Obstructive Sleep Apnea a type of sleep disorder
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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.
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Child with OSA Anesthetic considerations
This document discusses considerations for anesthesia in children with obstructive sleep apnea (OSA). It provides background on OSA, including definitions and classifications. It notes that children with OSA are at risk of postoperative complications like hypertension and pulmonary edema. The document recommends careful preoperative evaluation in high risk children. It suggests avoiding sedative premedication and using techniques like jaw thrust and CPAP at induction to relieve airway obstruction. Maintenance should use low doses of opioids and extubation when fully awake. Postoperative monitoring on a high dependency unit is important due to risk of reobstruction.
OSA & COPD (OVERLAP SYNDROME)
This document provides an overview of obstructive sleep apnea (OSA) written by Dr. Lokesh Verma, a junior resident in pulmonary medicine. It defines OSA and various respiratory events observed during polysomnography. It discusses risk factors for OSA like obesity, neck circumference, and craniofacial abnormalities. Clinical features include loud snoring, sleep fragmentation, and daytime sleepiness. Diagnosis is made based on an apnea-hypopnea index of over 5 events per hour during a sleep study. Screening tools and questionnaires are presented. Treatment options include positive airway pressure devices, oral appliances, and surgery. OSA-related syndromes like metabolic syndrome and obesity hypoventilation are
Obstructive sleep apnea
Case Presentation on Obstructive Sleep Apnoea with Diabetic Nephropathy, Cardiomyopathy and Oral Candidiasis
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Sleep disruption caused by breathing disorders are potentially life-threatening and therefore an important global health issue.
Sleep disorders, particularly untreated obstructive sleep apnea (OSA) has been known as a risk and possible causative factor in
1.
development of systemic hypertension,
2.
depression,
3.
stroke, angina
4.
cardiac dysrhythmias.
5.
can be associated with motor vehicle accidents,
6.
poor work performance and therefore, also makes a person prone to occupational accidents and reduced quality of life.
7.
adversely affects patients on their personal, social and professional levels.
Obstructive sleep apnea (OSA)
Definition: cessation of airflow for more than 10 seconds and hypopnoea is 50% reduction in air flow
It is Classified as central, obstructive and mixed and can be graded as mild, moderate and severe
Sleep Apnea.ppt
This document provides information about sleep apnea, including its causes, signs and symptoms, risk factors, diagnosis, treatment, and self-care strategies. It defines two main types of sleep apnea - obstructive, which occurs when throat muscles relax and block the airway, and central, which occurs when the brain fails to signal breathing muscles. Common signs include loud snoring, breathing pauses during sleep, daytime sleepiness, and morning headaches. Risk factors include excess weight, neck size, and family history. Treatments may include devices like CPAP machines, oral appliances, surgery, weight loss, and yoga practices targeting the breathing, throat, and nasal areas.
OSA- Undergraduate level
Snoring and obstructive sleep apnea occur when the muscles in the back of the throat relax during sleep, causing vibration that produces snoring sounds or complete or partial airway obstruction. Obstructive sleep apnea is defined by cessation of breathing lasting 10 seconds or more during sleep and is classified based on the respiratory disturbance index. Polysomnography is the gold standard test used to diagnose sleep apnea and involves monitoring various physiological parameters during sleep. Treatment options include lifestyle changes, oral appliances, continuous positive airway pressure therapy, and various surgical procedures to reduce tissue volumes or advance structures in the throat.
Obstructive Sleep Apnea
Obstructive sleep apnea (OSA)—also referred to as obstructive sleep apnea-hypopnea—is a sleep disorder that involves cessation or significant decrease in airflow in the presence of breathing effort. It is the most common type of sleep-disordered breathing and is characterized by recurrent episodes of upper airway collapse during sleep. These episodes are associated with recurrent oxyhemoglobin desaturations and arousals from sleep.
OBSTRUCTIVE SLEEP APNEA.ppt
The document discusses sleep apnea, its types, causes, symptoms, diagnosis and various treatment options. It defines sleep apnea as cessation of breath lasting at least 10 seconds during sleep. The main types are obstructive, central and mixed apnea. Common risk factors include obesity, retrognathia and tonsillar hypertrophy. Diagnosis involves polysomnography and questionnaires. Treatments include oral appliances, CPAP, surgery like maxillomandibular advancement and tracheostomy. The role of orthodontists is in diagnosis and oral appliance therapy.
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This document discusses considerations for anesthesia in children with obstructive sleep apnea (OSA). It provides background on OSA, including definitions and classifications. It notes that children with OSA are at risk of postoperative complications like hypertension and pulmonary edema. The document recommends careful preoperative evaluation in high risk children. It suggests avoiding sedative premedication and using techniques like jaw thrust and CPAP at induction to relieve airway obstruction. Maintenance should use low doses of opioids and extubation when fully awake. Postoperative monitoring on a high dependency unit is important due to risk of reobstruction.
OSA & COPD (OVERLAP SYNDROME)
This document provides an overview of obstructive sleep apnea (OSA) written by Dr. Lokesh Verma, a junior resident in pulmonary medicine. It defines OSA and various respiratory events observed during polysomnography. It discusses risk factors for OSA like obesity, neck circumference, and craniofacial abnormalities. Clinical features include loud snoring, sleep fragmentation, and daytime sleepiness. Diagnosis is made based on an apnea-hypopnea index of over 5 events per hour during a sleep study. Screening tools and questionnaires are presented. Treatment options include positive airway pressure devices, oral appliances, and surgery. OSA-related syndromes like metabolic syndrome and obesity hypoventilation are
Obstructive sleep apnea
Case Presentation on Obstructive Sleep Apnoea with Diabetic Nephropathy, Cardiomyopathy and Oral Candidiasis
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obstructive sleep apnea and orthodontics including diagnosis and treatment
Sleep disruption caused by breathing disorders are potentially life-threatening and therefore an important global health issue.
Sleep disorders, particularly untreated obstructive sleep apnea (OSA) has been known as a risk and possible causative factor in
1.
development of systemic hypertension,
2.
depression,
3.
stroke, angina
4.
cardiac dysrhythmias.
5.
can be associated with motor vehicle accidents,
6.
poor work performance and therefore, also makes a person prone to occupational accidents and reduced quality of life.
