Positive Airway Pressure Essay

Thesis: Sleep Apnea is becoming more of a dangerous disease that more people are starting to be diagnosed with. It is extremely important that Sleep Apnea is emphasized so that more people are aware of it.

18 study data were derived from the apnea database (PhysioNet) corresponding to MIT/BIH database. AirFlow, SaO2, Abdominal and Thoracic Movements were obtained from full PSG records. Each record includes a period of nearly eight hours and signals annotation is done minute-by-minute. A minute is labeled as an apnea case if it contains at least one condition of apnea or hypopnea, otherwise labeled as a non-apnea. The patients mean age and weight are between 27 to 63 years (4810.8) and 53 to 135 kg (86.322.2), respectively. PhysioNet data are classified in two categories: Apnea Group (Class A, more than 100 minutes of apnea, mean age: 50 years in range of 29 to 63 years) and Normal Group (class C, less than 5 minutes of apnea, mean age of 33 years

There are numerous different challenges that the paramedic will face in attempting to keep an airway patent. These challenges vary from patient to patient depending on their condition. One challenge in keeping a patent airway the paramedic will face is trying to maintain the airway of a trauma patient. Trauma patients make it difficult to maintain an airway due to the traumatic damage, especially if it has affected the face and neck regions.

Sleep apnea is a common sleeping disorder where a person has experiences of not breathing during sleep. Over 20 million Americans, mostly overweight men, suffer from sleep apnea. Despite these numbers, sleep apnea is often not treated directly because its symptoms are thought to be those of depression, stress, or just loud snoring. There may be a genetic component to this disorder as it often occurs within families.People with sleep apnea stop breathing for at least 10 seconds at a time; these short stops in breathing can happen up to 400 times every night.

The population who are diagnosed with obstructive sleep apnea (OSA) often experience daytime drowsiness and are at risk for ischemic heart disease, arrhythmias, hypertension, and other vascular related problems (Hsu et al., 2007). There are several treatment options for people with OSA, which are weight loss, continuous positive airway pressure (CPAP), dental appliances, and surgical procedure. This study evaluates patients who have

What is Sleep Apnea? Sleep apnea is sleep related breathing disorder. It disrupts a person's normal breathing pattern while sleeping. This serious disorder decreases the levels of oxygen in the blood during long periods of sleep when the breathing repeatedly stops and starts while asleep. This chronic condition happens when the muscles at the back the throat relaxes and narrows the airway causing breathing pauses or shallow breaths, a common condition called Obstructive Sleep Apnea (OSA). This occurrence significantly affects the quality of sleep that explains the feeling of tiredness and sleepiness during the day.

Obstructive sleep apnea (OSA) is a common, yet under recognized condition. It is estimated that some form of OSA affects approximately 17% of the adult population. Over the years, this number has consistently increased possibly secondary to the rising prevalence of obesity in the population [1]. The pathophysiology of OSA is postulated to be related to decreased parasympathetic activity during sleep, leading to decreased muscle tone in the upper airway, which can lead to repetitive collapse of the upper airway, causing the characteristic apneic or hypopneic events that define the diagnosis of OSA [2].

In this work, there were significant positive correlations between PTT Ar. and AHI, RDI, ODI, snore index and EPSS. In a study of 144 subjects with OSA, it revealed that PTT Ar/I correlate significantly with the RDI and with the arousal index (15). Also Chakrabarti et al found significant correlation between PTT Ar and AHI, RDI and ODI while no significant correlation was found between PTT Ar and snore index and EPSS (11). A study of OSAS patients randomised to CPAP aiming either to suppress IFL as well as apnoeas and hypopneas or to abolish only apneas and hypopneas, reported a greater scatter in maintenance of wakefulness test values and decreased CPAP usage in the latter group (16). Also, Chakrabarti et al., observed statistically significant associations between CPAP compliance and lower pulse transit time (PTT) in 27 subjects with inspiratory flow limitation (17). A limitation of this study is that PTT indices may be affected by sleep fragmentation due to external stimuli or non-respiratory events, the

Obstructive Sleep Apnea Syndrome is a common comorbidity that can have detrimental results on patient safety in the perioperative phase. Symptoms of OSA include daytime somnolence, loud snoring, and irritability. Obesity and anatomic abnormalities are considered risk factors of this sleep disorder. (Brousseau, Dobson, & Milne, 2014). OSA is characterized by periods of apnea during sleep which are caused by obstruction of the upper airway. The obstruction can be partial or complete and places a patient at a high risk for complications in conjunction with general anesthesia. OSA occurs in 28% of women and 38% of men and the rate increases with a BMI > 40. (AORN, 2014). Currently, with the exception of patients

