OSA, or Obstructive Sleep Apnea, is a sleep disorder characterized by repeated interruptions in breathing during sleep due to blocked or narrowed airways. This obstruction can lead to fragmented sleep, daytime fatigue, and other health complications if left untreated. Treatment options include lifestyle changes, CPAP therapy, and in some cases, surgery.
2. CONTENT
Introduction to obstructive sleep apnea
Prevalence of OSA
Anatomy of sleep apnea
Causes of obstructive sleep apnea
Symptoms of obstructive sleep apnea
Complication of untreated OSA
Diagnosis of obstructive sleep apnea
Screening and assessment
Treatment options
CPAP Therapy
Exercise for OSA
Surgical interventions
Lifestyle modification
3.
4. INTRODUCTION TO OBSTRUCTIVE
SLEEP APNEA
DEFINITION
Obstructive sleep apnea (OSA) is characterized by episodes of a complete
(apnea) or partial collapse (hypopnea) of the upper airway and associated with
decrease in oxygen saturation or arousal from sleep.
OSA is often classified as mild, moderate and severe according to the
AHI(Apnea-Hypoapnea Index).
A common scheme is 5 to 15(mild),15 to 30 (moderate),
>30 event/h (severe)
5. PREVALENCE
According to various studies and estimates, the prevalence of OSA in India
ranges from 9% to 13% among adults.
In India 5% to 10% of people affected by mild OSA.
In India 2% to 5% of people affected by moderate OSA.
In India 1% to 3% of people affected by severe OSA.
In India, as in other parts of the world, OSA prevalence tends to increase
with age, with middle-aged and older adults being more commonly
affected.
However, OSA occur in younger individuals, including children and
adolescents.
6. ANATOMY OF SLEEP APNEA
The anatomy of OSA involves various structures in the upper airway:
1.Soft palate and uvula:
The soft palate and uvula can collapse backward during sleep,partially or
completely blocking the airway
2.Tongue:
The tongue can fall back against the soft palate or the throat.
3.Tonsils and adenoids
Enlarged tonsils and adenoids especially in children can contribute to airway
obstruction
7. CONT…
4.Throat muscles:
Relaxation of the muscles in throat and tongue during sleep can lead to the
collapse of these tissues into the airways
5.Nasal passages:
Narrow or congested nasal passages can increase the resistance of airflow,
exacerbating the obstruction.
6.Jaw and oral cavity:
The position of the jaw and the structure of the oral cavity can affect the size
and shape of the airway.
7.Neck size:
A large neck circumference, often associated with obesity, can be risk factor
for OSA as it may indicate excess soft tissue in the throat.
8. CAUSES OF OBSTRUCTIVE SLEEP
APNEA
Age
Endocrine disorder or any changes in hormone
Family history and genetics
Heart or kidney failure
Large tonsils and thick neck
Lifestyle habits
Obesity
Gender
9. SYMPTOMS OF OBSTRUCTIVE SLEEP
APNEA
Loud snoring
Episodes in which you stop breathing during sleep — which would be
reported by another person
Gasping of air during sleep
Awakening with dry mouth
Morning headache
Difficulty staying asleep, known as insomnia
Excessive daytime sleepiness, known as hypersomnia
Difficult paying attention while awake
Irritability
10. COMPLICATION OF UNTREATED
OSA
Cardiovascular problem
Daytime fatigue and sleepiness
Metabolic disorder
Mood disorder
Memory and cognitive impairment
Decreased quality of life
Increased risk of accidents
11. DIAGNOSIS OF OSA
Physical examination
Polysomnography (PSG) or sleep study
Home sleep apnea testing (HSAT)
12. SCREENING AND ASSESSMENT
To identify the risk of the patient, there are several screening tools they are:
1.Berlin questionnaire
2.STOP-BANG questionnaire
3.Preoperative questionnaire
STOP-BANG is a easily administrable tool for high sentivity
13. STOP-BANG
SCORE
Patient with score of 0 to 2
will be in low risk of OSA,
whereas the patient with the
score of 5 to 8 will be in
moderate to high risk of
OSA
14. TREATMENT OPTIONS
We can treat the obstructive sleep apnea in three ways they are:
1.PAP therapy (CPAP)
2.Oral appliances
3.Surgical interventions
16. CPAP THERAPY
CPAP is applied to the upper airway act as
a pneumatic splint and prevent the collapse
of upper airway during inspiration.
Nasal CPAP is first describe in 1981 and
has since first line therapy in OSA
The device is applied to nasal or oronasal
mask, overnight or sleeping hours at set
positive pressure.
17. SURGICAL INTERVENTION
There are two types of surgeries
1. Uvulopalatopharyngoplasty(UPPP)
2. maxillomandibular advancement (MMA)
20. EXERCISE FOR OSA
YOGA exercise
1. Nadi shodhana
2. Brahmari
3. Ujjayi breathing
Myofunctional therapy exercise
1. Push up the tongue
2. Touch the nose
3. Touch the chin
4. Push tongue left
5. Push tongue right
6. Roll tongue
7. Click the tongue
8. Push tongue against the spoon
9. Hold a spoon
21. LIFESTYLE MODIFICATION
Weight loss
Exercise
Avoiding alcohol and sedatives
Quitting smoking
Sleeping position
Establishing a regular sleep schedule
Elevating the head of the bed
22. REFERENCE
Obstructive Sleep Apnea Jennifer M. Slowik; Abdulghan Sankari;
Jacob F. Collen.
Obstructive Sleep Apnea Diagnosis and Management
Munish Goyal, MD
Obstructive sleep apnea syndrome and its management lucia
spicuzza,Daniela carsuso and Giuseppe di maria
Adult obstructive sleep apnoea Amy S. Jordan, PhD, David G. McSharry,
MB, and Prof. Atul Malhotra, MD
Fishman’s pulmonary disease and disorders
Egans
