnia' be used in patients with ALI/ARDS in the setting of upper
respiratory tract infections?

Risk Factors For Cardiovascular Disease
Critical Analysis
Introduction
Hypertension impacts nearly 25% of the adult population around the world. It is considered one of
the foremost risk factors for mortality, and is responsible for 13.5% of all deaths. In addition, half of
all strokes and ischemic cardiac disease are triggered from high blood pressure (Pepin et al.2014).
According to the newest guidelines, hypertension is defined as a systolic blood pressure greater than
or equal to 140 or a diastolic blood pressure greater than or equal to 90 (Jin, 2014). Systemic
hypertension remains one of the most modifiable risk factors for cardiovascular disease. In
hypertensive patients, between 12%–27% require at least 3 medications to achieve sufficient
control; these patients are considered to have resistant hypertension. Furthermore, those with
resistant hypertension have a 50% greater chance of experiencing a cardiovascular event in
comparison to those without resistant hypertension, and according to the literature, the numbers of
cases are increasing (Martinez–Garcia et al. 2013). As of recent, obstructive sleep apnea (OSA) has
been recognized as a risk factor in the development of hypertension according to European and US
International guidelines (Pepin et al. 2014). Obstructive sleep apnea is characterized by the collapse
of the upper airway during sleep, consequently ending in intermittent asphyxia. Moreover, this
disruption increases brain arousal, transient hypoxemia, and increased sympathetic flow.

Non-Invasive Positive Pressure Ventilator (NPPV)
Mechanical ventilation is any method by which physical devices or machines assist or replace
spontaneous breathing. It is indicated when there is ineffective gas exchange in the lungs or the
patient's spontaneous ventilation is inadequate. Mechanical ventilation can be classified into
negative and positive pressure ventilation. Mechanical ventilation may also be classified as invasive
or non–invasive.
Non–Invasive positive pressure ventilator (NPPV) is a means of supporting failing respiratory
function by providing oxygen enriched gas under pressure without requiring endotracheal
intubation. Options for NPPV include
– Continuous Positive Airway Pressure (CPAP)
– Bi–level Positive Airway pressure (BPAP)
The Respironics BiPAP Auto Bi–Flex system ... Show more content on Helpwriting.net ...
1. Prior to bedtime, fill the humidifier tank with distilled water. Gently lift up the humidifier door
and slide the tank towards you. Open up the tank and fill with distilled water to the maximum line. (
do not go over this line). Reassemble the tank and slide it back into the humidifier and close the
door.
2. Connect the device to a power source to turn on the device.
3. The home screen appears on the display. Using the control dial, highlight therapy then depress the
dial to turn on air flow and start therapy.
4. Put on the mask and headgear and adjust to prevent air leakage (Do not overtighten)
5. The flexible tubing connected to the humidifer delivers air to the patient through the mask. Make
sure it has room to move freely when you turn on your side or move your head from side to side.
6. The humidity setting may be adjusted. The ideal humidity is different for each patient and
depends on the temperature and humidity of the room.
7. The ramp feature can be pressed to gradually increase the air pressure to your prescription setting,
to allow you fall asleep easily
8. In the morning when you wake up, turn off the device my pressing the control

Sleep Apnea Definition
According to the National heart, lung, and blood institute website, Sleep apnea is a common
disorder in which a person has one or more pauses in breathing or weak breaths while they sleep
(NIH–National heart, lung and blood Institute, 2012, definition). The pauses and breathing can last
from a few seconds to minutes, and breathing pauses may happen 30 times or more an hour. After
the pauses, normal breathing can start but with a loud snort or choking sound (NIH–National heart,
lung and blood Institute, 2012, definition). Sleep Apnea can be categorized in three types:
obstructive sleep apnea, central sleep apnea and complex sleep apnea syndrome.
The cause of sleep apnea is due to a blockage of the throat muscles that keep airway flow open.
Some of the reasons for the blockage can be the relaxing of throat muscles and tongue unusually, the
size of your tongue and tonsils are not appropriate for the opening of your windpipe, and people
with weight issues. Other reasons can be the size of your head and neck which may lead to a narrow
airway passage in the mouth and throat. In addition, as people get older, the brain signals' ability
gets worse and causes throat muscles to stiffen. Consequently, airways have an increased chance of
narrowing or collapsing (NIH–National heart, lung and blood Institute, 2012, causes). Snoring is
one of the most known factor of sleep apnea, and ... Show more content on Helpwriting.net ...
According to Sleep Education website, Other symptoms of sleep apnea are daytime

