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SLEEP APNEA

SLEEP APNEA. Juan A. Albino, MD, FCCP Village Sleep Lab 751-4955 October, 2007. Thank You !!!. Debbie Hurtt, Rotary Club Phillip Ratliff, AWAKE Group (753-8773) Heather Ellington, Office Manager John Crawford, Technical Director Thomas Chaput, Sleep Technologist Miyoshi Scott, Nurse

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SLEEP APNEA

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  1. SLEEP APNEA Juan A. Albino, MD, FCCP Village Sleep Lab 751-4955 October, 2007

  2. Thank You !!! • Debbie Hurtt, Rotary Club • Phillip Ratliff, AWAKE Group (753-8773) • Heather Ellington, Office Manager • John Crawford, Technical Director • Thomas Chaput, Sleep Technologist • Miyoshi Scott, Nurse • Brigette Hayes, Receptionist

  3. Common Sleep Disorders • Insomnia: wants to sleep but cannot • Sleep Deprivation: does not want to sleep but can; problem of sleep quantity • SLEEP APNEA: sleepy during day, snores at night because of obstruction in throat; problem of sleep quality • Restless Legs Syndrome: leg discomfort, relieved by movement that hinders sleep

  4. Good Sleep Hygiene: Basics • Regular times for sleeping and awakening • Maintain bedroom dark, quiet, cool • Use bed only for sleep and sex • Avoid late daytime naps • Avoid at night: alcohol, caffeine, nicotine • Sleep around 7 to 8 hours every night • Prudent exercise and eating • Avoid stressful situations at bednight

  5. Restless Legs Syndrome • Leg discomfort, worse at night, relieved by movement, affects 5-10% of population • Familial, begins in childhood • Associated with iron deficiency, drugs, Periodic Limb Movements of Sleep • Easily treatable with medicines • Restless Legs Syndrome Foundation, June K. Wharton (259-0979)

  6. Sleep Deprivation • Disasters: Exxon Valdez, Challenger Space Shuttle, Chernoble Nuclear Plant, Commuter plane crash in Kentucky • 33% of fatal truck accidents • 10% of fatal car accidents • Impairment the same whether: drunk, sleep deprived (<4-6hrs.), sleep apnea • Must be taken seriously: sleep 8 hours • Leads to obesity and diabetes

  7. Insomnia: Acute or Chronic • Insomnia: inability to get to sleep, stay asleep, wakes up early, with daytime impairment • Acute Insomnia (<4 weeks): stress, illness • Sleep medicines work well in acute stage • Chronic Insomnia: >4 weeks, often years • Treat basic problem: >60% psychological • Psychotherapy and behavioral therapy better than medicines, not easy to treat • Psychologists, Psychiatrists, PCP

  8. Sleep Apnea: Risk Factors • Affects: 4 to 5% of population: common • Family history, Sleep maintenance insomnia • Obesity: 80 % of sleep apnea patients; central (visceral, apples) obesity • Increasing age, Male gender • Large tonsils / adenoids in children • Small mandible, large neck • Smoking, alcohol, sedatives, nasal allergies

  9. Sleep Apnea: Consequences • During night: snoring, snorting, gasping, difficult or stops breathing, wife worries • During day: sleepy, tired, depressed, irritabile, impotent, forgets, sometimes few complaints • More accidents: work, home, motor vehicle • Higher death rates with severe sleep apnea • Hypertension, Congestive Heart Failure • Heart Attacks, Strokes, Atrial Fibrillation • Promotes Obesity and Diabetes • Problems: at night, during day, risk factor

  10. Obstructive Sleep Apnea • What is OSA? • Cessation of airflow with ongoing respiratory effort • NORMALSNORINGSLEEP APNEA

  11. Sleep Apnea: Treatment • Behavioral: Weight Loss, Sleep Position (Sleep on side, head raised), Oxygen, Avoid sedatives • CPAP: proven therapy, needs motivation: widely available, 70%: patients adapt well • Surgery: tracheostomy, tonsillectomy, pull forth mandible or tongue • Bariatric Surgery: banding, bypass (Bob Eisenhauer 259-1485; Lewis Jones 753-3459) • Dental appliances: also pull forth mandible or tongue; expertise necessary

  12. Treatment Options: CPAP • Treatment • -CPAP treatment • Positive pressure • keeps airway open • 100% effective CPAP therapy

  13. Summary: Sleep Apnea • Very common and dangerous • Easily diagnosed and treated • Benefits of treatment:sleep better at night, also • Feel better during the day: less sleepiness and fatigue, more energy, less accidents • Reduce risk factor for heart disease and strokes • Control better: obesity, diabetes, hypertension • Bed partner sleeps better: less noise and less worry (but dog is scared of CPAP)

  14. Websites • National Sleep Foundation: sleepfoundation.org • American Sleep Apnea Association: sleepapnea.org • Restless Legs Syndrome Foundation: rls.org • National Center on Sleep Disorders: healthfinder.gov/orgs/HR2536.htm • Commercial: MyResmed.com • Commercial: Respironics.com

  15. Books • The Promise of Sleep by William Dement • Sleeping Well by Michael Thorpy • No More Sleepless Nights by Peter Hauri • A Woman’s Guide to Sleep Disorders by Meir H. Kryger • Restless LegsSyndromeby Robert H. Yoakum • Say Good Night to Insomnia by Gregg D. Jacobs

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