7.
adversely affects patients on their personal, social and professional levels.
Obstructive sleep apnea (OSA)
Definition: cessation of airflow for more than 10 seconds and hypopnoea is 50% reduction in air flow
It is Classified as central, obstructive and mixed and can be graded as mild, moderate and severe
Sleep Apnea.ppt
This document provides information about sleep apnea, including its causes, signs and symptoms, risk factors, diagnosis, treatment, and self-care strategies. It defines two main types of sleep apnea - obstructive, which occurs when throat muscles relax and block the airway, and central, which occurs when the brain fails to signal breathing muscles. Common signs include loud snoring, breathing pauses during sleep, daytime sleepiness, and morning headaches. Risk factors include excess weight, neck size, and family history. Treatments may include devices like CPAP machines, oral appliances, surgery, weight loss, and yoga practices targeting the breathing, throat, and nasal areas.
OSA- Undergraduate level
Snoring and obstructive sleep apnea occur when the muscles in the back of the throat relax during sleep, causing vibration that produces snoring sounds or complete or partial airway obstruction. Obstructive sleep apnea is defined by cessation of breathing lasting 10 seconds or more during sleep and is classified based on the respiratory disturbance index. Polysomnography is the gold standard test used to diagnose sleep apnea and involves monitoring various physiological parameters during sleep. Treatment options include lifestyle changes, oral appliances, continuous positive airway pressure therapy, and various surgical procedures to reduce tissue volumes or advance structures in the throat.
Obstructive Sleep Apnea
Obstructive sleep apnea (OSA)—also referred to as obstructive sleep apnea-hypopnea—is a sleep disorder that involves cessation or significant decrease in airflow in the presence of breathing effort. It is the most common type of sleep-disordered breathing and is characterized by recurrent episodes of upper airway collapse during sleep. These episodes are associated with recurrent oxyhemoglobin desaturations and arousals from sleep.
OBSTRUCTIVE SLEEP APNEA.ppt
The document discusses sleep apnea, its types, causes, symptoms, diagnosis and various treatment options. It defines sleep apnea as cessation of breath lasting at least 10 seconds during sleep. The main types are obstructive, central and mixed apnea. Common risk factors include obesity, retrognathia and tonsillar hypertrophy. Diagnosis involves polysomnography and questionnaires. Treatments include oral appliances, CPAP, surgery like maxillomandibular advancement and tracheostomy. The role of orthodontists is in diagnosis and oral appliance therapy.
Sleep apnoea in pcos by dr alka mukherjee nagpur m.s. india
Polycystic ovary syndrome (PCOS), the most common endocrine disorder of pre-menopausal women, is characterized by chronic hyperandrogenism, oligoanovulation, obesity and insulin resistance. Importantly, PCOS women are at increased risk for glucose intolerance, type 2 diabetes and cardiovascular disorders. Recent reports indicate an unexpectedly high prevalence of obstructive sleep apnea (OSA) in PCOS. Alterations in sex steroids (i.e. high androgen and low estrogen levels) and increased visceral adiposity in PCOS could potentially contribute to the increased prevalence of OSA in this disorder. There is some evidence to suggest that there may be strong associations between the presence and severity of OSA and the metabolic disturbances that characterize PCOS. Causal mechanisms in the link between PCOS and OSA remain to be elucidated. Clinicians who manage PCOS patients should be aware of the high prevalence of OSA in these patients and systematically evaluate these women for sleep disturbances.
Etiology Of Obstructive sleep apnea
Obstructive sleep apnea (OSA) is a common sleep disorder where the airway becomes blocked during sleep, interrupting breathing. It is characterized by loud snoring, breathing pauses, and fatigue. Risk factors include obesity, large neck size, and family history. OSA can be classified by the site of airway obstruction and is diagnosed using tests like polysomnography. Untreated OSA has health consequences and increased mortality. Dentofacial features associated with OSA include a narrow upper airway and retrognathic mandible.
Etiology Of Obstructive sleep apnea
Obstructive sleep apnea (OSA) is a common sleep disorder where the airway becomes blocked during sleep, interrupting breathing. It is characterized by loud snoring, breathing pauses, and fatigue. Risk factors include obesity, large neck size, and family history. OSA can be classified by the site of obstruction and severity. Symptoms include excessive daytime sleepiness, impaired cognition, and increased health risks if left untreated. Dentofacial features associated with OSA include a narrow upper airway and retrognathic mandible.
Sleep apnea
Sleep apnea is a serious sleep disorder where a person's breathing is interrupted during sleep. There are two main types - obstructive sleep apnea caused by blockage of the airway, and central sleep apnea caused by problems in the brain's respiratory control center. Symptoms include loud snoring, waking with gasping sensations, and daytime sleepiness. Risk factors include obesity, large neck size, and family history. Diagnosis involves an overnight sleep study to monitor breathing, brain waves, muscle activity and more. Treatment options include lifestyle changes, oral devices, ventilation with CPAP machines, and in some cases surgery.
Obstructive sleep apnea
Obstructive sleep apnea (OSA) is a prevalent chronic disease characterized by pharyngeal collapse during sleep.
Sleep disorder that involves cessation or significant decrease in airflow through the upper airway in the presence of breathing effort.
Obstructive sleep apnea is the second most common sleep disorder, insomnia being the most common.
Associated with recurrent oxyhemoglobin desaturations and arousals from sleep
Apnea index- no. of apneas /hr of total sleep time.
AHI (APNEA-HYPOPNEA INDEX)- No of apneas and hypoapneas/hr of total sleep time.
RDI (Respiratory Disturbance Index) – no. of apneas, hypoapneas and respiratory effort related arousals(RERA)/hr of total sleep time.
Osa tongue-based- Surgical Procedures
This document provides an overview of tongue base procedures for obstructive sleep apnea. It discusses sleep physiology and testing methods like polysomnography. It describes adult obstructive sleep apnea including pathophysiology, evaluation, and medical and surgical management options. Tongue base procedures are discussed as a surgical treatment that can help reduce airway collapse and obstruction at the base of the tongue. The document reviews considerations for various surgical approaches to treat obstructive sleep apnea.
sleep apneas
This document discusses sleep apnea and its diagnosis and treatment. It begins with an overview of sleep physiology and the different stages of sleep. It then discusses the different types of sleep apnea, most notably obstructive sleep apnea (OSA). The risk factors, symptoms, diagnostic tools and treatments for OSA are explained in detail. Key points include that OSA is caused by upper airway obstruction during sleep, and is diagnosed using polysomnography and treated initially through weight loss, sleep position changes, and CPAP therapy. Surgery may be considered if other treatments are unsuccessful.
