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SLEEP APNEA The Village Sleep Lab Accredited by the American Academy of Sleep Medicine Juan A. Albino, MD Board Certified in Sleep Medicine 751-4955 751-4955.

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Presentation on theme: "SLEEP APNEA The Village Sleep Lab Accredited by the American Academy of Sleep Medicine Juan A. Albino, MD Board Certified in Sleep Medicine 751-4955 751-4955."— Presentation transcript:

1 SLEEP APNEA The Village Sleep Lab Accredited by the American Academy of Sleep Medicine Juan A. Albino, MD Board Certified in Sleep Medicine 751-4955 751-4955 February, 2009

2 Thank You !!! Ron Kiedrowski, Rotary Club Ron Kiedrowski, Rotary Club Phillip Ratliff, AWAKE Group (753-8773) Phillip Ratliff, AWAKE Group (753-8773) Heather Ellington, Office Manager Heather Ellington, Office Manager Jim Grazis, RPSGT, CRT, Technologist Jim Grazis, RPSGT, CRT, Technologist Melyssa Rivera, Technologist Melyssa Rivera, Technologist Miyoshi Scott, Nurse Miyoshi Scott, Nurse

3 Common Sleep Disorders Insomnia: wants to sleep but cannot Insomnia: wants to sleep but cannot Sleep Deprivation: does not want to sleep but can; problem of sleep quantity Sleep Deprivation: does not want to sleep but can; problem of sleep quantity SLEEP APNEA: during day, snores at night because of obstruction in throat; problem of sleep quality SLEEP APNEA: sleepy during day, snores at night because of obstruction in throat; problem of sleep quality Restless Legs Syndrome: leg discomfort, relieved by movement that hinders sleep Restless Legs Syndrome: leg discomfort, relieved by movement that hinders sleep

4 Good Sleep Habits: Basics Regular times for sleeping and awakening Regular times for sleeping and awakening Maintain bedroom dark, quiet, cool Maintain bedroom dark, quiet, cool Use bed only for sleep and sex Use bed only for sleep and sex Avoid late daytime naps Avoid late daytime naps Avoid at night: alcohol, caffeine, nicotine Avoid at night: alcohol, caffeine, nicotine Sleep around 7 to 8 hours every night Sleep around 7 to 8 hours every night Prudent exercise and eating Prudent exercise and eating Avoid stressful situations at bed time Avoid stressful situations at bed time

5 Restless Legs Syndrome Leg discomfort, worse at night, relieved by movement, affects 5-10% of population Leg discomfort, worse at night, relieved by movement, affects 5-10% of population Familial, begins in childhood Familial, begins in childhood Associated with iron deficiency, drugs, Periodic Limb Movements of Sleep Associated with iron deficiency, drugs, Periodic Limb Movements of Sleep Easily treatable with medicines Easily treatable with medicines Restless Legs Syndrome Foundation Restless Legs Syndrome Foundation

6 Sleep Deprivation Disasters: Exxon Valdez, Challenger Space Shuttle, Chernobyl Nuclear Plant, Commuter plane crash in Kentucky Disasters: Exxon Valdez, Challenger Space Shuttle, Chernobyl Nuclear Plant, Commuter plane crash in Kentucky 33% of fatal truck accidents 33% of fatal truck accidents 10% of fatal car accidents 10% of fatal car accidents Impairment the same whether: drunk, sleep deprived (<4-6hrs.), sleep apnea Impairment the same whether: drunk, sleep deprived (<4-6hrs.), sleep apnea Must be taken seriously: sleep 7-8 hours Must be taken seriously: sleep 7-8 hours Leads to obesity and diabetes Leads to obesity and diabetes

7 Insomnia: Acute or Chronic Insomnia: inability to get to sleep, stay asleep, wakes up early, with daytime impairment Insomnia: inability to get to sleep, stay asleep, wakes up early, with daytime impairment Acute Insomnia (<4 weeks): stress, illness Acute Insomnia (<4 weeks): stress, illness Sleep medicines work well in acute stage Sleep medicines work well in acute stage Chronic Insomnia: >4 weeks, often years Chronic Insomnia: >4 weeks, often years Treat basic problem: >60% psychological Treat basic problem: >60% psychological Psychotherapy and behavioral therapy better than medicines, not easy to treat Psychotherapy and behavioral therapy better than medicines, not easy to treat Psychologists, Psychiatrists, PCP Psychologists, Psychiatrists, PCP

