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Obstructive Sleep Apnea Hypopnea.
Obstructive sleep apnea hypopnea (OSAH) has been on the rise for the last 50 years and has resulted to significant mortality and morbidity in well-developed and developing countries. It has also been noted to be a major cause of sleepiness during daytime (Senaratna et al., 2017). Most patients with this condition usually present early to primary care settings and early recognition and diagnosis can prompt effective management with improved quality of life.Obstructive Sleep Apnea Hypopnea.
Patients with obstructive sleep apnea hypopnea often present with a positive history of excessive somnolence during the day, loud snoring, choking while sleeping, sexual dysfunction, headaches in the morning and nocturia. Research also reveals that up to 90% of patients with OSAH are obese and have signs of narrowing of the upper airways on physical examination. The narrowing of the airways is what often results to breathing problems when sleeping (Senaratna et al., 2017). However, it should be noted that no all clients who present with daytime somnolence have obstructive sleep apnea hypopnea. In comparison, other factors can also result to daytime sleepiness such as insufficient sleep, narcolepsy, medications such as stimulants and sedatives and bad sleeping habits. Therefore, any suspicion for OSAH should include a thorough and comprehensive history on routines for bedtime and sleep time. Obstructive Sleep Apnea Hypopnea.
A more accurate diagnosis can also be obtained through the Epworth Sleepiness Scale Questionnaire whereby a score that is more than 10 of 24 reveals that he/she has excess daytime somnolence. The STOP-BANG Questionnaire which is highly sensitive and feasible can also later be used which has a total of 8 questions and a score of more than or equal to 3 indicates a high risk for OSAH (Chung, Abdullah & Liao, 2016). Patients at high risk can undergo sleeping test evaluations either through a polysomnograph.Obstructive Sleep Apnea Hypopnea.
Obstructive sleep apnea/hypopnea syndrome (OSAHS) is characterized by recurrent episodes of partial or complete upper airway collapse during sleep that is highlighted by a reduction in, or complete cessation of, airflow despite documented on going inspiratory efforts. Due to the lack of adequate alveolar ventilation that results from the upper airway narrowing, oxygen saturation may drop and partial pressure of CO2 may occasionally increase. The events are mostly terminated by arousals. Clinical consequences are excessive daytime sleepiness related to the sleep disruption. Minimal diagnostic criteria have been defined for OSAHS. Patients should have excessive daytime sleepiness that can not be better explained by other factors, or experience two or more of the following symptoms, again that are not better explained by other factors: choking or gasping during sleep; recurrent awakenings from sleep; un-refreshing sleep; daytime fatigue; and impaired concentration. Obstructive Sleep Apnea Hypopnea.All patients should have more than five obstructed breathing events per hour during sleep. An obstructive apnea or hypopnoea can be defined as an event that lasts for ≥ 10 s and is characterized by an absence or a decrease from baseline in the amplitude of a valid measure of breathing during sleep that either reaches >50% with an oxygen desaturation of 3% or an arousal (alternatively a 30% reduction with 4% desaturation). The American Academy of Sleep Medicine (AASM) recommends these definitions. The Task Force of the AASM also states that there are common pathogenic mechanisms for obstructive apnea syndrome, central apnea syndrome, sleep hypoventilation syndrome and Cheyne-Stokes breathing. It was more preferable to discuss each of these separately; although, they could be placed under the common denominator of “sleep-disordered breathing syndrome”. The definition of OSAHS using two components, daytime symptoms and breathing pattern disturbances during sleep, may suggest that there is a tight correlation between the two. However, unfortunately this is not the case. The breathing pattern abnormalities, mostly described by an Apnea/Hypopnoea Index (AHI), only weakly correlate with quantified measures of sleepiness, such as the Epworth Sleepiness Scale (ESS). This probably means that interindividual sensitivity, with some individuals coping better with sleep fragmentation than others, does compromise the relationship between the AHI and daytime sleepiness scores. In addition, epidemiological studies show a broad range of sleepiness in the general population. Obviously, epidemiological studies investigating the prevalence of OSAHS are all biased by the lack of a uniform definition. The prevalence of an AHI of >5 events · h-1 in a general population (without taking into account symptoms of sleepiness) has previously been estimated to be 24% in a male population. When symptoms of sleepiness were also taken into account, the prevalence decreased to 4% in males and 2% in females.Obstructive Sleep Apnea Hypopnea.