What Causes Obstructive Sleep Apnea?
Obstructive Sleep Apnea (OSA) is one of three types of sleep apnea and is the most common. If you
are diagnosed with OSA you are not getting the sleep you need. Apnea is a period without breathing.
While you're sleeping your airway is becoming narrow and obstructed. If you're not breathing your
body is not getting the oxygen it needs to function properly. This period of apnea may cause you to
wake up excessively during the night. Sleep deprivation in conjunction with the lack of oxygen
during the apneic period has many severe long lasting effects on the body. Not only are you
suffering from this lack of sleep, but your spouse maybe too. The obstruction of the airway
sometimes causes you to snore and may make for a long night for the both of you. Since being
actively involved with the EMS profession for ten ... Show more content on Helpwriting.net ...
Doctors don't just prescribe medications for treatment of sleep apnea there are other options. They
may prescribe Continuous Positive Airway Pressure Device (CPAP), oral device (OA), surgery, and
diet. (Ronald M. Harper, 1988) The outcome depends on the patients' compliance to treatment. I
would like to explain what causes OSA, the treatments for OSA, and the negative effects if left
untreated.
Obstructive Sleep Apnea may be caused by either structural defect, swelling to airway passages,
obesity, or the muscles are unable to support the airway due to loss of muscle tone during sleep.
Structural defects include deviated septum, which narrows the nasal canals causing airflow to
increase in speed and increase the chance of airway collapse. Changes in the spinal column can
cause the tongue to sit closer to the pharynx causing the airway. Mucosal swelling to the nasal
canals can be cause by allergy's, allergic reaction, or upper airway infections. (Ronald M. Harper,
1988) Obesity

Sleeping Disorders In Older Adults
Sleep and Sleep Disorders in the Older Adult There are four main reasons why we sleep. The first is
for cardiovascular relaxation which lower blood pressure, lowers heart rate, and lowers metabolic
rate. The second reason is for mental and physical restorative properties. Lack of sleep will then
manifest itself with physical and cognitive side effects such as fatigue, difficulty focusing, slower
response times, memory problems, decreased balance, and decreased ability to perform tasks. The
third reason we sleep is to help with learning. Studies have shown that good sleep prior to taking
tests increases performance. Finally sleep is the only cure for sleepiness. Daytime sleepiness can
cause a person to fall asleep while reading, watching television, talking to others, or even driving.
Not getting enough sleep puts people at risk for hypertension and coronary events. It also increases
morbidity and mortality. ... Show more content on Helpwriting.net ...
Sleep apnea leads to increased blood pressure and daytime sleepiness. The apnea is caused by a
blocking of the airway. There are three main reasons for this blockage. One reason is obesity, when
excess fat causes too much pressure and restricts air flow. Excessive relaxation of the neck muscles
caused by deep sleep, alcohol, sedatives and smoking is another cause. And finally there can be a
structural abnormality due to enlarged tonsils, enlarged tongue, excessive tissues, a receding lower
jar, or a tumor. There are three different levels of obstructive sleep apnea and they are classified by
how many 10 second or more episodes of apnea occur within our hour of sleep. Mild is 5 to 14
episodes, moderate with 15 to 30 episodes, and finally severe is more than 30 episodes of apnea in
one hour of

The Routine Use Of Endotracheal Tube
It has been established that inability to successfully manage very difficult airway was been
responsible for as many as 30% of death totally attributable to anesthesia. (1)
The routine use of endotracheal tube is to secure the airway and prevent the aspiration of gastric
content in case of regurge or vomiting but there is a case series demonstrated that the routine use of
the endotracheal tube did not reduce maternal death due to aspiration(2)
Supraglottic airway devices have become a standard in airway management. These devices sit
outside trachea but provide a hands free means of achieving a gas tight airway(3). The i–gel is
supraglottic airway devices. The soft non inflatable cuff fits snugly on to the perilaryngeal frame
work, mirroring the shape of the epiglottis, aeryepiglottic folds, piriform fossae, perithyroid,
pericricoid, posterior cartilages and spaces. The seal created is sufficient for both spontaneously
breathing patients and for intermittent positive pressure ventilation. it provides a better seal for
positive pressure ventilation, separation of the respiratory from the alimentary tract.(4) The drain
tube prevents gastric insufflations, allows easy placement of gastric tube it has been shown that the
i–gel airway is better alternative device compared to PLMA for ease of insertion and maintenance of
anesthesia. (3,4) The i–gel works in harmony with the patient's anatomy so that compression and
displacement trauma are significantly reduced or

Ventilatory Analysis
In this article, the authors emphasise the use of noninvasive methods of providing ventilation to
neonates as they were introduced to do away with the mechanical ventilation techniques. De Winters
and Vries claim that the use of noninvasive techniques reduces the incidences of bronchopulmonary
dysplasia in neonates, a complication most common with standard ventilatory techniques. The
article discusses the best ways in which the modern noninvasive respiratory support techniques
should be administered to neonates. The authors argue that non–intubated continuous positive
airway pressure (nCPAP) is beneficial to an infant in some ways. It stabilizes the airways, increases
the volume of the lungs and decreases the effort required for respiration.

Sleep Apnea Essay

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