OSA JC
The document summarizes guidelines from the American Association of Orthodontists on the role of orthodontists in screening for and managing obstructive sleep apnea. It discusses how orthodontists can screen patients for risk factors and signs of sleep apnea. It also outlines how orthodontic treatments like oral appliances and orthognathic surgery can be used to treat sleep apnea in collaboration with physicians. The document separates discussions on adult and pediatric sleep apnea, covering etiology, risk factors, symptoms, diagnosis, and treatment approaches for each.
Introduction to Sleep apnea for Orthodontists
This document summarizes a presentation on obstructive sleep apnea (OSA) given by Dr. Jean-Marc Retrouvey. The presentation defines OSA, discusses its manifestations, describes common patient types, recognizes the difference between OSA and snoring, and suggests treatment approaches. It provides details on quantifying OSA severity using the apnea-hypopnea index and discusses common contributing factors like obesity, allergies, and genetics. The role of orthodontics in treating OSA and potential craniofacial impacts of untreated OSA are also summarized.
Intro to OSA and CPAP.pptx
A polysomnogram is a sleep study that records brain waves, oxygen levels, heart rate, breathing, eye and leg movements to diagnose sleep disorders like obstructive sleep apnea (OSA). OSA involves periods where breathing is reduced or stops completely during sleep due to throat muscle relaxation and airway collapse. Untreated OSA increases risks for high blood pressure, heart disease, stroke and accidents due to fragmented sleep and oxygen deprivation. Continuous positive airway pressure (CPAP) therapy is the standard treatment and works by providing steady airflow through a mask to keep the airway open during sleep.
Sleep apnea in dentistry and Orthodontics
1. Sleep Apnea Prepared by: dr. Mohamad Ghazi 1
2. Outline: • Sleep Apnea definition • Epidemiology • Types of Sleep Apnea • Risk factors for Obstructive sleep apnea • Diagnosis • OSA can increase the risk of ? • Treatment Options for Sleep Apnea • Conclusion 2
3. Sleep Apnea is defined as the stopping of airflow during sleep and preventing air from entering the lungs caused by an obstruction.(1) What is Sleep Apnea? 1.British Snoring & Sleep Apnoea Association . 2. Orthodontics - Current Principles and Techniques - Graber 5th edition - 2011 Just as allergic disease significantly affects quality of life, obstructive sleep apnea, if it is untreated, may affect adversely the ability of adults and children to function adequately at work and at school.(2) 3
4. 4
5. Is Sleep Apnea Significant Health Issue ? 22 million Americans suffer from sleep apnea, with 80 percent of the cases of moderate and severe obstructive sleep apnea undiagnosed. (3) 3.American Sleep Apnea Association 4.Young et al 1993 5.Young et al 2002 15. Marcus CL, Brooks LJ, Draper KA, Gozal D, Halbower AC, Jones J, et al. Diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatrics. 2012; 130: 576-84. EPIDEMIOLOGY: OSA present in 25-58% of Male and 10-37% of Female. (4)(5) According to a report by American Academy of Pediatrics, depends on the population studied, the prevalence of OSAS is in the range of 1% to 5% (15) 5
6. Types of Sleep Apnea: Obstructive sleep apnea is the most common type of sleep apnea. It occurs when the soft tissue in the back of your throat relaxes during sleep and blocks the airway, often causing you to snore loudly. 6
7. Central sleep apnea is a much less common type of sleep apnea that involves the central nervous system, occurring when the brain fails to signal the muscles that control breathing. People with central sleep apnea seldom snore. Complex sleep apnea is a combination of obstructive sleep apnea and central sleep apnea. A) Obstructive sleep apnea. Note continued chest and abdominal effort in the absence of airflow. B) Central sleep apnea. Note absence of chest and abdominal effort, as well as absence of airflow 7
8. You have a higher risk for obstructive sleep apnea if you are: Overweight ??? (Most Important Factor) 5.Young et al 2002 6.National Institutes of Health 14.Malhotra et al 2002 • About 70% of those with OSA are obese (14) • Higher BMI associated with higher prevalence – BMI>30: 26% with AHI>15, 60% with AHI>5 – BMI>40: 33% with AHI>15, 98% with AHI>5 Obese people have extrinsic narrowing of the area surrounding collapsible region of the pharynx and regional soft tissue enlargement. Increased fat deposits posteriolateral to oropharyngeal airspace at level of soft palate, in the soft palate, and in submental area. Risk factors for Obstructive sleep apnea(6) 8
9. • Sex : Male are more likely than Female to have sleep apnea. • Age : the risk increases as you get older. • A family history of sleep apnea.
obstructive sleep apnoea
Sleep occurs in stages, with the deepest stages characterized by paralysis of voluntary muscles and rapid eye movements. Sleep apnea is a disorder where breathing stops briefly during sleep, often due to airway obstruction, which interrupts sleep quality. The main types are obstructive sleep apnea, caused by relaxation of throat muscles blocking the airway, and central sleep apnea, caused by failure of the brain to signal breathing muscles. Risk factors include obesity, large neck size, and family history. Treatment options include devices that use air pressure to keep the airway open as well as surgery in severe cases. Untreated sleep apnea can increase health risks like hypertension, heart disease, and diabetes.
Fw Obstructive Sleep Apnea
Obstructive sleep apnea (OSA) is a serious medical condition where the airway becomes blocked during sleep, preventing oxygen from reaching the lungs for 10 seconds or more. It is associated with increased risks of heart problems, stroke, high blood pressure, and diabetes. OSA is caused when the muscles in the back of the throat relax and block the airway during sleep. It can be mild, moderate, or severe depending on how many times per hour the airway becomes blocked. Treatment options include devices that hold the lower jaw forward during sleep to open the airway, as well as CPAP machines and surgery.
