1. WSS and OSA… What we NEED to know
Ned Barnes, RPSGT, RST, CCSH, Clinical Sleep Educator
Tiffin Mercy Hospital Sleep Improvement Center
A Catholic healthcare ministry serving Ohio and Kentucky

2. Normal Breathing While Asleep
Airway is Open

3. Normal Breathing While Asleep
Airway is Open
Air flow is
Unobstructed

4. Normal Breathing While Asleep
Airway is Open
Air flow is
Unobstructed
Brain is at Rest

5. Obstructive Pattern
Air Flow is
Obstructed

6. Obstructive Pattern Air Flow is Obstructed Brain is Unable
to Effectively Rest

7. Cycle of Obstructive Sleep
Onset of Snoring

8. Cycle of Obstructive Sleep
Onset of Snoring
Airway
Narrows

9. Normal Obstructed

10. Cycle of Obstructive Sleep
Onset of Snoring
Airway Narrows
Breathing Becomes
Labored or Stops

11. Cycle of Obstructive Sleep
Onset of Snoring
Sleep is Airway Disrupted Narrows
Breathing Becomes
Labored or Stops

12. Cycle of Obstructive Sleep
Onset of Snoring
Sleep is Airway
Disrupted Narrows
Breathing Becomes
Labored or Stops

13. What Does OSA Do? Causes Hardening of the Arteries
Dr. Louis Tartaglia, MD, DABSM

14. What Does OSA Do? Causes Hardening of the Arteries High Blood Pressure
Heart Attack
Stroke
Excessive Weight (BMI)
Erectile Dysfunction
Dr. Louis Tartaglia, MD DABSM

15. What Does OSA Do? Decreases Blood Oxygen During Sleep
Dr. Louis Tartaglia, MD DABSM

16. What Does OSA Do? Decreases Blood Oxygen During Sleep Headaches
Cardiac Arrhythmia
A-Fib
Dr. Louis Tartaglia, MD DABSM

17. What Does OSA Do?
80% correlation to onset of Diabetes in Patients with Moderate to Severe OSA who do not use CPAP.
2007 study, University of Chicago

18. What Does OSA Do? OSA is now linked with Cancer
2016 BRPT Clinical Sleep Educator Seminar
Dr. Naresh A. Dewan, MD

19. Symptoms of OSA
Fatigue and/or Excessive Daytime Sleepiness

20. Symptoms of OSA Fatigue and/or Excessive Daytime Sleepiness
Falling Asleep at Inappropriate Times

21. Symptoms of OSA Fatigue and/or Excessive Daytime Sleepiness
Falling Asleep at Inappropriate Times
Recurrent Awakening from Sleep

22. Symptoms of OSA Fatigue and/or Excessive Daytime Sleepiness
Falling Asleep at Inappropriate Times
Recurrent Awakening from Sleep
Trouble Concentrating

23. American Academy of Sleep Medicine ‘Hidden Health Crisis Costing America Billions’ Article: Monday August 8, 2016

24. American Academy of Sleep Medicine ‘Hidden Health Crisis Costing America Billions’ Article: Monday August 8, 2016
‘OSA is a chronic disease that is rising in prevalence in the U.S…OSA afflicts 29.4 million American men and women, which represents 12 percent of the U.S. adult population…’

25. Weidemann-Steiner Syndrome
Obstructive Sleep Apnea and Sleep Disorders

26. Weidemann-Steiner Syndrome
Developmental Syndromes with a propensity for Obstructive Sleep Apnea…
--Down Syndrome
--Weidemann-Steiner Syndrome
--Prader Willi Syndrome
--Williams Syndrome
--Kabuki Syndrome

27. Weidemann-Steiner Syndrome
Developmental Syndromes with a propensity for Obstructive Sleep Apnea…
--Down Syndrome
--Weidemann-Steiner Syndrome
--Prader Willi Syndrome
--Williams Syndrome
--Kabuki Syndrome
Common Denominator:
Lack of patent airway in sleep, due to Hypotonia and/or facial/airway anatomical structure

28. Weidemann-Steiner Syndrome
Complications of untreated OSA in developmental years…
--Cognative Development and Function
--Physical Growth and overall health
--Cardiovascular issues
Dr. Daniel J. Sak D.O., FCCP

29. Weidemann-Steiner Syndrome
Airway issues
Sleep Stages and Architecture
Parasomnias

30. Weidemann-Steiner Syndrome
Airway issues
Sleep Stages and Architecture
Parasomnias

31. Weidemann-Steiner Syndrome
Allison’s Airway…

32. Weidemann-Steiner Syndrome

33. Weidemann-Steiner Syndrome
Airway issues
Sleep Stages and Architecture
Parasomnias

34. Weidemann-Steiner Syndrome
Stage 1… Sleep Onset (transitional)…
Stage 2… Consolidated Sleep (unrestorative)
Stage 3… Slow Wave Sleep (physically restorative)
REM… Rapid Eye Movement (mentally/cognitively restorative)

35. Weidemann-Steiner Syndrome
Normal Adult Sleep Architecture…
Stage 1… 8% - 10%
Stage 2… 41% - 56%
Stage 3… 16% - 20%
REM… 20% – 29%

36. Weidemann-Steiner Syndrome
Normal Adult Sleep Architecture…
Stage 1… 8% - 10%
Stage 2… 41% - 56%
Stage 3… 16% - 20% (30% - 60% in developing years)
REM… 20% – 29%

37. Weidemann-Steiner Syndrome
Stage 1… Sleep Onset (transitional)…
Stage 2… Consolidated Sleep (unrestorative)
Stage 3… Slow Wave Sleep
(Insufficient N3 may yield Physical Development, Metabolism and/or Immune System affects)
REM… Rapid Eye Movement
(Insufficient REM may yield Cognitive Issues i.e. memory and/or emotional stability)

38. Weidemann-Steiner Syndrome
Airway issues
Sleep Stages and Architecture
Parasomnias

39. Weidemann-Steiner Syndrome
Parasomniaˌ[perəˈsämnēə]
a disorder characterized by abnormal or unusual behavior of the nervous system during sleep.
--Sleep Walking (Talking)
--Bed Wetting
--Bruxism
--Head Banging (rolling)
--Sleep/Wake interface anomalies
--Night Terrors

40. How to get help for Sleep Disorders…
PCP Referral
Consultation with a Sleep Specialist
Overnight Sleep Study (PSG or HST)
Follow Up with Sleep Specialist
CPAP Titration (if indicated by PSG)
Referral to DME Supplier of Choice
Regular Follow Ups with Sleep Specialist

41. Tiffin Mercy Sleep Wellness Center

42. WSS and OSA… What we NEED to know
Thanks for Coming
WSS and OSA… What we NEED to know
Ned Barnes, RPSGT, RST, CCSH, Clinical Sleep Educator
Tiffin Mercy Hospital Sleep Improvement Center
A Catholic healthcare ministry serving Ohio and Kentucky