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Obstructive sleep apnea

Classification and Symptoms: – Obstructive sleep apnea is classified into adult OSA and pediatric OSA. – It is differentiated from central sleep apnea by decreased […]

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Classification and Symptoms:
– Obstructive sleep apnea is classified into adult OSA and pediatric OSA.
– It is differentiated from central sleep apnea by decreased effort, not upper airway obstruction.
– Symptoms in adults include daytime sleepiness, loud snoring, and restless sleep.
– Less common symptoms in adults are morning headaches, mood changes, and weight gain.
– Symptoms in children with severe OSA include behavioral problems and obstructive tonsils and adenoids as common causes.
– Obesity contributes to the prevalence and severity of pediatric OSA.

Pathophysiology and Risk Factors:
– Obesity can lead to upper airway obstruction during sleep and contribute to changes in pediatric OSA prevalence.
– Age-related muscle tone changes, decreased muscle tone, and increased soft tissue around the airway increase OSA risk.
– Lifestyle factors like obesity, alcohol consumption, and sedative medications can impact muscle tone and increase OSA risk.
– Genetic factors and craniofacial syndromes like Down syndrome can increase the risk of developing OSA.
– Medications that cause decreased muscle tone increase OSA risk.

Complications and Consequences:
– Physiological consequences of OSA include hypoxia, sleep fragmentation, inflammation, and metabolic dysfunction.
– Clinical repercussions involve pulmonary hypertension and heart diseases.
– Neurocognitive consequences include cognitive deficits, attention difficulties, and lower academic performance.
– OSA in children is linked to higher risk for cardiovascular morbidities and metabolic disturbances.
– Nocturnal enuresis is more common in children with OSA, and adenotonsillectomy can positively impact and resolve enuresis.

Diagnosis and Treatment:
– Diagnosis of OSA involves assessing respiratory effort and categorizing apnea as obstructive.
– Lifestyle changes like weight loss and CPAP therapy can help improve OSA symptoms.
– Orthognathic surgery offered by maxillofacial surgeons is a treatment for OSA.
– Adverse consequences of OSA can be mitigated through proper diagnosis and treatment.
– Velopalatal insufficiency surgery and pharyngeal flap surgery can lead to post-operative OSA, increasing perioperative risk for OSA patients.

Impact and Comparison:
– OSA affects cognitive functions in adults and children, leading to attention difficulties and lower academic performance.
– Excessive daytime sleepiness is more common in adult OSA.
– OSA in adults has adverse consequences and higher mortality rates.
– Both pediatric and adult OSA have variability in blood pressure and cardiovascular morbidities.
– Internalizing disorders like anxiety and depression are more prevalent in individuals with OSA.

Obstructive sleep apnea (Wikipedia)

Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder and is characterized by recurrent episodes of complete or partial obstruction of the upper airway leading to reduced or absent breathing during sleep. These episodes are termed "apneas" with complete or near-complete cessation of breathing, or "hypopneas" when the reduction in breathing is partial. In either case, a fall in blood oxygen saturation, a disruption in sleep, or both, may result. A high frequency of apneas or hypopneas during sleep may interfere with the quality of sleep, which – in combination with disturbances in blood oxygenation – is thought to contribute to negative consequences to health and quality of life. The terms obstructive sleep apnea syndrome (OSAS) or obstructive sleep apnea–hypopnea syndrome (OSAHS) may be used to refer to OSA when it is associated with symptoms during the daytime (e.g. excessive daytime sleepiness, decreased cognitive function).

Obstructive sleep apnea
Other namesObstructive sleep apnoea
Obstructive sleep apnea: As soft tissue falls to the back of the throat, it impedes the passage of air (blue arrows) through the trachea.
SpecialtySleep medicine

Most individuals with obstructive sleep apnea are unaware of disturbances in breathing while sleeping, even after awakening. A bed partner or family member may observe a person snoring or appear to stop breathing, gasp, or choke while sleeping. People who live or sleep alone are often unaware of the condition. Symptoms may be present for years or even decades without identification, during which time the person may become conditioned to the daytime sleepiness, headaches and fatigue associated with significant levels of sleep disturbance. Obstructive sleep apnea has been associated with neurocognitive morbidity and there is a link between snoring and neurocognitive disorders.

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