Sleep disorders in elderly
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SLEEP+DISORDERED+BREATHING- DrNalamati 5-13-09.ppt
Obstructive sleep apnea (OSA) involves cessation of breathing during sleep due to collapse of the upper airway. The document discusses the history, types, prevalence, risk factors, symptoms, diagnosis and treatment of OSA. Regarding treatment, positive airway pressure with CPAP is very effective but requires good mask fit and humidification. Surgery and oral appliances can also be used but may not be curative. Lifestyle changes like weight loss and avoiding alcohol before bed can help reduce OSA severity. Untreated OSA is associated with increased risk of health issues like hypertension.
SLEEP+DISORDERED+BREATHING- DrNalamati 5-13-09.ppt
Obstructive sleep apnea (OSA) involves cessation of breathing during sleep due to collapse of the upper airway. Risk factors include obesity, older age, family history, and anatomic abnormalities. Symptoms include excessive daytime sleepiness, loud snoring, and witnessed breathing pauses. Polysomnography is used to diagnose by measuring breathing, oxygen levels, brain waves and more during sleep. Treatment options include weight loss, CPAP, oral appliances, surgery, and lifestyle changes. CPAP is often first-line treatment and improves symptoms and health outcomes but requires good compliance.
Living with Sleep Apnea
Sleep apnea is a serious condition that affects over 12 million Americans, causing them to stop breathing during sleep sometimes hundreds of times per night. It can be terrifying and debilitating for sufferers. Those who are obese or have heart disease or stroke are most at risk. There are two main types - obstructive sleep apnea which is caused by throat tissues blocking breathing, and central sleep apnea where the brain fails to signal breathing. Symptoms include daytime sleepiness, memory problems, and high blood pressure. Diagnosis involves a sleep study to monitor breathing and oxygen levels. Treatment options include lifestyle changes, CPAP machines, and surgeries like nasal procedures or throat reduction. Living with sleep apnea requires following an
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2. Flexible laryngoscopy and other scoping procedures are important for evaluating the airway and detecting issues like laryngomalacia. Swallowing disorders are common in children with neurological conditions and may require videofluoroscopy.
3. Hemangiomas are a frequent congenital issue but often resolve spontaneously. Propranolol is now used to treat hemangiomas in addition to older surgical approaches.
OSA (Obstructive Sleep Apnea)
It is the most common sleep apnea. It is characterized by repeated episodes of complete or partial obstructions of the upper airway during sleep.
obstructive Sleep apnea - current view
This document provides an overview of obstructive sleep apnea syndrome (OSA) in both adults and pediatrics. It defines OSA and discusses symptoms, risk factors, pathophysiology, diagnosis using polysomnography, and various treatment options including weight loss, CPAP, oral appliances, surgery, and drugs. For children, it notes key differences in presentation compared to adults and conditions commonly associated with pediatric OSA such as adenotonsillar hypertrophy. The gold standard treatment is adenotonsillectomy for children and weight loss and CPAP for adults.
Meconium Aspiration Syndrome|MAS in neonates
Meconium Aspiration Syndrome (MAS) is a serious and potentially life-threatening condition affecting newborns. It occurs when a baby inhales a mixture of meconium and amniotic fluid into the lungs around the time of delivery.
Meconium is your baby's first poop. It's darker and thicker than typical poop and extremely sticky. Meconium builds up inside your baby's intestines from swallowing amniotic fluid (the fluid that surrounds and cushions them inside your uterus). Ideally, your baby passes meconium shortly after birth. In some cases, babies will pass this substance before they are born. Swallowing meconium in the womb is not harmful, but breathing it in can cause serious complications.
This introduction delves into the nature of meconium, the circumstances leading to its aspiration, and the implications for neonatal health.
Respiratory conditions of the lungs diseases
Respiratory conditions encompass a wide array of disorders affecting the lungs and respiratory system, often causing difficulty breathing and impacting overall health and well-being. These conditions can range from mild, such as the common cold, to severe, like chronic obstructive pulmonary disease (COPD) or lung cancer.
A common respiratory condition is asthma, characterized by inflammation and narrowing of the airways, leading to wheezing, coughing, and shortness of breath. Triggers for asthma can vary from allergens like pollen or pet dander to exercise or stress.
Chronic obstructive pulmonary disease (COPD) is a progressive lung disease that includes chronic bronchitis and emphysema, often caused by long-term exposure to irritants like cigarette smoke. Symptoms include coughing, wheezing, and shortness of breath, which worsen over time and can significantly impair daily activities.
Pneumonia is an infection that inflames air sacs in one or both lungs, commonly caused by bacteria, viruses, or fungi. Symptoms may include fever, chills, cough, and difficulty breathing, and severe cases can be life-threatening, especially in vulnerable populations like the elderly or those with weakened immune systems.
Another significant respiratory condition is chronic bronchitis, characterized by inflammation of the bronchial tubes, leading to increased mucus production and coughing. It is often associated with smoking and can result in breathing difficulties and reduced lung function.
Emphysema is a type of COPD where the air sacs in the lungs are gradually destroyed, impairing the exchange of oxygen and carbon dioxide. It is typically caused by long-term exposure to cigarette smoke or other lung irritants and leads to shortness of breath and reduced exercise tolerance.
Lung cancer is a type of cancer that begins in the lungs, usually due to smoking or exposure to carcinogens like asbestos or radon. Symptoms may include coughing, chest pain, and difficulty breathing, and treatment options vary depending on the stage and type of cancer.
Other respiratory conditions include bronchiolitis, cystic fibrosis, pulmonary fibrosis, and sleep apnea, each with its own set of symptoms, causes, and treatments. Proper diagnosis and management are essential for improving quality of life and preventing complications associated with respiratory conditions.
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Semelhante a Obstructive Sleep Apnea a type of sleep disorder
Sleep apnoea in pcos by dr alka mukherjee nagpur m.s. india
Polycystic ovary syndrome (PCOS), the most common endocrine disorder of pre-menopausal women, is characterized by chronic hyperandrogenism, oligoanovulation, obesity and insulin resistance. Importantly, PCOS women are at increased risk for glucose intolerance, type 2 diabetes and cardiovascular disorders. Recent reports indicate an unexpectedly high prevalence of obstructive sleep apnea (OSA) in PCOS. Alterations in sex steroids (i.e. high androgen and low estrogen levels) and increased visceral adiposity in PCOS could potentially contribute to the increased prevalence of OSA in this disorder. There is some evidence to suggest that there may be strong associations between the presence and severity of OSA and the metabolic disturbances that characterize PCOS. Causal mechanisms in the link between PCOS and OSA remain to be elucidated. Clinicians who manage PCOS patients should be aware of the high prevalence of OSA in these patients and systematically evaluate these women for sleep disturbances.
