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Sleep Apnea Syndrome
(TL011)

Introduction


There are several disorders termed "sleep-related breathing disorders" (SRBDs). These include obesity-hypoventilation, central sleep apnea syndrome, and obstructive sleep apnea (OSA). OSA, occlusion of the upper airway with continued respiratory effort, is the most common and well-known of these disorders.

The primary mechanism leading to OSA is a repetitive narrowing of the upper airway during sleep, followed by an increase in upper airway resistance or complete cessation of ventilation for 10 to 120 seconds. In milder forms of OSA, the sleeping individual may maintain airflow at the expense of increased work of breathing and frequent arousals. As OSA progresses, the respiratory events become more severe; hypoxia (low oxygen level), hypercarbia (increased carbon dioxide level), and dramatic disruptions of sleep occur.

OSA has been strongly associated with several cardiovascular disorders such as systemic hypertension, and there is association with pulmonary hypertension, cardiac ischemia (impaired blood flow to the heart), dysrhythmias, and strokes.

Initial management of OSA emphasizes correction of medical conditions such as hypothyroidism or anatomical factors as well as weight control, and avoidance of sedative medications. Choices regarding treatment are often based on the individual's preference and lifestyle.

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