A sleep disorder, or somnipathy, is a medical disorder of
the sleep patterns of a person or animal. Some sleep disorders are serious
enough to interfere with normal physical, mental, social and emotional
functioning. Polysomnography is a test commonly ordered for some sleep
disorders.
Disruptions in sleep can be caused by a variety of issues,
from teeth grinding (bruxism) to night terrors.
- Insomnia When a person suffers from difficulty falling
asleep and staying asleep with no obvious cause, it is referred to as.
- Dyssomnia refers to a group of sleep disorders with the
symptoms of trouble falling asleep or maintaining sleep, which may cause an
elevated sense of sleepiness during the day.
- Delayed sleep phase disorder (DSPD): inability to awaken and fall asleep at
socially acceptable times but no problem with sleep maintenance, a disorder of
circadian rhythms.
- Advanced sleep phase disorder (ASPD), non-24-hour sleep–wake disorder (non-24),
and irregular sleep wake rhythm, all much less common than DSPD, as well as the
transient jet lag and shift work sleep disorder.
- Sleep apnea a.k.a obstructive sleep apnea: Obstruction of the airway during sleep, causing lack of sufficient deep sleep, often accompanied by snoring. Other forms of sleep apnea are less common. When air is blocked from entering into the lungs, the individual unconsciously gasps for air and sleep is disturbed. Stops of breathing of at least ten seconds, 30 times within seven hours of sleep, classifies as apnea. Other forms of sleep apnea include central sleep apnea and sleep-related hypoventilation.
Today we will learn more about Sleep Apnea and tell how the
problem is easy to address once the first step of consulting the doctor is
done!
According to Dr. H. B. Chandrashekar, Director Jain Institute of
Pulmonary and Sleep Medicine the diagnosis of sleep apnea is based on the
conjoint evaluation of clinical symptoms (e.g. excessive daytime sleepiness and
fatigue) and of the results of a formal sleep study (polysomnography, or reduced
channels home based test).
This helps in establishing an "objective" diagnosis indicator
linked to the quantity of apneic events per hour of sleep (Apnea Hypopnea
Index(AHI), or Respiratory Disturbance Index (RDI)), associated to a formal threshold,
above which a patient is considered as suffering from sleep apnea, and the
severity of their sleep apnea can then be quantified. Mild OSA (Obstructive
Sleep Apneas) ranges from 5 to 14.9 events per hour of sleep, moderate OSA
falls in the range of 15–29.9 events per hour of sleep, and severe OSA would be
a patient having over 30 events per hour of sleep.
Treatment often starts with behavioral therapy. Many
patients are told to avoid alcohol, sleeping pills, and other sedatives, which
can relax throat muscles, contributing to the collapse of the airway at night. As
sleep apnea is inherently worse in the supine position for many patients
(positional sleep apnea), sleeping on one's side is often advised.
For moderate to severe sleep apnea, the most common
treatment is the use of a Continuous Positive Airway Pressure (CPAP) device which 'splints' the
patient's airway open during sleep by means of a flow of pressurized air into
the throat.
The patient typically wears a plastic facial mask, which is
connected by a flexible tube to a small bedside CPAP machine. The CPAP machine
generates the required air pressure to keep the patient's airways open during
sleep. While pure CPAP machines require one to input a desired pressure
(usually determined in an overnight sleep study), an APAP machine will
automatically titrate the air pressure as needed to minimize apneas and
hypopneas. Advanced models may warm or humidify the air and monitor the
patient's breathing to ensure proper treatment.
Although CPAP therapy is extremely effective in reducing
apneas and less expensive than other treatments, some patients find it
extremely uncomfortable. Many patients refuse to continue the therapy or fail
to use their CPAP machines on a nightly basis, especially in the long term. One
way to ensure CPAP therapy remains comfortable and effective for patients is to
carefully consider the right CPAP face mask to be used. CPAP masks come in
different shapes, sizes and materials to ensure effective treatment for
obstructive sleep apnea. It is important to select the right mask to fit each
patient.
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