Etiology Of Obstructive sleep apnea
Obstructive sleep apnea (OSA) is a common sleep disorder where the airway becomes blocked during sleep, interrupting breathing. It is characterized by loud snoring, breathing pauses, and fatigue. Risk factors include obesity, large neck size, and family history. OSA can be classified by the site of airway obstruction and is diagnosed using tests like polysomnography. Untreated OSA has health consequences and increased mortality. Dentofacial features associated with OSA include a narrow upper airway and retrognathic mandible.
Etiology Of Obstructive sleep apnea
Obstructive sleep apnea (OSA) is a common sleep disorder where the airway becomes blocked during sleep, interrupting breathing. It is characterized by loud snoring, breathing pauses, and fatigue. Risk factors include obesity, large neck size, and family history. OSA can be classified by the site of obstruction and severity. Symptoms include excessive daytime sleepiness, impaired cognition, and increased health risks if left untreated. Dentofacial features associated with OSA include a narrow upper airway and retrognathic mandible.
Sleep apnea
Sleep apnea is a serious sleep disorder where a person's breathing is interrupted during sleep. There are two main types - obstructive sleep apnea caused by blockage of the airway, and central sleep apnea caused by problems in the brain's respiratory control center. Symptoms include loud snoring, waking with gasping sensations, and daytime sleepiness. Risk factors include obesity, large neck size, and family history. Diagnosis involves an overnight sleep study to monitor breathing, brain waves, muscle activity and more. Treatment options include lifestyle changes, oral devices, ventilation with CPAP machines, and in some cases surgery.
Obstructive sleep apnea
Obstructive sleep apnea (OSA) is a prevalent chronic disease characterized by pharyngeal collapse during sleep.
Sleep disorder that involves cessation or significant decrease in airflow through the upper airway in the presence of breathing effort.
Obstructive sleep apnea is the second most common sleep disorder, insomnia being the most common.
Associated with recurrent oxyhemoglobin desaturations and arousals from sleep
Apnea index- no. of apneas /hr of total sleep time.
AHI (APNEA-HYPOPNEA INDEX)- No of apneas and hypoapneas/hr of total sleep time.
RDI (Respiratory Disturbance Index) – no. of apneas, hypoapneas and respiratory effort related arousals(RERA)/hr of total sleep time.
Osa tongue-based- Surgical Procedures
This document provides an overview of tongue base procedures for obstructive sleep apnea. It discusses sleep physiology and testing methods like polysomnography. It describes adult obstructive sleep apnea including pathophysiology, evaluation, and medical and surgical management options. Tongue base procedures are discussed as a surgical treatment that can help reduce airway collapse and obstruction at the base of the tongue. The document reviews considerations for various surgical approaches to treat obstructive sleep apnea.
sleep apneas
This document discusses sleep apnea and its diagnosis and treatment. It begins with an overview of sleep physiology and the different stages of sleep. It then discusses the different types of sleep apnea, most notably obstructive sleep apnea (OSA). The risk factors, symptoms, diagnostic tools and treatments for OSA are explained in detail. Key points include that OSA is caused by upper airway obstruction during sleep, and is diagnosed using polysomnography and treated initially through weight loss, sleep position changes, and CPAP therapy. Surgery may be considered if other treatments are unsuccessful.
OSA JC
The document summarizes guidelines from the American Association of Orthodontists on the role of orthodontists in screening for and managing obstructive sleep apnea. It discusses how orthodontists can screen patients for risk factors and signs of sleep apnea. It also outlines how orthodontic treatments like oral appliances and orthognathic surgery can be used to treat sleep apnea in collaboration with physicians. The document separates discussions on adult and pediatric sleep apnea, covering etiology, risk factors, symptoms, diagnosis, and treatment approaches for each.
Introduction to Sleep apnea for Orthodontists
This document summarizes a presentation on obstructive sleep apnea (OSA) given by Dr. Jean-Marc Retrouvey. The presentation defines OSA, discusses its manifestations, describes common patient types, recognizes the difference between OSA and snoring, and suggests treatment approaches. It provides details on quantifying OSA severity using the apnea-hypopnea index and discusses common contributing factors like obesity, allergies, and genetics. The role of orthodontics in treating OSA and potential craniofacial impacts of untreated OSA are also summarized.
Intro to OSA and CPAP.pptx
A polysomnogram is a sleep study that records brain waves, oxygen levels, heart rate, breathing, eye and leg movements to diagnose sleep disorders like obstructive sleep apnea (OSA). OSA involves periods where breathing is reduced or stops completely during sleep due to throat muscle relaxation and airway collapse. Untreated OSA increases risks for high blood pressure, heart disease, stroke and accidents due to fragmented sleep and oxygen deprivation. Continuous positive airway pressure (CPAP) therapy is the standard treatment and works by providing steady airflow through a mask to keep the airway open during sleep.
