Obstructive Sleep Apnea - Symptoms and causes, In adults and children скачать в хорошем качестве

Obstructive Sleep Apnea - Symptoms and causes, In adults and children

Sleep apnea is a serious sleep disorder in which, breathing repeatedly stops and starts. Obstructive sleep apnea is a form of sleep apnea, in which repetitive episodes of nocturnal breathing cessation happens due to upper airway collapse. The typical adult obstructive sleep apnea patient is an overweight, or obese middle-aged male, or a postmenopausal female with excessive daytime sleepiness and loud nightly snoring. They may also complain of waking to gasp for breath or choking, sleep maintenance insomnia, night sweats, nighttime reflux, and nocturia in the absence of excessive nighttime liquid intake. A physical exam is typically notable for a larger than average neck circumference (17 inches in males) with crowded oropharynx and large tongue. Patients with refractory atrial fibrillation, resistant hypertension, and history of a stroke should be screened for sleep apnea regardless of symptoms. The typical child with obstructive sleep apnea will have loud nightly snoring, may be hyperactive rather than sleepy, and may have academic difficulties. These children can be incorrectly diagnosed with attention deficit hyperactivity disorder (ADHD). Night sweats, nighttime reflux, sleep maintenance insomnia, restless sleep with frequent limb movements, and secondary nocturnal enuresis may also be present. A physical exam is often notable for adenoidal facies, tonsillar hypertrophy, hyponasal speech, and a high arched palate. Patients with Down syndrome and any other condition associated with hypotonia should be screened for obstructive sleep apnea regardless of symptoms. Risk Factors: Excess weight and Obesity greatest risk factors. Fat deposits around your upper airway can obstruct your breathing. Male sex. Being older. Family history. Use of alcohol, sedatives or tranquilizers. These substances relax the muscles in your throat, which can worsen obstructive sleep apnea. Smoking. Nasal congestion. If you have difficulty breathing through your nose — whether from an anatomical problem or allergies — you're more likely to develop obstructive sleep apnea. Medical conditions. Congestive heart failure, high blood pressure, type 2 diabetes and Parkinson's disease are some of the conditions that may increase the risk of obstructive sleep apnea. Polycystic ovary syndrome, hormonal disorders, prior stroke and chronic lung diseases such as asthma also can increase risk. Main characteristic of obstructive sleep apnea is, episodes of complete or partial collapse of the airway, it causes decrease oxygen in the blood and it causes arousal from sleep. The Main mechanism is throat muscles relax. When muscle tone is decreased, the result is a repetitive total or partial collapse of the airway. It happens during REM sleep. This collapse lasts more then 10 seconds. And oxygen desaturation causes arousal, awake state. The majority of patients with Obstructive Sleep Apnea have upper airway obstruction either at the level of the tongue or the soft palate. In children, the most common cause of obstructive sleep apnea is enlarged tonsils and/or adenoids. In adults, it is most commonly associated with obesity, male sex, and advancing age. Other common symptoms include: loud and disruptive snoring. Excessive daytime sleepiness. Anatomical factors that contribute to Obstructive Sleep apnea include enlarged tonsils, a large volume of the tongue, abnormal maxilla position, length of the soft palate, and a decrease in the cross-sectional area of the upper airways. The people who has obstructive sleep apnea, commonly also have higher risk of hypertension, coronary artery disease, depression, insulin-resistant diabetes, and sleep-related accidents. Obstructive sleep apnea is common, as high as 14% of men and 5% of women in the United States. Prevalence also increases with age, and when individuals reach 50 years of age or more, there are as many women as men who develop the disorder. Nighttime in-laboratory Level 1 polysomnography is the gold standard test for the diagnosis of obstructive sleep apnea. Home sleep tests (HST) have gained popularity due to their relative accessibility and lower cost. The primary treatment for obstructive sleep apnea in a child is tonsillectomy and adenoidectomy.