Hypopnea is related to sleep apnea and is a part of the same family of sleep disorders. In hypopnea, there is a decrease of airflow for at least 10 seconds in respirations, a 30-percent reduction in ventilation, and a decrease in oxygen saturation. This decreases the amount of oxygen that is getting to your red blood cells.Obstructive Sleep Apnea Hypopnea.
Hypopnea often happens at night while you sleep, but it can also occur during the hours that you’re awake. There are two main types of hypopnea, but they are hard to distinguish clinically from apnea — when breathing stops completely. Apnea is thought of as:
- Central sleep apnea: This is when your breathing is disrupted, but respiratory effort is maintained.
- Obstructive sleep apnea: This is when both your breathing and respiratory effort are disrupted.Obstructive Sleep Apnea Hypopnea.
Sleep apnea and hypopnea are different versions of the same sleep disorder. An apnea is the complete blockage of air, while hypopnea is the partial blockage of air. Many times, they occur together.
Hypopnea was discovered when doctors noticed that sleep apnea patients did not always have a complete blockage of air intake when they were sleeping. Instead of being just a complete periodic blockage, it was either just partial blockage or a mix of both complete (apnea) or partial (hypopnea).Obstructive Sleep Apnea Hypopnea.
In most cases, you will have both sleep apnea and sleep hypopnea. If you just have hypopnea, there is a good chance you will develop sleep apnea.Obstructive Sleep Apnea Hypopnea.
The causes of hypopnea are similar to those of sleep apnea.
- Obstructive sleep apnea/hypopnea is caused by the relaxation of your throat muscles while you’re asleep.
- Central sleep apnea/hypopnea is caused by your brain failing to send the right signals to the muscles that allow you to breathe.Obstructive Sleep Apnea Hypopnea.
The risks can be slightly different for each type of hypopnea. The risk factors for obstructive hypopnea include:
- the size of your neck
- obesity
- gender (it’s more common in men)
- smoking
- alcohol consumption
- taking sedatives or sleep medication
- age (it’s more common in middle-aged and older adults)
- congested nasal passages
- genetics (family history can play a role)
The symptoms of sleep hypopnea include the following when they occur without another cause:
- being unusually tired during the day
- waking up from a full night’s sleep feeling tired
- waking up choking
- waking up often during the night
- snoring loudly
- waking up with a headache
The treatment of sleep hypopnea depends somewhat on the cause and severity. However, there are treatment options that are commonly used. Again, the treatments for sleep hypopnea are similar to those of sleep apnea. Some of these treatments include:
- continuous positive airway pressure therapy
- removal of the obstruction or other surgery if applicable
- a mechanism for your mouth that makes the airway larger or more stable
Lifestyle changes that your doctor may suggest you try as a part of your treatment include:
- losing weight
- consuming a healthy diet
- giving up smoking
- avoiding sleep medications or sedative medication
- drinking less alcohol or stopping completely
- changing your sleep position
If your hypopnea is mild, then lifestyle changes may be the only treatment necessary.
Obstructive sleep apnea-hypopnea syndrome (OSAHS) is a more serious form of sleep apnea or sleep hypopnea. OSAHS is a chronic condition that requires ongoing management. Treatment is usually lifelong.Obstructive Sleep Apnea Hypopnea.
It’s not uncommon to have either sleep apnea or sleep hypopnea, but there are certain factors that increase your risk. It’s more common in men than in women, and people between the ages of 40 and 65 have an increased risk of developing it. Other conditions that may increase your risk are:
- obesity
- change in the jawbone (structure or length)
- hypothyroidism
- enlarged adenoids or tonsils in children
- smoking
- some sedative medications
- a history of stroke
- heart disease
- some narcotics
While some of these risk factors cannot be changed, there are many that you can eliminate from your life to lessen your risk of ever having an issue with hypopnea. Losing weight, quitting smoking (or not starting), and limiting alcohol can all help reduce your risk.
Many times, hypopnea can be eliminated through lifestyle changes or minor medical treatments. Those cases that are more severe or chronic, including OSAHS, may take more time or require management and treatment for years. However, talking to your doctor as soon as you notice symptoms will help reduce the severity and the length of treatment.Obstructive Sleep Apnea Hypopnea.
While some causes of hypopnea can’t be prevented, there are some steps you can take to reduce your risk. These include losing weight if you are overweight, not smoking, avoiding alcohol in excess, eating healthy, and exercising. All of these will help in the prevention of not only sleep hypopnea, but also other health-related conditions.Obstructive Sleep Apnea Hypopnea.
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