Sleep apnea in dentistry and Orthodontics
1. Sleep Apnea Prepared by: dr. Mohamad Ghazi 1
2. Outline: • Sleep Apnea definition • Epidemiology • Types of Sleep Apnea • Risk factors for Obstructive sleep apnea • Diagnosis • OSA can increase the risk of ? • Treatment Options for Sleep Apnea • Conclusion 2
3. Sleep Apnea is defined as the stopping of airflow during sleep and preventing air from entering the lungs caused by an obstruction.(1) What is Sleep Apnea? 1.British Snoring & Sleep Apnoea Association . 2. Orthodontics - Current Principles and Techniques - Graber 5th edition - 2011 Just as allergic disease significantly affects quality of life, obstructive sleep apnea, if it is untreated, may affect adversely the ability of adults and children to function adequately at work and at school.(2) 3
4. 4
5. Is Sleep Apnea Significant Health Issue ? 22 million Americans suffer from sleep apnea, with 80 percent of the cases of moderate and severe obstructive sleep apnea undiagnosed. (3) 3.American Sleep Apnea Association 4.Young et al 1993 5.Young et al 2002 15. Marcus CL, Brooks LJ, Draper KA, Gozal D, Halbower AC, Jones J, et al. Diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatrics. 2012; 130: 576-84. EPIDEMIOLOGY: OSA present in 25-58% of Male and 10-37% of Female. (4)(5) According to a report by American Academy of Pediatrics, depends on the population studied, the prevalence of OSAS is in the range of 1% to 5% (15) 5
6. Types of Sleep Apnea: Obstructive sleep apnea is the most common type of sleep apnea. It occurs when the soft tissue in the back of your throat relaxes during sleep and blocks the airway, often causing you to snore loudly. 6
7. Central sleep apnea is a much less common type of sleep apnea that involves the central nervous system, occurring when the brain fails to signal the muscles that control breathing. People with central sleep apnea seldom snore. Complex sleep apnea is a combination of obstructive sleep apnea and central sleep apnea. A) Obstructive sleep apnea. Note continued chest and abdominal effort in the absence of airflow. B) Central sleep apnea. Note absence of chest and abdominal effort, as well as absence of airflow 7
8. You have a higher risk for obstructive sleep apnea if you are: Overweight ??? (Most Important Factor) 5.Young et al 2002 6.National Institutes of Health 14.Malhotra et al 2002 • About 70% of those with OSA are obese (14) • Higher BMI associated with higher prevalence – BMI>30: 26% with AHI>15, 60% with AHI>5 – BMI>40: 33% with AHI>15, 98% with AHI>5 Obese people have extrinsic narrowing of the area surrounding collapsible region of the pharynx and regional soft tissue enlargement. Increased fat deposits posteriolateral to oropharyngeal airspace at level of soft palate, in the soft palate, and in submental area. Risk factors for Obstructive sleep apnea(6) 8
9. • Sex : Male are more likely than Female to have sleep apnea. • Age : the risk increases as you get older. • A family history of sleep apnea.
obstructive sleep apnoea
Sleep occurs in stages, with the deepest stages characterized by paralysis of voluntary muscles and rapid eye movements. Sleep apnea is a disorder where breathing stops briefly during sleep, often due to airway obstruction, which interrupts sleep quality. The main types are obstructive sleep apnea, caused by relaxation of throat muscles blocking the airway, and central sleep apnea, caused by failure of the brain to signal breathing muscles. Risk factors include obesity, large neck size, and family history. Treatment options include devices that use air pressure to keep the airway open as well as surgery in severe cases. Untreated sleep apnea can increase health risks like hypertension, heart disease, and diabetes.
Fw Obstructive Sleep Apnea
Obstructive sleep apnea (OSA) is a serious medical condition where the airway becomes blocked during sleep, preventing oxygen from reaching the lungs for 10 seconds or more. It is associated with increased risks of heart problems, stroke, high blood pressure, and diabetes. OSA is caused when the muscles in the back of the throat relax and block the airway during sleep. It can be mild, moderate, or severe depending on how many times per hour the airway becomes blocked. Treatment options include devices that hold the lower jaw forward during sleep to open the airway, as well as CPAP machines and surgery.
Sleep disorders in elderly
This document discusses sleep patterns and common sleep disorders in the elderly. It begins by noting that sleep complaints are common in over half of elderly patients. It then describes normal physiologic changes in sleep patterns with age, including decreased total sleep time and slow wave sleep. Common sleep disorders discussed include advance sleep phase disorder, sleep disordered breathing/obstructive sleep apnea, insomnia, periodic limb movement disorder, and REM sleep behavior disorder. Treatment options for obstructive sleep apnea such as CPAP and oral appliances are also summarized.
SLEEP+DISORDERED+BREATHING- DrNalamati 5-13-09.ppt
Obstructive sleep apnea (OSA) involves cessation of breathing during sleep due to collapse of the upper airway. The document discusses the history, types, prevalence, risk factors, symptoms, diagnosis and treatment of OSA. Regarding treatment, positive airway pressure with CPAP is very effective but requires good mask fit and humidification. Surgery and oral appliances can also be used but may not be curative. Lifestyle changes like weight loss and avoiding alcohol before bed can help reduce OSA severity. Untreated OSA is associated with increased risk of health issues like hypertension.
SLEEP+DISORDERED+BREATHING- DrNalamati 5-13-09.ppt
Obstructive sleep apnea (OSA) involves cessation of breathing during sleep due to collapse of the upper airway. Risk factors include obesity, older age, family history, and anatomic abnormalities. Symptoms include excessive daytime sleepiness, loud snoring, and witnessed breathing pauses. Polysomnography is used to diagnose by measuring breathing, oxygen levels, brain waves and more during sleep. Treatment options include weight loss, CPAP, oral appliances, surgery, and lifestyle changes. CPAP is often first-line treatment and improves symptoms and health outcomes but requires good compliance.
Living with Sleep Apnea
Sleep apnea is a serious condition that affects over 12 million Americans, causing them to stop breathing during sleep sometimes hundreds of times per night. It can be terrifying and debilitating for sufferers. Those who are obese or have heart disease or stroke are most at risk. There are two main types - obstructive sleep apnea which is caused by throat tissues blocking breathing, and central sleep apnea where the brain fails to signal breathing. Symptoms include daytime sleepiness, memory problems, and high blood pressure. Diagnosis involves a sleep study to monitor breathing and oxygen levels. Treatment options include lifestyle changes, CPAP machines, and surgeries like nasal procedures or throat reduction. Living with sleep apnea requires following an
Office based ent practise in (2)
1. The document discusses office-based ENT practices for children, covering diagnostic tools, common conditions, and treatment approaches. Polysomnography is the gold standard for diagnosing sleep disorders, while adenotonsillectomy is often the primary treatment for sleep-disordered breathing.
2. Flexible laryngoscopy and other scoping procedures are important for evaluating the airway and detecting issues like laryngomalacia. Swallowing disorders are common in children with neurological conditions and may require videofluoroscopy.
3. Hemangiomas are a frequent congenital issue but often resolve spontaneously. Propranolol is now used to treat hemangiomas in addition to older surgical approaches.
