obstructive sleep apnea

apnea /ap·nea/ (ap´ne-ah) cessation of breathing.apne´ic

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central sleep apnea  sleep apnea from failure of stimulation by medullary respiratory centers.

obstructive sleep apnea  sleep apnea from collapse or obstruction of the airway during sleep, such as in the obese.

sleep apnea  transient attacks of apnea during sleep, resulting in acidosis and pulmonary arteriolar vasoconstriction and hypertension.

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Obstructive sleep apnea (OSA)

A potentially life-threatening condition characterized by episodes of breathing cessation during sleep alternating with snoring or disordered breathing. The low levels of oxygen in the blood of patients with OSA may eventually cause heart problems or stroke.

Mentioned in: Snoring

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obstructive sleep apnea,

a form of sleep apnea involving a physical obstruction in the upper airways. The condition tends to affect mainly obese people, particularly those with secondary pulmonary insufficiency or a constitutional defect. A nonobese person with a congenital abnormality of the upper airways also may experience obstructive sleep apnea. The condition is usually marked by recurrent sleep interruptions, snoring, choking and gasping spells on awakening, and drowsiness caused by loss of normal sleep. Uncorrected, the disorder often leads to central sleep apnea, pulmonary failure, and cardiac abnormalities. See also pickwickian syndrome.

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apnea [ap´ne-ah]

cessation of breathing, especially during sleep. The most common type is adult sleep apnea. Central apnea in which there is failure of the central nervous system drive to respiration sometimes occurs in infants younger than 40 weeks after the date of conception.

adult sleep apnea frequent and prolonged episodes in which breathing stops during sleep. Diagnosis is confirmed by monitoring the subject during sleep for periods of apnea and lowered blood oxygen levels. Sleep apnea is divided into three categories: (1) obstructive, resulting from obstruction of the upper airways; (2) central, caused by some pathology in the brain's respiratory control center; and (3) mixed, a combination of the two (see above).

Treatment. Obstructive and mixed types are amenable to therapy. Since many sleep apnea patients are overweight, weight loss improves the symptoms. Central sleep apnea is the most difficult to control. Medications to stimulate breathing have not proven beneficial. Mechanical ventilation or administration of oxygen during the night may help some patients.

The most common treatment for obstructive sleep apnea is nasal continuous positive airway pressure, which the patient uses during sleep; the positive pressure exerted prevents the airway from obstructing. Another method that may be tried is a dental appliance to move the jaw forward during sleep. In the most refractory cases, such as when an anatomical airway obstruction can be demonstrated, surgery to remove it may be performed after consultation with a surgeon experienced in evaluating and treating such obstructions. Another treatment that is occasionally used is insertion of a special type of tracheostomy tube that can be plugged during the day for normal use of the upper airway and opened at night to bypass upper airway obstruction

central apnea (central sleep apnea) see adult sleep apnea.

deglutition apnea a temporary arrest of the activity of the respiratory nerve center during an act of swallowing.

initial apnea a condition in which a newborn fails to establish sustained respiration within two minutes of delivery.

late apnea cessation of respiration in a newborn for more than 45 seconds after spontaneous breathing has been established and sustained.

mixed apnea see adult sleep apnea.

obstructive apnea (obstructive sleep apnea) see adult sleep apnea.

primary apnea cessation of breathing resulting when a fetus or newborn infant is deprived of oxygen; exposure to oxygen and stimulation usually restore respiration.

prolonged infantile apnea sudden infant death syndrome.

secondary apnea a period of time following primary apnea during which continued asphyxia of the fetus or newborn, with a fall in blood pressure and heart rate, necessitates artificial ventilation for resuscitation and reestablishment of ventilation.

sleep apnea transient periods when breathing stops during sleep; see adult sleep apnea.

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obstructive sleep apnea

Obstructive sleep apnea syndrome Sleep disorders A clinical complex due to the pathophysiologic response to anatomic defects of the nasopharynx, characterized by loud snoring, nocturnal oxyHb desaturation, disrupted sleep, hundreds of apneic episodes during sleep, resulting in upper airway closure for ≥ 10 secs Clinical Daytime drowsiness, especially in obese middle-aged ♂, cardiovascular Sx–eg, apnea-induced arrhythmia, bradycardia, ↑ ventricular ectopic activity Contributing factors Alcohol or sedatives before sleep, obesity, nasal obstruction, adenoid/tonsillar hyperplasia, macroglossia, retrognathia, acromegaly, hypothyroidism, HTN, pulmonary HTN Management Individualized–eg, surgery; uvulopalatopharyngoplasty is successful in 50%. Cf Snoring. Cf Narcolepsy, Sleep disorders.