Since the dawn of time humans, for some reason or another has had difficulty with sleep. The cause could vary from the rock pillow was too hard to a pea under the mattress. We have now come to learn that a disorder called sleep apnea could be the reason. According to the National Institutes of Health approximately 12 million United States citizens were afflicted by this disorder (Singer). The Greek word Apnea means without breath and sleep apnea is an involuntary cessation of breathing that occurs while a person is asleep (American Sleep Apnea Association). There are three different types of sleep apnea, when the back of the throat closes called Obstructive Sleep Apnea (OSA), for Central Sleep Apnea the brain “forgets” to signal muscles to

Dysphagia is a swallowing disorder that is described as an abnormality in transferring a solid or liquid bolus from the oral cavity to the stomach (Bernard, Loeslie, & Rabatin, 2015). With a diagnosis of dysphagia, a patient will likely aspirate foods and/or liquids of different consistencies. Aspiration is “the entry of food or liquid into the airway below the true vocal folds” (Logemann, 1998, p. 5). Specifically, thin liquid dysphagia occurs when a patient aspirates while consuming any liquids that are not thickened, such as water. Patients with thin-liquid dysphagia are often prescribed a modified thickened liquid-only diet, meaning they consume liquids that are thickened to a greater consistency of nectar, honey, or pudding (Carlaw et al., 2007). An increased viscosity reduces the flow rate of a bolus, makes it more cohesive, and is easier for many people to control intraorally, thus preventing spillage into the airway (Murray, Miller, Doeltgen, & Scholten, 2013). Dysphagia can also contribute to the occurrence of aspiration pneumonia. Aspiration pneumonia occurs “when organisms infiltrate the lower respiratory tract during an episode of aspiration and the

PSV is a weaning mode that relies on the patient to trigger the adjusted support pressure in every breath. Therefore, the patient is required to be conscious with intact respiratory drive6. Although Vt is variable in PSV, the pressure will be adjusted to deliver a Vt within a reasonable range. However, the number of triggered breaths in PSV will provide inconsistent minute ventilation that may or may not be required by the patient during sleep. So, either it causes abnormal CO26 levels or increases WOB6, both in which sleep quality might be interrupted. Therefore, high-pressure support levels in PSV attribute to central sleep apnea and more arousal events per hour. Low-pressure levels are associated with more patient-ventilatory asynchronies. Moreover, during NREM (non-rapid eye movement) sleep, the stage that proceeds the deep sleep or REM (rapid eye movement) sleep, the PaCO2 apneic threshold gets elevated7. For example, when a PaCO2 of 32 cmH2O usually triggers a central sleep apnea (CSA) during awakening hours, it takes a slightly elevated PaCO2, such as 34 cmH2O, to trigger CSA during NREM sleep. Patients who have chronic slow circulation, such as in left heart diastolic dysfunction, tend to have low awake CO28. And due to their CO2 chemoreceptor sensitivity, the difference between eupneic PaCO2, and apneic threshold, PaCO2

Fig. 3. (a-b) Frequency spectra for heart rate variability and respiration in a healthy adult male (age 35). (d-e) Frequency spectra for heart rate variability and respiration in an adult male (age 38) diagnosed with moderate obstructive sleep apnea. (c-f) Cross correlations between respiration and heart rate variability for each

Background: Airway assessment is one of the most predictable ways to identify the difficulties of the airway, especially if the patient has to do a surgery and have to be intubated. We can predict by airway examination the difficulties of the patient’s airway track, and put many plans regarding how to do intubation safely. The target of patient’s airway assessment is to detect any existing deformities in the airway and face in order to make a suitable plan to secure the airway successfully. Between June 2002 and September 2003, an observational study conducted in the emergency department of UK teaching hospital, 156 patients who involved in the study and undertook airway assessment based on L-E-M-O-N method were all intubated successfully. The study concluded that “Use of this score would encourage airway managers to conduct a thorough systematic evaluation of the airway and to readily anticipate problems in its management.

The field of Sleep Medicine is developing at a yearly rate of 10–15%. Actually, 44 million grown-ups experience the ill effects of some type of Sleep-disordered breathing (SDB) (Gibbons, 2003). Obstructive sleep apnea (OSA) is similar to diabetes and asthma, with more than 18 million grown-ups affected (Jean-Louis, Zizi, Clark, Brown, & McFarlane, 2008). Continuous Positive Airway Pressure (CPAP) and Bi-level Positive Airway Pressure (BIPAP) devices are the fastest-growing Home Medical Equipment expenditure. PCI can help employers and payers manage the high costs associated with the rapid growth in both the diagnosis and treatment of patients with Sleep Disordered Breathing (SDB). PCI will simplify and coordinate post-hospital care for all