OSA (Obstructive Sleep Apnea)
It is the most common sleep apnea. It is characterized by repeated episodes of complete or partial obstructions of the upper airway during sleep.
obstructive Sleep apnea - current view
This document provides an overview of obstructive sleep apnea syndrome (OSA) in both adults and pediatrics. It defines OSA and discusses symptoms, risk factors, pathophysiology, diagnosis using polysomnography, and various treatment options including weight loss, CPAP, oral appliances, surgery, and drugs. For children, it notes key differences in presentation compared to adults and conditions commonly associated with pediatric OSA such as adenotonsillar hypertrophy. The gold standard treatment is adenotonsillectomy for children and weight loss and CPAP for adults.
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Meconium Aspiration Syndrome|MAS in neonates
Meconium Aspiration Syndrome (MAS) is a serious and potentially life-threatening condition affecting newborns. It occurs when a baby inhales a mixture of meconium and amniotic fluid into the lungs around the time of delivery.
Meconium is your baby's first poop. It's darker and thicker than typical poop and extremely sticky. Meconium builds up inside your baby's intestines from swallowing amniotic fluid (the fluid that surrounds and cushions them inside your uterus). Ideally, your baby passes meconium shortly after birth. In some cases, babies will pass this substance before they are born. Swallowing meconium in the womb is not harmful, but breathing it in can cause serious complications.
This introduction delves into the nature of meconium, the circumstances leading to its aspiration, and the implications for neonatal health.
Respiratory conditions of the lungs diseases
Respiratory conditions encompass a wide array of disorders affecting the lungs and respiratory system, often causing difficulty breathing and impacting overall health and well-being. These conditions can range from mild, such as the common cold, to severe, like chronic obstructive pulmonary disease (COPD) or lung cancer.
A common respiratory condition is asthma, characterized by inflammation and narrowing of the airways, leading to wheezing, coughing, and shortness of breath. Triggers for asthma can vary from allergens like pollen or pet dander to exercise or stress.
Chronic obstructive pulmonary disease (COPD) is a progressive lung disease that includes chronic bronchitis and emphysema, often caused by long-term exposure to irritants like cigarette smoke. Symptoms include coughing, wheezing, and shortness of breath, which worsen over time and can significantly impair daily activities.
Pneumonia is an infection that inflames air sacs in one or both lungs, commonly caused by bacteria, viruses, or fungi. Symptoms may include fever, chills, cough, and difficulty breathing, and severe cases can be life-threatening, especially in vulnerable populations like the elderly or those with weakened immune systems.
Another significant respiratory condition is chronic bronchitis, characterized by inflammation of the bronchial tubes, leading to increased mucus production and coughing. It is often associated with smoking and can result in breathing difficulties and reduced lung function.
Emphysema is a type of COPD where the air sacs in the lungs are gradually destroyed, impairing the exchange of oxygen and carbon dioxide. It is typically caused by long-term exposure to cigarette smoke or other lung irritants and leads to shortness of breath and reduced exercise tolerance.
Lung cancer is a type of cancer that begins in the lungs, usually due to smoking or exposure to carcinogens like asbestos or radon. Symptoms may include coughing, chest pain, and difficulty breathing, and treatment options vary depending on the stage and type of cancer.
Other respiratory conditions include bronchiolitis, cystic fibrosis, pulmonary fibrosis, and sleep apnea, each with its own set of symptoms, causes, and treatments. Proper diagnosis and management are essential for improving quality of life and preventing complications associated with respiratory conditions.
High-Frequency oscillatory ventilation HFOV
High-frequency oscillatory ventilation (HFOV) is an advanced mechanical ventilation strategy utilized in the management of respiratory failure, particularly in critically ill patients. It employs small tidal volumes delivered at rapid rates to maintain lung recruitment and gas exchange while minimizing the risk of ventilator-induced lung injury (VILI). HFOV is commonly employed in neonates, infants, and adults with acute respiratory distress syndrome (ARDS) or other conditions characterized by severe respiratory compromise.
The fundamental principle of HFOV involves the delivery of very small tidal volumes (often in the range of 1-3 mL/kg) at high frequencies (typically between 3 and 15 Hz). This approach differs from conventional mechanical ventilation, where larger tidal volumes are delivered at slower rates. The goal of HFOV is to provide adequate ventilation and oxygenation while minimizing the risk of lung injury associated with high tidal volumes and pressures.
In HFOV, gas is delivered into the airways in the form of rapid oscillations, creating small pressure changes that promote lung recruitment and gas exchange. These oscillations are superimposed on a baseline level of continuous positive airway pressure (CPAP), which helps to maintain lung volume and prevent atelectasis during expiration. The combination of high-frequency oscillations and continuous positive pressure facilitates gas exchange by improving alveolar ventilation and reducing intrapulmonary shunting.
The oscillations in HFOV are typically generated by a piston or a diaphragm within the ventilator circuit. The rapid oscillatory motion of the ventilator creates pressure fluctuations that are transmitted to the airways, causing the lungs to expand and contract at high frequencies. This cyclical stretching and relaxation of the lung tissue help to open collapsed alveoli, redistribute lung volume, and improve overall lung compliance.
One of the key advantages of HFOV is its ability to deliver ventilation while minimizing the risk of VILI. By using very small tidal volumes and high frequencies, HFOV reduces the mechanical forces applied to the lungs, thereby decreasing the likelihood of barotrauma (pressure-related lung injury) and volutrauma (overdistension of the alveoli). This makes HFOV particularly suitable for patients with ARDS or other conditions where lung injury may be exacerbated by conventional ventilation strategies.
HFOV can be used as a primary mode of ventilation or as a rescue therapy for patients who fail to respond to conventional ventilation. It is often initiated when patients exhibit severe respiratory distress, hypoxemia, or signs of impending respiratory failure. HFOV may also be used prophylactically in high-risk patients to prevent the development of ARDS or other complications.
Despite its potential benefits, HFOV requires careful patient selection, monitoring, and management to optimize outcomes.
Veno-Arterial Ecmo (VA-ECMO) & Their basic
VA ECMO stands for Venoarterial Extracorporeal Membrane Oxygenation. It's a life-saving medical procedure used in critical situations where the heart and lungs are unable to function adequately. VA ECMO involves diverting blood from the body, oxygenating it outside the body, and then returning it to the arterial system, effectively bypassing the heart and lungs. This allows time for the organs to rest and heal, supporting patients with severe cardiac or respiratory failure.
