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SNORING, ETC,ETC,&ETC

SNORING, ETC,ETC,&ETC. WHAT YOU NEED TO KNOW. WHAT CAN MAKE FOR RESTORITIVE SLEEP. ADIQUATE SLEEP CYCLE ADIQUATE AMOUNT OF SLEEP ABSENCE OF DISORDERS THAT DISTURB SLEEP. SLEEP.

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SNORING, ETC,ETC,&ETC

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  1. SNORING, ETC,ETC,&ETC WHAT YOU NEED TO KNOW

  2. WHAT CAN MAKE FOR RESTORITIVE SLEEP • ADIQUATE SLEEP CYCLE • ADIQUATE AMOUNT OF SLEEP • ABSENCE OF DISORDERS THAT DISTURB SLEEP

  3. SLEEP SLEEP IS AN ACTIVE RESTORATIVE PROCESS REQUIRING STIMULATION OF CERTAIN BRAIN CENTERS AND INHIBITION OF OTHERS. THE STAGE OF SLEEP IS DEPENDENT ON THE BRAIN WORKING PROPERLY AT THE RIGHT TIME IN THE RIGHT SETTING

  4. BAD SLEEP • RESTLESS SLEEP • INSOMNIA • OBSTRUCTIVE SLEEP APNEA • NARCOLEPSY • PARASOMNIAS • SLEEP STATE MISPERSEPTION

  5. INSOMNIA / RESTLESS SLEEP • RESTLESS LEG SYNDROME • PERIODIC LEG MOVEMENT DISORDER • STRESS/PSYCHIATRIC DISORDERS • SLEEP APNEA (OSA)/UPPER AIRWAY RESISTANCE SYNDROME (UARS) • GASTROESOPHAGEAL REFLUX

  6. INSOMNIA / RESTLESS SLEEP • PARASOMNIAS • SEIZURES • CONDITIONED AROUSALS • “NIGHTMARES”

  7. SLEEP HISTORY • CIRCADIAN STATE • SLEEP ENVIRONMENT • SLEEP LATENCY • AROUSALS • SNORING / APNEA • DAYTIME SLEEP

  8. SLEEP HISTORY • WAKENINGS • SLEEP BEHAVIOR • MEDICAL HISTORY • DRUG HISTORY • NEUROLOGICAL/PSYCHIATRIC HISTORY • FAMILY HISTORY

  9. EXCESSIVE DAYTIME SLEEPINESS • HIGHLY VARIABLE ACCURANCE • EPWORTH SCORE OR OTHER SCALES FOR EVALUATION HELPFUL • SLEEPINESS • INCREASE MORBIDITY • GOOD PROGNOSTIC INDICATOR

  10. MANIFESTATIONS OF EXCESSIVE SLEEPINESS • TENDENCY TO FALL ASLEEP EASILY • SLEEP ATTACKS • FREQUENT DAYTIME NAPPING • AMNESTIC EPISODES WITH AUTOMATIC BEHAVIOR

  11. MANIFESTATIONS OF EXCESSIVE SLEEPINESS • IMPAIRED COGNITION • MEMORY DISTURBANCES • VISUAL DISTURBANCES

  12. EPWORTH SLEEPINESS SCALE

  13. SLEEP DISORDERED BREATHING • OBSTRUCTIVE SLEEP APNEA • CENTRAL SLEEP APNEA • MIXED APNEA SYNDROME • CHEYNE STOKES BREATHING • UPPER AIRWAY RESISTANCE SYNDROME

  14. SLEEP DISORDERED BREATHING (SDB) AND HEART FAILURE • INCREASE MORBIDITY HF • INCREASE MORTALITY HF • CHEYNE STOKES BREATHING POOR PROGNOSTIC SIGN

  15. OSA RISKS ANALYSIS • ELEVATED C REACTIVE PROTEIN • ELEVATED IL-6 • ELEVATED TNFa • IMPAIRMENT VASODILATION • INCREASE IN ENDOTHELIN-1

  16. SDB AND INSULIN RESISTANCE • NOT DEPENDENT ON BODY MASS INDEX • “EACH ADDITIONAL APNEA / HOUR INCREASED THE FASTING INSULIN LEVEL” • INCREASED INSULIN LEVELS MOST PRONE TO DEVELOPMENT OF HTN

  17. SDB / INSULIN RESISTANCE • INSULIN RESISTANCE MORE PREVELANT WITH SEVERITY OF HYPOXEMIA • AM J OF RESP CRITICAL CARE • MARY ET EL VOL 165, 670-676 2002 • NARESH ET EL VOL 165, 677-682 2002

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