Sleep Apnea

Cessation of airflow >10s that occurs at least 10-15x per hour during sleep

O2 sat decreases during apneic episodes, and pulmonary pressures increase

Daytime somnolence is mandatory for the diagnosis of sleep apnea

2 main classes:

  1. Obstructive sleep apnea - floppy airways despite adequate ventilatory effort; pts are usually obese and have abnormal airways. Tx - weight loss and nasal CPAP
  2. Central sleep apnea (<5%) - inadequate ventilatory drive; Tx - acetazolamide, progesterone, and supplemental O2

Dx

confirmed by polysomnography (sleep studies)

Central sleep apnea Obstructive Sleep Apnea
• result from temporary loss of ventilation effort
• respiratory muscles from chest and abdomen are not working
• didn’t  receive the signal from the brain
• associated with heart failure  and stroke
• not fully yet understood of MOA • due to narrow collapse air way
• Due to airway obstruction
• Respiratory muscles of chest and abdomen are working normal
• associated with obesity ,myotonic dystrophy, Ehler-Danlos $
• Hypothyroidism or acromegaly predisposed by narrowing upper air way

Central hypoventilation syndrome (CHS) is a respiratory disorder that results in respiratory arrest during sleep. CHS can either be congenital (CCHS) or acquired (ACHS) later in life. It is fatal if untreated. It is also known as Ondine's curse.