Veno-venous Extracorporeal membrane oxygenation (ECMO).pptx
Veno-venous extracorporeal membrane oxygenation (VV ECMO) is a life-saving therapy for severe respiratory failure. It involves using an external circuit to oxygenate and remove carbon dioxide from the blood, providing temporary support to the lungs. This allows the patient's lungs to rest and recover while maintaining oxygen delivery to the body. VV ECMO can be a bridge to recovery or lung transplantation for patients with acute respiratory distress syndrome (ARDS), pneumonia, or other conditions causing respiratory failure. It requires specialized equipment and expertise for cannulation, management, and monitoring.
#ecmo #vvecmo #heartlungmachine #vaecmo
extracorporeal membrane oxygenation (ecmo)
ECMO (Extracorporeal Membrane Oxygenation) is a life-saving therapy that provides temporary support for patients with severe respiratory or cardiac failure. It involves the use of a machine to oxygenate the blood and remove carbon dioxide outside the body, allowing the lungs and/or heart to rest and recover. ECMO is used in critical care settings and can be deployed in various scenarios, including acute respiratory distress syndrome (ARDS), cardiogenic shock, or as a bridge to lung or heart transplantation.
NON-INVASIVE VENTILATION A TYPE OF VENTILATION
Non-invasive ventilation (NIV) is a method of delivering respiratory support without the need for invasive procedures like endotracheal intubation. It typically involves wearing a mask or nasal prongs connected to a ventilator that delivers air or a mixture of air and oxygen to the lungs. NIV is commonly used to treat respiratory conditions such as chronic obstructive pulmonary disease (COPD), pneumonia, and acute respiratory distress syndrome (ARDS). It helps improve oxygenation, reduce work of breathing, and relieve respiratory distress, while allowing patients to remain conscious and communicate. NIV can be administered in various settings, including hospitals, intensive care units, and at home, depending on the patient's condition and needs.
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PGx Analysis in VarSeq: A User’s Perspective
Since our release of the PGx capabilities in VarSeq, we’ve had a few months to gather some insights from various use cases. Some users approach PGx workflows by means of array genotyping or what seems to be a growing trend of adding the star allele calling to the existing NGS pipeline for whole genome data. Luckily, both approaches are supported with the VarSeq software platform. The genotyping method being used will also dictate what the scope of the tertiary analysis will be. For example, are your PGx reports a standalone pipeline or would your lab’s goal be to handle a dual-purpose workflow and report on PGx + Diagnostic findings.
The purpose of this webcast is to:
Discuss and demonstrate the approaches with array and NGS genotyping methods for star allele calling to prep for downstream analysis.
Following genotyping, explore alternative tertiary workflow concepts in VarSeq to handle PGx reporting.
Moreover, we will include insights users will need to consider when validating their PGx workflow for all possible star alleles and options you have for automating your PGx analysis for large number of samples. Please join us for a session dedicated to the application of star allele genotyping and subsequent PGx workflows in our VarSeq software.
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Cancer remains one of the leading causes of death worldwide, prompting the need for innovative treatment methods. Nanotechnology offers promising new approaches, including the use of gold nanoparticles (nanogold) for targeted cancer therapy. Nanogold particles possess unique physical and chemical properties that make them suitable for drug delivery, imaging, and photothermal therapy.
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Osvaldo Bernardo Muchanga
Gastrointestinal Infections
GASTROINTESTINAL INFECTIONS result from the ingestion of pathogens that cause infections at the level of this tract, generally being transmitted by food, water and hands contaminated by microorganisms such as E. coli, Salmonella, Shigella, Vibrio cholerae, Campylobacter, Staphylococcus, Rotavirus among others that are generally contained in feces, thus configuring a FECAL-ORAL type of transmission.
Among the factors that lead to the occurrence of gastrointestinal infections are the hygienic and sanitary deficiencies that characterize our markets and other places where raw or cooked food is sold, poor environmental sanitation in communities, deficiencies in water treatment (or in the process of its plumbing), risky hygienic-sanitary habits (not washing hands after major and/or minor needs), among others.
These are generally consequences (signs and symptoms) resulting from gastrointestinal infections: diarrhea, vomiting, fever and malaise, among others.
The treatment consists of replacing lost liquids and electrolytes (drinking drinking water and other recommended liquids, including consumption of juicy fruits such as papayas, apples, pears, among others that contain water in their composition).
To prevent this, it is necessary to promote health education, improve the hygienic-sanitary conditions of markets and communities in general as a way of promoting, preserving and prolonging PUBLIC HEALTH.
Gastritis and Gastric Health
Gastric Health is one of the most relevant concerns in human health, with gastrointestinal infections being among the main illnesses that affect humans.
Among gastric problems, we have GASTRITIS AND GASTRIC ULCERS as the main public health problems. Gastritis and gastric ulcers normally result from inflammation and corrosion of the walls of the stomach (gastric mucosa) and are generally associated (caused) by the bacterium Helicobacter pylor, which, according to the literature, this bacterium settles on these walls (of the stomach) and starts to release urease that ends up altering the normal pH of the stomach (acid), which leads to inflammation and corrosion of the mucous membranes and consequent gastritis or ulcers, respectively.
In addition to bacterial infections, gastritis and gastric ulcers are associated with several factors, with emphasis on prolonged fasting, chemical substances including drugs, alcohol, foods with strong seasonings including chilli, which ends up causing inflammation of the stomach walls and/or corrosion. of the same, resulting in the appearance of wounds and consequent gastritis or ulcers, respectively.
Among patients with gastritis and/or ulcers, one of the dilemmas is associated with the foods to consume in order to minimize the sensation of pain and discomfort. Skin Diseases That Happen During Summer.
Summer is a time for fun in the sun, but the heat and humidity can also wreak havoc on your skin. From itchy rashes to unwanted pigmentation, several skin conditions become more prevalent during these warmer months.
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Breast cancer: Post menopausal endocrine therapy
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
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Obstructive Sleep Apnea a type of sleep disorder
- 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
- 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
- 15. CONT….
- 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