primary apnea


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Related to primary apnea: secondary apnea

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.

primary apnea

a self-limited condition characterized by an absence of respiration. It may follow a blow to the head and is common immediately after birth in the newborn who breathes spontaneously when the carbon dioxide level in the circulation reaches a certain value. Reflexes are present and the heart is beating, but the skin may be pale or blue and muscle tone is diminished. No treatment is necessary, but careful observation, maintenance of body temperature, and oral pharyngeal aspiration are usually performed. Within seconds the newborn usually begins breathing, becomes pinker, moves the arms and legs, and cries. Compare periodic apnea of the newborn, secondary apnea.
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