8 Sleep Apnea: Risk Factors Affects: 4 to 5% of population: common Affects: 4 to 5% of population: common Family history, Sleep maintenance insomnia Family history, Sleep maintenance insomnia Obesity: 80 % of sleep apnea patients; central (visceral, apples) obesity Obesity: 80 % of sleep apnea patients; central (visceral, apples) obesity Increasing age, Male gender Increasing age, Male gender Large tonsils / adenoids in children Large tonsils / adenoids in children Small mandible, large neck Small mandible, large neck Elderly & women: little snoring & not obese Elderly & women: little snoring & not obese

9 Sleep Apnea: Consequences Night: snoring, stops breathing snorting, gasping, bed partner worries Night: snoring, stops breathing snorting, gasping, bed partner worries Day: sleepy, tired, depressed, irritable, impotent, forgets, ? few complaints Day: sleepy, tired, depressed, irritable, impotent, forgets, ? few complaints Accidents: work, home, motor vehicle Accidents: work, home, motor vehicle Higher death rates with severe sleep apnea Higher death rates with severe sleep apnea Hypertension, Heart Failure, Heart Attacks Hypertension, Heart Failure, Heart Attacks Strokes, Atrial Fibrillation Strokes, Atrial Fibrillation Promotes Obesity and Diabetes Promotes Obesity and Diabetes

10 What is OSA? NO AIRFLOW DESPITE RESPIRATORY EFFORT NORMALSNORING SLEEP APNEA Obstructive Sleep Apnea

11 Sleep Apnea: Treatment Behavioral: Weight Loss, Sleep Position (Sleep on side, head raised), Oxygen, Avoid sedatives Behavioral: Weight Loss, Sleep Position (Sleep on side, head raised), Oxygen, Avoid sedatives CPAP: proven therapy, needs motivation: widely available, 70%: patients adapt well CPAP: proven therapy, needs motivation: widely available, 70%: patients adapt well Surgery: tracheostomy, tonsillectomy, pull forth mandible or tongue Surgery: tracheostomy, tonsillectomy, pull forth mandible or tongue Bariatric Surgery: banding, bypass (Bob Eisenhauer 259-1485; Lewis Jones 753-3459) Bariatric Surgery: banding, bypass (Bob Eisenhauer 259-1485; Lewis Jones 753-3459) Dental appliances: also pull forth mandible or tongue; expertise necessary Dental appliances: also pull forth mandible or tongue; expertise necessary

12 Continuous Positive Airway Pressure: CPAP Keeps airway open 100% effective, simple CPAP therapy Treatment Options: CPAP

13 Summary: Sleep Apnea Very common and dangerous Very common and dangerous Easily diagnosed and treated Easily diagnosed and treated Benefits of treatment: sleep better at night, also Benefits of treatment: sleep better at night, also Feel better during the day: less sleepiness and fatigue, more energy, less accidents Feel better during the day: less sleepiness and fatigue, more energy, less accidents Reduce risk factor for heart disease and strokes Reduce risk factor for heart disease and strokes Control better: obesity, diabetes, hypertension Control better: obesity, diabetes, hypertension Bed partner sleeps better: less noise and less worry (but dog is scared of CPAP) Bed partner sleeps better: less noise and less worry (but dog is scared of CPAP)

14 Websites The Village Sleep Lab: www.villagesleeplab.com The Village Sleep Lab: www.villagesleeplab.com National Sleep Foundation: www.sleepfoundation.org National Sleep Foundation: www.sleepfoundation.org American Sleep Apnea Association: www.sleepapnea.org American Sleep Apnea Association: www.sleepapnea.org Restless Legs Syndrome Foundation: www.rls.org Restless Legs Syndrome Foundation: www.rls.org American Academy of Sleep Medicine: www.sleepeducation.com American Academy of Sleep Medicine: www.sleepeducation.com Commercial: www.talkaboutsleep.com Commercial: www.talkaboutsleep.com Commercial: www.MyResmed.com Commercial: www.MyResmed.com Commercial: www.Respironics.com Commercial: www.Respironics.com

15 Books The Promise of Sleep by William Dement The Promise of Sleep by William Dement Sleeping Well by Michael Thorpy Sleeping Well by Michael Thorpy No More Sleepless Nights by Peter Hauri No More Sleepless Nights by Peter Hauri A Woman’s Guide to Sleep Disorders by Meir H. Kryger A Woman’s Guide to Sleep Disorders by Meir H. Kryger Restless Legs Syndrome by Robert H. Yoakum Restless Legs Syndrome by Robert H. Yoakum Say Good Night to Insomnia by Gregg D. Jacobs Say Good Night to Insomnia by Gregg D. Jacobs


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