1. John Paquet III BME 281 S01 02 October 2013

2.  Apnea (“want of breath”) = a pause in breathing  Narrower throat area  When muscles in upper throat relax during sleep, airway becomes blocked  Results in repeating pattern of heavy snoring, a silent period, and a gasp

3.  Obstructive Sleep Apnea ◦ Most common kind of sleep-disordered breathing  Central Sleep Apnea ◦ Imbalance of respiratory control centers in brain during sleep ◦ Controls fail to give signal to inhale, resulting in missed cycles of breathing  Complex/Mixed Sleep Apnea ◦ Combination of obstructive and central

4.  Each apnea can last from 10 seconds to minutes  5 to 30 or more apneas per hour  Affects around 18 million people in US, many of whom are unaware that they have the condition

5.  Obesity  Large neck  Large tongue  Short lower jaw in comparison with upper jaw

6.  Irritability and impatience  Forgetfulness  Drowsiness  Headaches  Increased risk of: ◦ High blood pressure ◦ Heart disease ◦ Stroke

7.  Continuous Positive Airway Pressure ◦ Small machine delivers stream of pressurized air through tube to mask  Traditional CPAP machines require patient to input desired pressure (determined from a sleep study)  APAP automatically changes air pressure as necessary to minimize number of apneas ◦ Can even warm/humidify air and monitor breathing

8.  Advantages: ◦ Better mood, better memory, higher alertness during day, increased productivity, regular sleep patterns  Disadvantages: ◦ Eye irritation, nasal congestion, dry or sore mouth ◦ These can typically be remedied by humidification, keeping CPAP equipment clean, and choosing the right mask

9.  Mandibular advancement splint  Uvulopalatopharyngoplasty (UPPP or UP3) ◦ Removes excess tissue at back of throat  Base-of-tongue advancement  Maxillomandibular advancement

10.  CPAP machines are far less expensive than surgery  Even if apnea is cured, surgical procedures pose potential risk of creating complications (i.e. via infection, nerve damage-TMD)  Dental appliances can be around the same cost or even cheaper than CPAP, but are less effective and only treat mild to moderate obstructive sleep apnea  CPAP is most common, effective, non-invasive treatment for patients with moderate to severe sleep apnea

11.  "Nasal CPAP." Medline Plus. U.S. National Library of Medicine, n.d. Web..  "Obstructive Sleep Apnea." Medline Plus. U.S. National Library of Medicine, n.d. Web..  "Sleep Apnea." Wikipedia. Wikimedia Foundation, n.d. Web..  "Sleep Apnea Facts." YourLungHealth.org - Sleep Apnea Facts. American Association for Respiratory Care, n.d. Web..