Sleep Related Breathing Disorders 2012 April Part One (1)

8/2/2019 Sleep Related Breathing Disorders 2012 April Part One (1)

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Sleep related breathingdisorders

Mahmoud Ibrahim MahmoudProfessor of Chest Diseases

Faculty of Medicine

Alexandria University

mimahmoudchest@yahoo.com

Age- and

sex-specific

prevalence

rates of the

AHI based

on polysomnog

raphic

sample of

352 males

and 250

femalesfrom

Wisconsin

Conclusion: 93% of women and 82% of men with

moderate to severe sleep apnea (AHI > 15) “undiagnosed”

Estimated clinical values of

specific symptoms in the

diagnosis of OSAHSChervin RD,

Estimated clinical values of

specific symptoms in the

diagnosis of OSAHSChervin RD,

Clinical Features: Overbite

Clinical Features: Retronagthia

Mallampati Airway Classification

Clinical Features: Body Fat Distribution

Apple shape is riskier than Pear shape

Hypersomnolence

Obese Hypersomnolent

Obesity

Pillar G, Shehadeh N. The chicken or the egg ?

Diabetes Care 2008;31 Suppl 2:S303-9.

Theories linking OSA and the metabolic

syndrome

Bonsignore MR, Eckel J. Eur Respir Rev 2009; 18(12):113

Obesity, retrognathia, mouth

breathing, hypersomnolent

Snoring

Snoring reported by bed partner

Witnessed

apnea, chocking

and restlesssleep

Tregear S, et al. J Clin Sleep Med 2009;5(6):573

•Annual recertification is required for an individual with untreated OSA and an

AHI ≤ 20, who is not sleepy or who is effectively treated;

•Dis ualification for drivers who re ort slee iness while drivin , have

experienced a crash with falling asleep, or have an AHI > 20 until CPAP is

instituted, or have had surgery for OSA but not had repeat PSG, or have a BMI

> 33 kg/m2 (until evaluated).

"The Posthumous Papers of the

Pickwick Club” Charles Dickens'

“Damn That Boy” Said the

old men, “He’s gone tosleep again”.

Joe, "wonderfully fat boy ……… with his eyes closed“

Joe was edematous, and a very loud snorer

“Very Extraordinary boy”,said Mr. Pickwick. Does he

always sleep in this way?

"The Posthumous Papers of the

Pickwick Club” Charles Dickens'

“Sleep” said the old

gentleman, “he’s alwaysasleep”. “Goes on errands

Joe, "wonderfully fat boy ……… with his eyes closed“

Joe was edematous, and a very loud snorer

waits at table”

Estimated clinical values of specific symptoms in

the diagnosis of OSAHS

Chervin RD,2000

Retrognathia

Kissing tonsils, crowded upper

airway

Obstructive apnea

Coleman J. Sleep studies. Otolaryngol Clin North

Am 1999;32(2):195

Central Apnea

Coleman J. Sleep studies. Otolaryngol Clin North Am 1999;32(2):195

Pathophysiology Obstruction

Increased respiratory effort Fragmentedsleep

Intermittent hypoxemia

Sleep Related Breathing Disorders 2012 April Part One (1)

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