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The ABCs of Catching Zzzzzzs Presented by T. “Massey” Arrington, RPSGT, MBA Director, Covenant Sleep Centers
The Future is Bright Sleep Center
Definition of Sleep ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],Sleep Stages
Amount of Sleep ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Sleep Deprivation ,[object Object],[object Object],[object Object],[object Object],[object Object]
Consequences of Sleep Loss ,[object Object],[object Object],[object Object],[object Object]
Consequences of Sleep Loss ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Sleep Deprivation In Society ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Prevalence of Obstructive Sleep Apnea (OSA)
Prevalence of Sleep Apnea   80% 50% 35% 50% Diabetes Obesity All Hypertension Atrial Fibrillation Congestive Heart Failure Drug-Resistant Hypertension Sjostrom et al, Thorax,  2002 Logan et al, J. Hypertension,  2001 Javaheri et al, Circulation,  1999 O'Keeffe & Patterson,  Obes Surgery,  2004 Einhorn et al. Endocrine Prac,  2007 50% Somers et al, Circulation,  2004  77% Coronary Artery Disease 30% 59% Pacemakers Garrigue et al. Circulation  2007 Schafer et al. Cardiology  1999
Sleep Apnea ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Sleep Disordered Breathing ,[object Object],[object Object],[object Object]
Normal Upper Airway
Snoring
Sleep Apnea
Normal
 
 
 
Consequences of OSA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Symptoms of Sleep-disordered Breathing ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Lost of Productivity
Snoring Spouse Syndrome (SSS)
 
 
Treatment of OSA ,[object Object],[object Object],[object Object],[object Object]
Baseline Arm Therapeutic  Arm  Effect of CPAP on Blood Pressure n = 60 patients Becker et al 2003  Circulation Ineffective therapy- no change in mean blood pressure  Effective therapy corresponds to a 10 mm Hg drop in blood pressure
Oral Appliances ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Oral Appliance: Mechanics
Oral Appliance
Uvulopalatopharyngoplasty  (UPPP)
SRS Basics of Sleep Guide.  Sleep Research Society.  P. 96. 2005.
Genioglossus Advancement
Maxillomandibular  Advancement
Clinical Consequences Sleep Apnea Excessive daytime sleepiness Sleep fragmentation, Hypoxia / Hypercapnia Cardiovascular Complications Morbidity Mortality
Diagnostic Process Evaluation/Consult Treatment Plan and Patient  Follow-Up Clinician Referral to Sleep Lab Sleep Study Titration Night Therapy Dispensed by Homecare Company Clinician Identifies Sleep Apnea Symptoms in Patient Discuss Results/Treatment Option
Treatment
Darth Vader
Insomnia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Insomnia Causes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Restless Legs and Periodic Limb Movement Disorder ,[object Object],[object Object],[object Object],[object Object]
Others ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Sleep Changes as We Age ,[object Object],[object Object],[object Object],[object Object]
Normal Sleep ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Other Sleep Changes with Age ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Changes in Sleep Quantity ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Changes in Sleep Quality ,[object Object],[object Object],[object Object],[object Object]
When To Get Help ,[object Object],[object Object],[object Object],[object Object]
Medical Problems Affecting Sleep ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pain in Sleep ,[object Object],[object Object],[object Object]
Menopause and Sleep ,[object Object],[object Object],[object Object]
Owls and Larks ,[object Object],[object Object],[object Object]
Sleep and Dementia ,[object Object],[object Object]
Medications Which Affect Sleep ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Behavioral Treatment:  Sleep Hygiene ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Polysomnography
 
Conclusions ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object]
Sleep studies at FSSMC ,[object Object]
How to Make an Appointment ,[object Object],[object Object],[object Object]

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