Obstructive Sleep Apnea (OSA)

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What is Obstructive Sleep Apnea?

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Sleep apnea and type 2 diabetes management

Courtesy of Philips Healthcare

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Key Symptoms

Loud snoringLack of energyDaytime sleepinessMorning headachesHigh blood pressureDepressionA partner or family member says you stop breathing during sleep

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Obstructive Sleep Apnea (OSA)Is present in patients with the following conditions:

83% of patients who are drug resistant to hypertension meds 60% of patients whove experienced a stroke 50% of patients with congestive heart failure (CHF) 48% of patients who suffer from type 2 diabetes

Can you die from sleep apnea?Yes.. Sudden cardiac death can also be a consequence of untreated sleep apnea. This could be because those with sleep apnea experience events, which happen at night while you sleep when your heart doesnt get enough blood

**NFL great Reggie White and the Grateful Deads Jerry Garcia both passed away as a result of complications directly related to sleep apnea.

How do we test for sleep apnea

OSA and type II DiabetesSleep apnea has adverse effects on glucose tolerance and insulin resistance, and may be related to type 2 diabetes independently of BMI (body mass index) and obesity.

DiabetesCardiovascular Implications

Sleep apnea cardiovascular implications

Obstructive sleep apnea syndrome increases the risk of stroke Risk of stroke doubles in men with mild sleep apneaRisk of stroke triples in men with moderate to severe sleep apneaAs many as 63% of stroke sufferers also experience sleep-disordered breathing

Sleep-disordered breathing and cardiovascular diseaseSevere sleep apnea sufferers have a 46% increased risk of mortality than those without the conditionThe greater the patient's apnea-hypopnea index, the greater the risk for developing hypertension and subsequently other forms of cardiovascular diseases

I Have Sleep ApneaNow What? CPAP therapy will relieve the airway obstruction that occurs while you sleep. PAP treatment can dramatically improve the life of someone diagnosed with sleep apnea.

Living with OSA

Courtesy of Philips Healthcare

When you wear the systemevery night during sleep and optimum therapy isachieved, you may experience the following benefits of treatment

Increased energy level and attentiveness Fewer morning headaches Reduced irritability Improved memory Less waking during the night to go to the bathroom Increased ability to exercise Increased effectiveness at home or at work Improved overall quality of life

Post CPAP Care

Solutions dapne du sommeil

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ObjectifsDcrire les troubles obstructifs de la respiration relis au sommeil (du ronflement l'apne du sommeil) Connatre l'impact de ces troubles obstructifs sur la sant du patient;Discuter de la pathophysiologie et du diagnostic des troubles obstructifs du sommeil Discuter des modalits de traitement mdicales et chirurgicales de l'apne du sommeil

tude de casHomme de 48 ansSa femme se plaint quil ronflePHx HypertensionSocial 2 bires/soir

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Quelles questions poserez-vous?

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HistoireMtierChauffeur de camion, plusieurs accidents de la routeSa femme tmoigne dpisodes dapneSomnolence diurnene se sent jamais comme sil avait eu une bonne nuit de sommeil

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Examen physique quelles parties accordez-vous le plus dimportance?

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Examen physiqueAucune anomalie nasaleMchoire infrieure et milieu du visage normauxPas de rtrognatieCirconfrence du cou Collet grandeur 17Cavit buccale / oropharynx

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Vous suspectez du ronflement +/- de lapne de sommeilQuels outils diagnostiques sont disponibles?

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Outils diagnostiqueschelle de somnolence dEpworthScore de 16

Polysomnographie (tude du sommeil)HpitalMaison

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DfinitionsHypopneDiminution de lamplitude respiratoire menant un rveil

ApneArrt de la respiration pour > 10 secondes menant un rveil

IAHNombre dpisodes dapne & dhypopne / heure de sommeil

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DfinitionApne obstructive du sommeil

Aucune dfinition universelle accepteIAH > 5

Lgre Modre Svre510152025303540IAH

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Pourquoi est-il ncessaire de traiter lapne du sommeil?

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Complications

Concentration/mmoire affecteIrritabilit, dpression Accidents de la route

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Complications

Infarctus du myocardeHypertension, arithmieInsuffisance cardiaque congestiveAccidents crbrovasculaires

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Options de traitement?

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tude de casPerte de poidsDiminution de la consommation dETOHCPAP

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Examen physiqueMchoire infrieure et milieu du visageRtrognatie

Circonfrence du cou

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Traitement de lAOSMesures conservatricesAppareils orauxCPAPProcdures / chirurgie

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Traitement de lAOSMesures conservatricesLattaque du nez Appareils orauxCPAPProcdures / Chirurgie

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Rsultat finalIAH sans CPAP = 18 (77 prcdemment)

Le CPAP est ainsi plus facile tolrer, donc le patient est plus observant du traitement

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AlgorythmeIdentifiez ces patients (Ronfleur, Homme > 40, Surplus de poids)

Epworth (www.sleepnow.ca)

Envoyez pour une tude du sommeilHpitalPriv - SAS(Kirkland, Laval, Westmount, etc)

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Merci